Constipation? Stubborn constipation? Don’t let constipation cause chronic damage to you!

Author: Yao Shukun, Chief Physician of China-Japan Friendship Hospital

Reviewer: Yang Weibin, Chief Physician, Xiyuan Hospital, China Academy of Chinese Medical Sciences

Vice President of Graduate School of China Academy of Chinese Medical Sciences

The clinical diagnostic criteria for constipation are: if two or more of the following criteria are met and these symptoms occur 1/4 of the time each week, constipation can be diagnosed.

First, defecation is laborious, or called difficulty in defecation. Second, the stool is very dry and hard, in the form of lumps or small hard balls. Third, there is a feeling of incomplete defecation, and there is always a feeling that there is still stool after defecation, as if it has not been completely defecate. Fourth, the number of bowel movements is less than three times within a week, there is no bowel movement for three or four days, or even no feeling of wanting to defecate for five or six days. Fifth, manual defecation is required, or laxatives or suppositories are required to defecate.

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If you have used laxatives, for example, two or more types, and your constipation has not been relieved within three months; or if you have become dependent on laxatives and cannot defecate without them, this situation is called stubborn constipation.

1. Will taking laxatives frequently lead to stubborn constipation?

Long-term abuse of some laxatives or cathartics will aggravate constipation and even induce stubborn constipation. Stubborn constipation is closely related to drug abuse, especially the use of some traditional Chinese medicines or Chinese patent medicines containing anthraquinones, such as rhubarb, knotweed, senna leaves, aloe, cassia seed, and Polygonum multiflorum. These medicines all contain the chemical substance anthraquinone. These medicines will be effective at the time or in the short term, but not only will they be ineffective over time, but they will also cause chronic poisoning.

For example, in the case of melanosis coli, the normal intestinal mucosa should be light red, but under colonoscopy, it can be observed to change to brown-yellow. Melanosis coli refers to the appearance of tiger-spotted or leopard-spotted changes in the intestinal mucosa. In severe cases, the entire mucosa turns black. This is actually lipofuscin particles formed by peroxidation damage to the intestinal mucosal epithelial cells.

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In addition, long-term use of this type of laxative can cause nerve and muscle damage. Once the nerves and muscles are damaged, laxatives and cathartics will have almost no effect.

2. What harm does stubborn constipation do to the body?

Stubborn constipation affects the body in many ways.

The biggest harm is that patients with hypertension, atherosclerosis, and high-risk factors for cardiovascular and cerebrovascular diseases may induce cardiovascular and cerebrovascular events, such as myocardial infarction, cerebral hemorrhage, and cerebral infarction, if they exert excessive force during defecation.

The most common harm of stubborn constipation is that it is easy to get hemorrhoids or anal fissures. For the elderly, stubborn constipation can also easily induce intestinal obstruction, that is, dry and hard stools block the intestines.

Long-term constipation can also damage the liver, because everything absorbed from the intestines, including toxins in the feces, will enter the liver through the portal vein. The liver will be in a state of chronic poisoning for a long time, making it impossible for the liver to completely detoxify. These toxins will enter the whole body and cause chronic damage to other organs of the body.

Pigmentation spots on the face, poor complexion and dull complexion are closely related to constipation and are caused by the deposition of lipofuscin particles in the facial skin cells.

Chronic constipation is also related to colon cancer. Patients with chronic constipation are prone to colon polyps. If polyps persist for 5-10 years, about 20% may become cancerous. More than 90% of colon cancers in my country are caused by colon polyps.

3. What is the most effective treatment for stubborn constipation?

Laxatives and prokinetic drugs, whether taken orally or by enema, are symptomatic treatments and can only temporarily relieve constipation. The most fundamental treatment for stubborn constipation is causal treatment, that is, removing the cause or inducement of stubborn constipation. Adjusting the dietary structure is the most fundamental and effective treatment, and five major types of food should be avoided.

The first is spicy food. Patients with stubborn constipation should not eat any spicy food. The main spicy foods are pepper and chili pepper, and others include mustard, onion, ginger, and garlic. There are also some vegetables that produce moisture and heat, such as leeks, fennel, and toon. Eating them frequently may aggravate constipation, so it is best not to eat them.

The second is food processed at high temperature, such as fried, stir-fried, cooked, and deep-fried food, especially fried, grilled, and stir-fried dried fruits; the third category is high-protein, high-fat food, such as meat, eggs, and milk, try to eat less; the fourth category is sticky food, such as sticky rice, rice cake, glutinous rice, and glutinous corn; the fifth category is alcohol, coffee, strong tea, and sugary drinks, especially black tea and dark tea, which all promote dampness and heat and will aggravate constipation. Green tea is good for constipation.

For stubborn constipation, it is recommended to eat more foods rich in dietary fiber, mainly coarse grains (whole wheat noodles, oats, brown rice, etc.) and buckwheat, eat more fruits (except hot fruits such as durian, lychee, longan, etc.) and vegetables, and sweet potatoes, yam, taro, potatoes and pumpkin can be used as substitutes for staple foods.

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It should be emphasized that the key to relieving stubborn constipation is not to simply increase the intake of certain foods, but to identify and avoid those foods that may aggravate symptoms, that is, to avoid eating certain foods.

In addition to diet, it is also important to exercise moderately, maintain a good mood, avoid staying up late, and drink enough water. If you do the above, more than 95% of stubborn constipation can be relieved long-term.