Chronic lock
Contents:
Description:
Chronic delay of bowel emptying more than for 48 hours.
Symptoms of the Chronic lock:
For most of people the chronic delay of bowel emptying more than for 48 hours should be considered as a lock. The calla, its increased firmness and dryness, lack of feeling of full bowel emptying after defecation are characteristic of it small quantity. All these signs occur at the patients suffering from a lock, however some of them can be absent. Existence even of one of the listed symptoms testifies to a lock. Change usual for this person of frequency and a rhythm of defecations - also important sign of a lock.
Signs of existence of a chronic lock
* A rarity of evacuation of contents from intestines (an emptying delay more than for 48 hours)
* Department at defecation of small quantity a calla (the mass of a chair less than 35 g/days)
* Department a calla of big density, dryness that injures area of an anal orifice and leads to inflammatory processes
* Lack of feeling of full bowel emptying after defecation
* Existence of feeling of blocking of contents in a rectum at the attempts occupying more than 25% of duration of emptying on time
* Need for strong attempts, despite existence of soft contents of a rectum and desires to emptying, sometimes need of manual removal of contents from a rectum
Reasons of the Chronic lock:
Recently, and not without justification, locks are brought to the level of an independent disease; and still they most often are a symptom of other pathology, say, of gastritis, cholecystitis, spastic or atonic colitis, etc.
Alimentary reasons (simple lock)
* General hypodynamia (slow-moving way of life, bed rest)
* Heart failure (developments of stagnation), including portal hypertensia
Metabolic/endocrine reasons
* A hypothyroidism, a diabetes mellitus, a hypopotassemia, a hypercalcemia (any etiology), hypo - or a gipermagniyemiya, pregnancy, uraemia, a pheochromocytoma, a glucagonoma, a porphyria
* Reception of medicines: anticholinergic/spasmolytic drugs; antidepressants, anticonvulsants; antiparkinsonichesky and antihistaminic drugs; non-steroidal anti-inflammatory drugs, hypotensive drugs (especially blockers of calcium channels), diuretics; the drugs containing bismuth, iron, carbonic calcium, an aluminum hydroxide; ganglioblokator, opiates, purgatives (at constant use)
* Diseases of internals: a scleroderma, viscerovisceral reflex, atonic locks at acute cholecystitis, pancreatitis, appendicitis and so forth.
* diseases of the central nervous system: Cerebral palsy, multiple sclerosis, back tabes, tumors, Parkinson's disease, disturbances of cerebral circulation, Alzheimer's disease
* Diseases of a peripheral nervous system: аганглиоз a large intestine (a disease of Girshprunga), hypo - or гиперганглиоз, a ganglioneuromatosis, damages of a horse tail and so forth.
* Psychogenic lock (depressions, schizophrenia, nervous anorexia, hypochiondrial states)
* Idiopathic lock (inert colonic or rectum)
The chronic lock connected with rectum pathology
* Usual lock
* The started usual lock
* Locks at neoplastic, inflammatory processes in a rectum (mechanical obstruction)
* The locks arising at disturbances which cause functional obstruction of ways of defecation — internal (perednestenochny, circular) and external (proctal) rectum prolapses
* A lock at pryamokishechny hernia (is more often than a lobby)
* A lock at a rectum achalasia
Treatment of the Chronic lock:
Necessary condition for a victory over a lock is the diet. Release of intestines is promoted by inclusion in рацион mushrooms, vegetables and fruit, berries (not less than 200 g a day), a chernoyosliv and dried apricots (8-12 pieces), bananas and apples, water-melons, rastiteny oil (1-2 tablespoons on an empty stomach), honey (1 tablespoon 2-3 times a day). As soft laxative, it is possible to give carrot or beet juice (of 1 h l. to 1/3 glasses 3 times a day before food depending on a vozyorast). Most of patients can rekomenyodovat also use of food fibers: bread of a rough grinding with bran, celluloses, wheat bran (20-30 g a day). In addition to aperient effect, they reduce cholesterol, regulate digestion, normalize an indestinal flora. The plantain seed which is also a source of food fibers is a part of a fizioyologicheska of the operating drug Mukofalk.
It is necessary to increase amount of liquid to 2 l a day, it is useful to drink 1-2 Art. of cold water (or juice) in the morning on an empty stomach with a dobavyoleniye of 1 tablespoon of honey or xylitol. Use of mineyoralny water is recommended. Sulphatic waters (Yessentuki 20, Morshinskaya, Hunyadi Janos) contain the salts which are badly soaking up in intestines, work as light laxative, but also improve outflow of bile and interfere with a lithogenesis in a gall bladder. Water has to be cool, gassy. It is necessary to drink it on 250-300 ml 3 times a day in 40-60 min. prior to food. A course of treatment – 4-6 weeks 4 times a year.
In certain cases, especially at patients of advanced age, use of the drugs improving digestion can be effective (Cholenzymum, Festal, Enzistal, etc.).
Despite observance of a diet, in many cases use of purgatives is required. In an initiation of treatment we can recommend phytocompositions of medicinal plants. One of new laxatives is Softovak, the Indian ayurvediyochesky composition which includes a cassia, a rose, seeds of a podoyorozhnik, a glycyrrhiza root, fennel, cinnamon, etc. thanks to what renders soft laxative effect, and also promotes spasmolytic and antiinflammatory effect.
At the locks which are followed by pains in the bottom of a stomach it is possible to apply gathering of structure: the Alexandria leaf – 5 h, peppermint leaves – 3 h, a root of an inula of-3 h, camomile flowers – 2 h, calendula flowers – 2 h, a St. John's Wort grass – 1 h, fennel fruits – 1 h 2 tablespoons of the crushed mix to fill in 0,5 glasses of boiled water, to insist in a thermos the 12th hour. To filter, drink 0,5 glasses 3 times a day for half an hour to food, a course – 2 weeks.
The cheapest and often used drugs – Senna prepayorata (Senadeksin, Senadum, Senadeks), buckthorns and an aloe, Bisacodyl (Lelaks, by Laksbene is widely applied, etc.), however at high performance they are not the most bezoyopasny means for long reception, quite often vyzyvayot intestines pains, to them the chuvstvitelyyonost gradually goes down that demands increase in a dose. In a number of the countries refuse some of them. One of drugs for replacement is Guttalaks (analogs - Laksigal, Pikolaks) which is not causing a priyovykaniye and toxic side effects. Forlaks has reliable fizioloyogichesky laxative effect.
At people of advanced age lactulose drugs – Dufalak give good effect, to Normaza, Laktusan, bags of Laktulaks which stimulate intestines and reduce the phenomena of a disbakyoterioz. As dysbacteriosis is the frequent reason of a lock, regular use of the drugs improving a condition of an indestinal flora is useful (Yogurt in capsules and tablets, Hilak, Lineks, etc.). At locks with abdominal distention it is possible to advise complex препрат Eukarbon.
(Within 5-20 min.) it is possible to apply one-time cleansing enemas to obtaining urgent laxative effect: Normakol, Norgal.
