Causes and Treatment of Constipation

Under normal circumstances, the time from food entering the digestive tract to the formation of feces is related to age and food type: the average time for breastfed babies is 13 hours, the average time for bottle-fed babies is 15 hours, and the average time for adults is 18-24 hours. Normal bowel movements are 1-3 times a day. Infants and young children may have 4-5 bowel movements a day.

Constipation means: having a bowel movement every 2-3 days, or once every longer (or having a bowel movement less than 3 times a week, the foreign standard is ≤2 times a week). The diagnosis also needs to be combined with the characteristics of the stool, the usual bowel movement habits, and whether there is difficulty in defecation. Constipation for more than 6 months is considered chronic constipation.

1. Causes and Pathogenesis

(I) Organic causes

1. Congenital malformations of colon, rectum, anus, digestive tract tumors, etc.

2. Endocrine and metabolic diseases such as congenital hypothyroidism and diabetes.

3. Drug factors: iron supplements, calcium supplements, antihistamines, etc.

2. Functional reasons

1. Eat less food and the food lacks crude fiber.

2. Changes in living environment, routine, and food types.

3. Colon motility is inhibited or disordered.

4. Old age, physical weakness, reduced activity, mental factors, etc.

2. Classification of constipation

At present, according to the time value (TI) of radiopaque markers passing through the colon, chronic constipation in children is divided into: chronic transit constipation (STC), outlet obstruction constipation (OOC), and mixed constipation. If TI < 0.5, there is a high possibility of STC, TI > 0.5, there is a high possibility of OOC, and TI = 0.5 is considered mixed constipation.

3. Diagnosis and differential diagnosis

1. Diagnosis can be made based on medical history, physical examination, and laboratory tests.

2. A differential diagnosis can be made based on feeding history, laboratory test results, and common functional causes.

IV. Treatment (must be carried out under the guidance of a professional physician)

1. Treatment of etiology

(II) Symptomatic treatment

1. Laxatives: laxatives with various characteristics.

2. Prokinetic agents include mosapride, itopride, prucalopride, etc.

(III) Lifestyle treatment

Develop a habit of regular bowel movements (at least once a day), increase the intake of crude fiber foods and water, and increase exercise.