Stomach bloating and inability to defecate

Our human body often has many problems, especially our stomach. The stomach can cause many diseases due to various reasons, including bloating. This situation also leads to many consequences, including constipation. This situation can be caused by many reasons, but many people don’t know, so why can’t you defecate due to bloating?

Causes of constipation.

Causes

1. Age-related

The prevalence of constipation in the elderly is significantly higher than that in young and middle-aged people. This is mainly because with increasing age, the elderly's food intake and physical activity decrease significantly, the gastrointestinal tract secretes less digestive fluid, the tension and peristalsis of the intestine weaken, the abdominal and pelvic floor muscles become weak, the internal and external anal sphincters weaken, the gastrocolic reflex weakens, and the rectal sensitivity decreases, which causes food to stay in the intestines for too long and excessive water absorption causes constipation. In addition, elderly people often lose their defecation reflex due to senile dementia or depression, causing constipation.

2. Bad living habits

(1) Dietary factors: Elderly people who have lost their teeth prefer to eat low-residue, refined foods. Or a small number of patients seek convenience and save time by eating a simple diet that lacks crude fiber, which reduces the size of their stool, increases its viscosity, slows down its movement in the intestines, and causes excessive water absorption, leading to constipation. In addition, the elderly may also suffer from constipation because they eat less, their food is low in calories, and their gastrointestinal transit time is slowed down. Reports have shown that the gastrocolic reflex is related to the amount of food eaten: a 1000-cal meal can stimulate colonic movement, while a 350-cal meal has no such effect. Fat is the main food that stimulates the reflex, while protein has no such effect.

(2) Bowel habits: Some elderly people do not develop the habit of regular bowel movements and often ignore the normal urge to defecate, which results in the suppression of the defecation reflex and causes constipation.

(3) Reduced activity. Due to certain diseases and obesity, the elderly have reduced activity, especially those who are bedridden or in a wheelchair. Due to the lack of exercise stimulation to promote the movement of feces, they are often prone to constipation.

3. Psychological factors

People with psychological disorders such as depression, anxiety, and obsessive-compulsive disorder are prone to constipation.

4. Intestinal lesions

Intestinal lesions include inflammatory bowel disease, tumors, hernia, rectal prolapse, etc. These lesions lead to functional outlet obstruction and cause defecation problems.

5. Systemic lesions

Systemic diseases include diabetes, uremia, cerebrovascular accident, Parkinson's disease, etc.

6. Iatrogenic (abuse of laxatives)

Long-term use of laxatives, especially stimulant laxatives, causes damage to the intestinal mucosal nerves, reduces intestinal muscle tension, and leads to severe constipation. In addition, other drugs that cause constipation include opioid analgesics, anticholine drugs, antidepressants, calcium ion blockers, diuretics, etc.

Clinical manifestations

The main symptoms of constipation are decreased frequency of bowel movements and difficulty in defecation. Many patients have bowel movements less than twice a week, and in severe cases, they may only have a bowel movement once every 2 to 4 weeks. Some patients may have prominent symptoms of difficulty in defecation, which may take more than 30 minutes, or they may have multiple bowel movements a day but the stool is difficult to pass and is hard like sheep dung and in small quantities. In addition, there are abdominal distension, lack of appetite, and abdominal pain before defecation due to improper use of laxatives. Physical examination revealed intestinal loops with feces in the left lower abdomen, and rectal examination revealed fecal masses.

When elderly people strain too much during bowel movements, it can cause changes in coronary artery and cerebral blood flow. Fainting may occur during bowel movements due to decreased cerebral blood flow. People with insufficient coronary artery blood supply may experience angina pectoris and myocardial infarction. Hypertension can cause cerebrovascular accidents, rupture of aneurysms or ventricular aneurysms, detachment of blood clots attached to the heart wall, arrhythmias, and even sudden death. Hirschsprung's disease may occur due to low tone of the colonic muscle layer. When straining during bowel movements, increased intra-abdominal pressure can cause or aggravate hemorrhoids. Forced defecation can damage the anal canal and cause anal fissures and other perianal diseases. Fecal impaction can cause intestinal obstruction, fecal ulcers, urinary retention and fecal incontinence.

examine

1. Abdominal plain film

It can show intestinal expansion, stool retention and air-liquid level, and can identify organic lesions such as colon cancer and constipation caused by stenosis.

2. Barium enema

You can understand the structure of the colon and rectum.

3. Colonoscopy and fiberoptic sigmoidoscopy

The intestinal mucosa and the cavity can be observed for lesions and stenosis, and colon melanosis can also be detected.

4. Anorectal pressure measurement

It can help determine whether there is rectal or pelvic floor dysfunction or abnormal rectal sensory threshold.

5. Balloon expulsion test

It helps to determine whether there are any abnormalities in the function of the rectum and pelvic floor muscles.

6. Pelvic floor electromyography

It can determine whether there is myogenic or neurogenic lesion.

7. Colonic Transit Function Experiment

Understand colon transit function.

8. Defecation radiography

It helps in the diagnosis of pelvic hernia and rectal intussusception.

diagnosis

Get a detailed understanding of the onset time and treatment process of constipation, recent changes in bowel movement time, ask about the number of bowel movements, whether defecation is difficult or straining, whether there is blood in the stool, whether it is accompanied by abdominal pain or bloating, the above-mentioned gastrointestinal symptoms and other systemic diseases that can cause constipation, especially to rule out organic diseases. If the disease lasts for more than several years and there is no change in the condition, it usually indicates functional constipation.

treat

1. Keep exercising

A survey of people over 60 years old showed that the incidence of constipation among those who seldom walk due to old age and frailty was 15.4%, while the incidence of constipation among those who exercised regularly was 0.21%. Therefore, patients are encouraged to participate in exercise within their ability, such as walking, strolling, or massaging the abdominal muscles with both hands several times a day to enhance gastrointestinal motility. Patients who have been bedridden for a long time should be turned over frequently and given circular abdominal massage or hot compresses.

2. Develop good bowel habits

Provide health education to help patients establish normal bowel movement behavior. You can practice having a bowel movement every morning. Even if you don't feel like doing it, you can wait a while to form a conditioned reflex. At the same time, create a quiet and comfortable environment and choose a sit-down toilet.

3. Eat a healthy diet

The elderly should eat more grains and vegetables, fruits, and beans containing crude fiber, and drink plenty of water, at least 1500 ml of water a day, especially a glass of warm water in the morning or before meals, which can effectively prevent constipation. In addition, you should eat some foods that have a laxative effect, such as black sesame, honey, bananas, etc.

4. Others

Prevent or avoid using medicines that cause constipation, do not abuse laxatives, actively treat systemic and perianal diseases, and adjust your mental state. A good mental state helps establish a normal defecation reflex.

prevention

Insist on participating in proper physical exercise, intentionally cultivate good bowel habits, eat a reasonable diet, and pay attention to supplementing dietary fiber. The foods containing the most dietary fiber are wheat bran, fruits, vegetables, oats, corn, soybeans, pectin, etc. In addition, systemic and perianal diseases should be actively treated, the use of drugs that cause constipation should be prevented or avoided, and a good mental state should be cultivated, all of which are beneficial to the prevention and treatment of constipation.