Lock – the defecation process violation which is characterized by lack of a chair over 48 hours or insufficient depletion of intestines. Manifestations of a lock are the urezheniye of habitual frequency of defecation, small portions of a chair, feeling of incomplete depletion of intestines, belly-ache. Locks cause development of a disbioz of intestines, chronic colitis, cause organism intoxication. The strong and frequent natuzhivaniye at the act of defecation leads to development of anal cracks, hemorrhoids, hernia. Frequent locks negatively influence a condition of skin and promote its aging.
The concept "lock" means difficulty of depletion of intestines, lack of defecation more than three days. It is necessary to distinguish a chronic lock from situational (incidental). The situational lock arises in various, provoking it at the persons inclined to defecation difficulty, situations (pregnancy, a travel – "the tourist's lock", the use of the products complicating transit of intestinal masses, the insufficient use of liquid, psycho-emotional experiences, stresses). Besides, locks can be caused by reception of medicines. Situational locks arise for short time and, as a rule, independently or by means of reception of depletive, are successfully resolved. Such states are not considered as a disease.
Chronic locks represent a regular delay of defecation for 48 hours and more. At the same time the small quantity dense and dry a calla is distinguished. Quite often after defecation there is no feeling full depletion of intestines. It is possible to speak about the lock taking place in the presence at the patient of one, several or all these signs. An important diagnostic sign is change of habitual frequency and character of defekation.
The lock is the disorder of digestion which is very extended among the population, tendency to locks can lead to development of serious proktologichesky diseases therefore this problem has high degree of the social importance. In connection with the prevalence and the expressed deterioration of life of patients, chronic locks are allocated in an independent syndrome, and now the perspective of locks is actively studied by proctologists, gastroenterologists and other experts.
Most often children of younger age and elderly people suffer from locks (is more senior than 60 years). Feeling of difficulty of depletion of intestines, impossibility of simplification, despite a persistent natuzhivaniye, need to apply additional, stimulating release of a rectum from kalovy masses, actions (pressing on a crotch, sidewalls of back pass, a vagina).
The constant condition of insufficient depletion of an ampoule of a rectum leads quite often to development of a syndrome of omission of a crotch. The chronic lock is diagnosed in cases when the frequency of a chair becomes more rare than 3 times a week, defecation is considerably complicated and demands the expressed efforts, the chair consistence dense, tuberous, takes place feeling of incomplete release of a rectum from kalovy masses.
Causes of a chronic lock
Features of a way of life, eating habits can become the reason of development of chronic locks. Locks are promoted by regular control of desires to defecation, reflex activity of intestines (a long bed rest, an intense operating schedule, frequent moving) over time oppressing. Frequent use of depletive because of unreasonable expectation of a chair (the normal rhythm of defekation is perceived by the patient as insufficiently frequent), the diet poor in the products containing vegetable cellulose, a lack of daily consumption of liquid – the factors promoting development of chronic difficulties of depletion of intestines.
Besides, the lock is one of signs of a syndrome of the angry large intestine. At this pathological state motility of intestines is broken and there can be an instability of a chair: locks with allocation of a firm poor chair (sometimes with slime) can alternate from ponosa. The stressful state in such cases only worsens functional activity of intestines.
Locks can be a consequence of the serious condition demanding quite often surgical correction: the mechanical intestinal impassability promoting development of a koprostaz. Depending on extent of narrowing of a gleam of intestines impassability can be full or partial. Tumoral processes, cicatricial changes, solderings, diverticulums of a large intestine, guts, helminthic invasions can be the reasons of an obturation of an intestinal gleam.
Koprostaz is characterized by long lack of a chair, feeling of overflow in intestines, the holding apart belly-aches. Liquid contents of intestines can sometimes bypass a kalovy stopper and to leave in the form of a diarrhea. The psychological fear of defecation developing as a result of the diseases of a rectum which are followed by the expressed pain syndrome can be the cause of locks (the anal crack, sharp hemorrhoids, paraproktit).
Neurologic frustration (stress, depression, nervous shocks) can also promote development of chronic violations of depletion of intestines. Besides, many medicines can cause braking of an intestinal vermicular movement as side effect and promote locks. Pathologies of an innervation of an intestinal wall (a disease of Girshprunga, multiple sclerosis, injuries and diseases of a spinal cord) also cause chronic locks.
Classification of locks
Locks are classified by an etiologichesky factor and the mechanism of development: alimentary (the diets connected with features), nevrogenny (caused by violations of neuro and reflex activity), psychogenic (connected with a psycho-emotional state), locks at anorektalny diseases (hemorrhoids, an anal crack, a paraproktita), toxic (at poisoning with lead or mercury, some medicines, chronic intoxication), proktogenny (the diaphragms of a pelvic bottom connected with functional violations of muscles), locks at mechanical obstacles (at tumors, striktura, cicatricial changes, polyps, anomalies of development of a digestive tract), yatrogenny locks (as a result of reception of medicines).
Symptoms of a chronic lock
Locks can be followed by diverse symptoms depending on the diseases causing them. In certain cases the lock is the only complaint of the patient. The individual rhythm of depletion of intestines can differ. Depending on change of habitual frequency of defecation depletion from once in 2-3 days and less often can be considered as a lock. Defecation at a lock is characterized by the expressed tension, demands considerable efforts. Kal is dense, dry, can remind dry balls in a form, has the form of beans, a cord.
In certain cases the so-called locking diarrhea when against the background of a long absence of normal defecation and feeling of overpopulation in a stomach the diarrhea a liquid chair with slime takes place can be noted. By the liquid stake containing slime it can be resolved it is long the existing lock as a result of irritation of an intestinal wall.
The lock quite often is followed by the pains and weight in a stomach which are facilitated after depletion of intestines, an exit of intestinal gases. Meteorizm also quite often accompanies difficulties of the movement of intestinal masses. The increased gas generation is a consequence of activity of the microorganisms inhabiting a large intestine.
The patients suffering from locks can note a loss of appetite, a fetid odor from a mouth, an eructation air. As a rule, it is long the existing chronic locks promote oppressed mood, decrease in working capacity, a sleep disorder, other neurotic frustration.
Complications of a chronic lock
Long chronic locks can promote development of complications from a digestive tract. It can be inflammatory diseases of intestines (colitis, proktosigmoidit), rektoanalny pathologies (hemorrhoids, an anal crack, paraproktit), a divertikulyarny disease of a large intestine, increase (stretching in width and length) a large intestine – megacolon.
One of the most serious consequences it is long the existing locks there can be a resistant impassability of intestines demanding the emergency surgery. It is long the existing impassability promotes development of ischemia of intestinal walls and can lead to a nekrotization. In certain cases locks can signal about the tumoral process taking place, and also to be a symptom of a disease inclined to an ozlokachestvleniye.
The alimentary locks connected with insufficiency of cellulose in a diet promote formation of carcinogens in intestines, and difficulty of passing of intestinal contents allows carcinogens to render long irritant action. At people of senile age and persons having mental disorders the kalovy blockage as a result of forgetfulness and lack of control over a defecation regularity can be formed.
Diagnostics of a chronic lock
Diagnostics of chronic locks is made step by step. At the first stage estimate clinical symptoms (complaints, the anamnesis, data of fizikalny survey) and the radiographic picture allowing to estimate a condition of a large intestine: a vermicular movement, the gleam width taking place tumoral formations, striktura, wall stretchings, congenital anomalies of development, megacolon. At an irrigoskopiya intestinal impassability distinctly comes to light.
As the second stage of diagnostic actions the kolonoskopiya (endoscopic inspection of a large intestine), a fence of bioptat of mucous membranes both their histologic and, if necessary, a cytologic research act. Then methods of a research of a functional condition of intestines depending on preliminary assumptions are appointed. It can be bacteriological tests, a koprogramma, a research regarding identification of the hidden blood, a technique of a manometriya of muscular walls of intestines (a sfinkterometriya, an anorektometriya), laboratory tests on identifications of functional violations of sekretorny bodies of a digestive tract, etc.
Purpose of these or those diagnostic techniques is made proceeding from complaints, the revealed features of work of intestines, assumptions about possible associated diseases and for the choice of tactics of treatment.
Treatment of a chronic lock
Treatment of chronic locks is not limited by prescription of depletive. Self-treatment as it is long the existing constant locks is inadmissible can be a symptom of a serious illness or promote development of dangerous complications. Besides, independent reception of depletive without their features, mechanisms of action and possible side effects often leads to formation of resistant problems with defecation as a result of decrease in motor functions of intestines. At the same time dosages of depletive increase and over time these medicines become inefficient at all.
Treatment of a chronic lock besides symptomatic therapy, includes measures for identification and treatment of a state which served as the reason of development of locks. Knowing the mechanism of emergence of a chronic lock at the patient, the doctor appoints treatment taking into account pathogenetic factors that promotes more effective action of symptomatic means and does not cause the vicious circle aggravating violations of intestinal motility.
Recommendations about treatment of functional locks
Functional locks can be caused by various reasons, but the pathologies interfering with functional characteristics of a digestive tract are always the cornerstone of their pathogenesis (unlike locks as a result of mechanical impassability when, as a rule, surgical treatment is optimum).
In therapy of locks an important link is the diet. Surely enter the products rich with vegetable cellulose (vegetables, fruit, cereals) and a large amount of liquid into a diet of patients (not less than two liters a day). In case against the background of a diet gas generation increases and the meteorizm develops, appoint medicine Mukofalk. Besides, exclude all products promoting aggravation of locks from a diet.
Food needs to be carried out according to the mode, not less than five times a day in the small portions. Not to allow long breaks between meals at all. Also it is necessary to watch closely a regularity of depletion of intestines. It is desirable to feel and restore an individual rhythm of natural defecation, to avoid control of desires. In case of reception of the medicines promoting difficulty of transit of intestinal masses (narcotic analgetics, ganglioblokator, iron medicines, diuretichesky means, oral contraceptives) it is necessary to cancel them and, whenever possible, to replace with the medicines which are not making impact on digestion.
As stimulation of work of a digestive tract and strengthening of a tone of intestinal muscles active lifestyle, walks, swimming, occupations is recommended by aerobics. Besides, the active living position positively influences the psycho-emotional status and promotes easy experience of stresses.
Depletive is appointed only in case of the persistent locks which are not giving in to adjustment by a diet and the mode. At the same time appoint medicine taking into account the mechanism of development of a lock. At purpose of depletive it is necessary to remember that long reception of the means irritating an intestinal wall strengthening a vermicular movement is fraught with development of a syndrome of "lazy intestines" when after medicine cancellation peristaltic activity of intestines falls to a minimum.
Prevention of locks
Prevention of locks is a timely identification and treatment of pathologies of a digestive tract and other diseases promoting locks, healthy nutrition, a diet rich with organic cellulose, enough the used liquid, and also active lifestyle and observance of the mode of meals and depletion of intestines.