Imithi ye-Classical ayiboni kudingekile ukuthi impilo iphume izigqiki nsuku zonke. Ukuthi uphuma kangaki ukukhishwa kwamathumbu kuncike kumuntu ngamunye, kodwa ngokuvamile kubizwa ngokuthi ukuqunjelwa uma kukhona okuphumayo okungaphansi kuka-3 ngesonto futhi kunzima noma kunzima ukudlula.

Udokotela uzoqale anqume ukuthi kungokwesibili (ngenxa yesinye isifo) noma ukuqunjelwa okuyinhloko. Esimweni sokuqala, uzophatha imbangela noma uzobeka izivivinyo ezengeziwe, njengokuthi colonoscopy. Phatha eyakho hemorrhoids Uma kwenzekile. Ngokuvamile ziyimbangela yokuqunjelwa. Uma ukuqunjelwa kwakho kusanda kwenzeka futhi uthatha okusha umuthi, khuluma nodokotela wakho. Umuthi wakho ungaba imbangela yenkinga yakho.

Khona-ke udokotela uzonquma ukuthi i-transitory noma i-terminal constipation.

ukuqunjelwa kwezokuthutha

Udokotela uzoqale ancome shintsha ukudla ukuze kwandiswe ukudla izintambo : imifino eluhlaza, imifino ephekiwe, imifino, izithelo ezicebile ku-pectin (i-apula, i-pear, i-peach, amajikijolo), kodwa ngaphezu kwakho konke okusanhlamvu.

Singengeza ummbila, iphezulu kakhulu ku-fiber, noma okunye okusanhlamvu ku-muffin zokupheka, njll. Ukwelapha ukuqunjelwa, kunconywa ukuthi udle cishe 1/4 inkomishi kakolweni kakolweni ngosuku. Ama-prunes aphelele kanye nejusi yokuthena ayasebenza kakhulu ekudambiseni ukuqunjelwa ngoba aqukethe i-sorbitol, i-laxative yemvelo. Umthamo wansuku zonke wama-ounces angu-8 ngokuvamile wanele⁴. Kodwa-ke, kwesinye isikhathi kungathatha amasonto ambalwa ukuzwa izinzuzo zokudla okunothiswe nge-fiber ekuhambeni¹⁹.

Ngesikhathi esifanayo, udokotela uzophinde atusa phuza ngokwanele, ngenkathi ugwema utshwala neziphuzo ze-caffeinated, eziqeda amanzi futhi zingacasula ikholoni. Kodwa-ke, uma ukuqunjelwa kungapheli futhi kuhambisana nokucasuka kwamathumbu, kufanele ugweme ukushintsha ukudla kwakho ngokuzumayo.

Uma ukuqunjelwa kuqhubeka, uzoncoma a i-laxative. Kunezigaba eziyisi-6:

• The ama-laxatives we-ballast noma ubukhulu ngokuvamile ama-mucilages noma imicu yokudla elungisiwe: i-hydrophilic psyllium muciloid noma i-methylcellulose. Lolu hlobo lwe-laxative luthambile kakhulu emathunjini. Ngokubopha ngamanzi, imicu iyavuvukala, esiza ukwakha indle exekethile, eyinqwaba. Umthamo wawo udala i-peristalsis yamathumbu, ehambisa indle ukuya ku-rectum. Kungase kuthathe izinsuku ezimbalwa ukuze umphumela we-laxative ubonakale. Kunconywa ukuphuza okulingana izikhathi ezingu-5 kuya kwezingu-10 umthamo wesamba se-ballast laxative engenisiwe. Izibonelo yi-Metamucil®, Prodiem® ne-Kellogs Bran Buds®.

  Imiphumela emibi engaba khona: ukuqunjelwa, igesi namajaqamba. Ukuzihlanganisa kancane kancane ekudleni kunciphisa lokhu kuphazamiseka.

• The ama-emollients, okuthambisa indle. Isibonelo, i-docusate sodium (Colace®, Ex-Lax®, Soflax®).

  Imiphumela emibi engaba khona: isifo sohudo kanye namajaqamba esiswini.

• The ama-osmotic laxatives ukusiza ukugcina amanzi amaningi emathunjini, ngaleyo ndlela kuthambisa indle. Zihlanganisa usawoti (i-sodium sulfate, i-magnesium sulfate noma usawoti we-Epsom), i-magnesium hydroxide (ubisi lwe-magnesia), ushukela ongenakulinganiswa namathumbu (i-lactulose, i-mannose, i-mannitol, i-sorbitol, njll. ) noma i-glycerin (njenge-suppository). Ama-laxative asuselwa ku-polyethylene glycol (Miralax®, Lax-A-Day®) ama-osmotic laxative atholakala kubantu abadala abakhala ngokuqunjelwa ngezikhathi ezithile.

  Umthelela oseceleni ongaba khona: isifo sohudo, igesi, amajaqamba, nemithamo ephezulu yokuphelelwa amanzi emzimbeni.

• The i-lubricant laxatives, okugcoba isihlalo futhi kube lula ukuphuma kwabo. Ngokuvamile kunamafutha amaminerali (amafutha kapharafini noma i-petrolatum). Zingasetshenziswa ngomlomo noma nge-rectally.

  Imiphumela emibi engaba khona: isifo sohudo kanye namajaqamba esiswini. Qaphela, ukuvuvukala kwamaphaphu kungenzeka uma uwoyela emuncwa ngephutha emaphashini.

• The ama-laxatives avuselelayo sebenza ngqo ku-mucosa yamathumbu nakho konke ukunyakaza kwe-peristaltic (i-bisacodyl, i-anthracene, i-emulsified castor oil). Banciphisa ukumuncwa kabusha kwamanzi nama-electrolyte kukholoni. Ama-laxatives avuselelayo, acasula kakhulu ulwelwesi lwekholoni, asetshenziswa njengendlela yokugcina. Azinconywa uma kwenzeka ukuqunjelwa okungapheli. Akufanele zithathwe isikhathi esingaphezu kwesonto eli-1 noma ama-2 ngaphandle kokuqondisa kodokotela.

  Imiphumela emibi engaba khona: amajaqamba esiswini, isifo sohudo kanye nomuzwa ovuthayo ku-rectum.

  Ukuqapha. Ukweqisa izidakamizwa kungabangela umlutha we-lazy bowel syndrome, futhi kuholele emazingeni aphansi e-sodium ne-potassium egazini, ukuphelelwa amanzi emzimbeni kanye nezinkinga ezingathi sína.

  Isexwayiso. Ziyi-contraindicated kwabesifazane abakhulelwe nabancelisayo.

Amanye amalungiselelo akhiwa izidakamizwa ezivela ku-2 noma 3 kulawa maqembu ama-laxatives.

• I-Lubiprostone (Amitiza®). Lesi sidakamizwa esisha sekilasi siboniswa ekwelapheni ukuqunjelwa okungapheli kubantu abadala, uma kwenzeka ukwehluleka kwezinye izindlela zokwelapha.¹⁹. Isebenza ngokwandisa ukukhishwa kwamanzi emathunjini.

  Imiphumela emibi engaba khona: isicanucanu, isifo sohudo, ubuhlungu besisu kanye negesi.

Ukuqunjelwa kwesikhumulo

Uma kwenzeka ukuqunjelwa okungapheli, udokotela angancoma ama-microlavements kuya amakhandlela ukuze ubuyisele i-reflex yokuphuma. Ukwengeza, nge-biofeedback, singakwazi ukufundisa kabusha amakhono e-anorectal motor ngemva kwesiqephu sokuqunjelwa okungapheli, uma kunesidingo.^{5, I-13}.