-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
It is only for medical professionals to read and refer to the suffering of constipation.
.
.
People who have not experienced constipation will not understand! "Expert Consensus Opinions on Chronic Constipation in China (2019, Guangzhou)" mentioned that the prevalence of chronic constipation in adults in China is 4.
0%-10.
0% [1]
.
The etiology of chronic constipation is complex, involving social psychology, dietary structure, drugs, intestinal flora imbalance, changes in mucosal immune function (low-grade intestinal inflammation, increased intestinal permeability, immune activation), visceral hypersensitivity, and abnormal gastrointestinal motility, etc.
comprehensive factors
.
So, how should patients with chronic constipation be managed with medication and diet? Next, let's look at a case and learn it
.
Medical History Summary The patient, a 21-year-old female, presented to the doctor with "10 years of constipation"
.
In the past, I took phenolphthalein tablets, lactulose, polyethylene glycol, and western medicines such as Kaisailu, and it was not relieved.
I started taking traditional Chinese medicine for conditioning in 18 years.
At present, I defecate once a day after taking traditional Chinese medicine.
After completing the relevant examinations, colonoscopy showed no abnormality, colonic transit showed slow transit type, defecography and anal motility test showed no abnormality
.
According to the relevant examination of the patient, it is considered to be slow transit constipation.
The use of prucalopride can promote colonic peristalsis and shorten the colonic transit time.
At the same time of medication, the patient's diet and life management are carried out
.
Inform the patient that the staple food should not be too refined or too fine, pay attention to eating some coarse grains and miscellaneous grains, eat more vegetables with high cellulose content, ensure sufficient water and diet every day, inform the patient to develop good bowel habits, arrange a reasonable time for defecation, and at the same time Actively exercise to improve bowel movement
.
After two weeks of medication and life management, the patient defecates once a day, and the patient's constipation symptoms are significantly improved
.
Discussion and Analysis 1 Analysis of Patients Diagnosed with Functional Constipation Functional constipation (FC) refers to constipation caused by various pathophysiological mechanisms, including intestinal motility disorder, Constipation caused by intestinal secretion disturbance, altered visceral sensitivity, pelvic floor muscle dysfunction, and enteric nervous system dysfunction
.
According to the current pathophysiological mechanism, constipation caused by functional diseases can be divided into slow transit constipation (STC), defecation disorder constipation, normal transit constipation (NTC) and mixed constipation
.
2 Medication analysis of constipation patients Constipation drugs can be selected according to the severity of the disease and the different types of constipation (Table 1 below) [2]
.
Among them, constipation-type irritable bowel syndrome is more common clinically, and osmotic laxatives can be used, and psychological treatment should be paid attention to
.
Table 1 Different types of constipation, different treatment plans.
Considering that the patient has slow transit constipation and is not relieved by other drugs, the prokinetic drug prucalopride can be used
.
Prucalopride is a highly selective, high-affinity 5-HT4 receptor agonist, which has prokinetic effects on the entire digestive tract, including the stomach, small intestine, and colon, and can make gastric emptying in constipated patients without anorectal dysfunction Empty, small bowel transit and colonic transit are accelerated
.
Prucalopride is more selective to the colon, can enhance the peristalsis of the proximal colon and reduce the peristalsis of the distal colon, and advance the luminal contents
.
Drug clinical studies have found that prucalopride has a significant improvement effect on the intestinal function of patients with constipation, and this effect is continuous.
Improve the symptoms of constipation in patients [3]
.
3 Analysis of diet management for patients with constipation For patients with chronic constipation, adjunctive treatment of diet management is required at the same time as drug treatment in order to achieve an ideal therapeutic effect.
The basic principles of diet management are: (1) Adjust life>
.
①Meal: Increase the intake of fiber (25-35 g/d) and water (1.
5-2.
0 L/d)
.
Appropriately increase high-fat food, oil can directly moisten the intestines, and its decomposition product fatty acid also has the effect of stimulating intestinal peristalsis, such as sesame, vegetable oil for cooking, but not too much, cooking oil is controlled at 25-30g per day
.
② Moderate exercise: It is recommended to exercise 5 days a week, at least 30 minutes of moderate-intensity aerobic exercise a day, such as brisk walking, jogging,
etc.
③ Defecation habit: Colon activity is most active when waking up in the morning and after meals.
It is recommended that patients try to defecate in the morning or within 2 hours after meals, concentrate on defecation, and reduce the interference of external factors; the time of each defecation should not be too long (< 10 min/time)
.
(2) Cognitive therapy: Risk factors for chronic constipation include advanced age, female, economic status, educational level, life>
.
Strengthening the patient's own cognition is of great help to the treatment of chronic constipation
.
Chronic constipation is often easily overlooked, including family members, relatives and friends.
They do not have enough awareness and attention to the hazards of chronic constipation
.
At the same time, some patients' lack of understanding of the disease will also delay the diagnosis and treatment of the disease
.
Studies have shown that parental cognition plays an important role in the pathophysiology and prognosis of chronic constipation in children, neuroticism and parents with depressive symptoms and parenting attitudes and nurturing behaviors of parents are associated with constipation severity; in this case, family-based cognitive interventions may be beneficial
.
Therefore, families and society should fully recognize and understand such diseases, create a relaxed atmosphere, increase patients' confidence in facing the disease, and receive regular treatment in a timely manner
.
Summary: Patients with chronic constipation first need to adjust their diet and life>
.
References: [1] Expert consensus on chronic constipation in China (2019, Guangzhou) [2] Chinese Medical Association, Journal of Chinese Medical Association, etc.
Guidelines for primary diagnosis and treatment of chronic constipation (practice version 2019) [J].
Chinese general practitioners Journal, 2020, 19(12):1108-1114.
[3] Anam Omer, et al.
An update on prucalopride in the treatment of chronic constipation.
Therap Adv Gastroenterol.
2017;10(11):877–887.
Expert profile Prof.
Xiaocang Cao, Chief Physician, Professor, Department of Gastroenterology, General Hospital of Tianjin Medical University, Master Supervisor of Tianjin Medical University, Ph.
D.
, Department of Medicine, Peking Union Medical College, Tsinghua University, Post-doctorate at Texas State University School of Medicine, and post-doctoral visiting at Lille University School of Medicine, France scholars
.
Member of the Digestive Endoscopy Committee of the Inflammatory Bowel Disease Group of the Gastroenterology Branch of the Chinese Medical Association, Deputy Director of the Youth Committee of the Behavioral Medicine Branch of the Chinese Medical Association, member of the Clinical Epidemiology Collaborative Group of the Gastroenterology Branch of the Chinese Medical Association, and Digestive Disease of the Chinese Medical Equipment Association Member of the Inflammatory Bowel Disease Group of the Academic Society Committee, member of the Inflammatory Bowel Disease Professional Committee of the Chinese Medical Doctor Association Anorectal Physician Branch, member of the Anorectal Intractable Disease Professional Committee, member of the Inflammatory Bowel Disease Expert Committee of the Digestive Endoscopy Professional Committee of the Chinese Society of Integrative Medicine, Beijing Member of the Inflammatory Bowel Disease Expert Committee of the Medical Award Foundation, member of the Standing Committee of the Inflammatory Bowel Disease Alliance of Wu Jieping Medical Foundation, member of the Standing Committee of the Intestinal Microecology Professional Committee, member of the Standing Committee of the Stem Cell Engineering Technology Branch of the Chinese Society of Biomedical Engineering, and Inflammation of the Gastroenterology Branch of the Tianjin Medical Association Deputy Director of the Sexual Bowel Disease Group Research direction: biological therapy and cell therapy for autoimmune diseases of inflammatory bowel disease and digestive tract immune disease, especially dedicated to the clinical application of mesenchymal stem cell transplantation
.
His research results have won awards from international conferences such as the American Gastroenterology Annual Meeting and the European Union Gastroenterology Annual Meeting, and he has published dozens of papers in SCI journals and Chinese series journals
.
Xie Dong is a clinical pharmacist in the General Hospital of Tianjin Medical University, a clinical pharmacist who specializes in gastroenterology in the National Clinical Pharmacist Training Base, and an MTM pharmacist certified by the American Pharmacists Association (APhA)
.
Li Aixin, Pharmacist, Hengshui Third People's Hospital
.
.
People who have not experienced constipation will not understand! "Expert Consensus Opinions on Chronic Constipation in China (2019, Guangzhou)" mentioned that the prevalence of chronic constipation in adults in China is 4.
0%-10.
0% [1]
.
The etiology of chronic constipation is complex, involving social psychology, dietary structure, drugs, intestinal flora imbalance, changes in mucosal immune function (low-grade intestinal inflammation, increased intestinal permeability, immune activation), visceral hypersensitivity, and abnormal gastrointestinal motility, etc.
comprehensive factors
.
So, how should patients with chronic constipation be managed with medication and diet? Next, let's look at a case and learn it
.
Medical History Summary The patient, a 21-year-old female, presented to the doctor with "10 years of constipation"
.
In the past, I took phenolphthalein tablets, lactulose, polyethylene glycol, and western medicines such as Kaisailu, and it was not relieved.
I started taking traditional Chinese medicine for conditioning in 18 years.
At present, I defecate once a day after taking traditional Chinese medicine.
After completing the relevant examinations, colonoscopy showed no abnormality, colonic transit showed slow transit type, defecography and anal motility test showed no abnormality
.
According to the relevant examination of the patient, it is considered to be slow transit constipation.
The use of prucalopride can promote colonic peristalsis and shorten the colonic transit time.
At the same time of medication, the patient's diet and life management are carried out
.
Inform the patient that the staple food should not be too refined or too fine, pay attention to eating some coarse grains and miscellaneous grains, eat more vegetables with high cellulose content, ensure sufficient water and diet every day, inform the patient to develop good bowel habits, arrange a reasonable time for defecation, and at the same time Actively exercise to improve bowel movement
.
After two weeks of medication and life management, the patient defecates once a day, and the patient's constipation symptoms are significantly improved
.
Discussion and Analysis 1 Analysis of Patients Diagnosed with Functional Constipation Functional constipation (FC) refers to constipation caused by various pathophysiological mechanisms, including intestinal motility disorder, Constipation caused by intestinal secretion disturbance, altered visceral sensitivity, pelvic floor muscle dysfunction, and enteric nervous system dysfunction
.
According to the current pathophysiological mechanism, constipation caused by functional diseases can be divided into slow transit constipation (STC), defecation disorder constipation, normal transit constipation (NTC) and mixed constipation
.
2 Medication analysis of constipation patients Constipation drugs can be selected according to the severity of the disease and the different types of constipation (Table 1 below) [2]
.
Among them, constipation-type irritable bowel syndrome is more common clinically, and osmotic laxatives can be used, and psychological treatment should be paid attention to
.
Table 1 Different types of constipation, different treatment plans.
Considering that the patient has slow transit constipation and is not relieved by other drugs, the prokinetic drug prucalopride can be used
.
Prucalopride is a highly selective, high-affinity 5-HT4 receptor agonist, which has prokinetic effects on the entire digestive tract, including the stomach, small intestine, and colon, and can make gastric emptying in constipated patients without anorectal dysfunction Empty, small bowel transit and colonic transit are accelerated
.
Prucalopride is more selective to the colon, can enhance the peristalsis of the proximal colon and reduce the peristalsis of the distal colon, and advance the luminal contents
.
Drug clinical studies have found that prucalopride has a significant improvement effect on the intestinal function of patients with constipation, and this effect is continuous.
Improve the symptoms of constipation in patients [3]
.
3 Analysis of diet management for patients with constipation For patients with chronic constipation, adjunctive treatment of diet management is required at the same time as drug treatment in order to achieve an ideal therapeutic effect.
The basic principles of diet management are: (1) Adjust life>
.
①Meal: Increase the intake of fiber (25-35 g/d) and water (1.
5-2.
0 L/d)
.
Appropriately increase high-fat food, oil can directly moisten the intestines, and its decomposition product fatty acid also has the effect of stimulating intestinal peristalsis, such as sesame, vegetable oil for cooking, but not too much, cooking oil is controlled at 25-30g per day
.
② Moderate exercise: It is recommended to exercise 5 days a week, at least 30 minutes of moderate-intensity aerobic exercise a day, such as brisk walking, jogging,
etc.
③ Defecation habit: Colon activity is most active when waking up in the morning and after meals.
It is recommended that patients try to defecate in the morning or within 2 hours after meals, concentrate on defecation, and reduce the interference of external factors; the time of each defecation should not be too long (< 10 min/time)
.
(2) Cognitive therapy: Risk factors for chronic constipation include advanced age, female, economic status, educational level, life>
.
Strengthening the patient's own cognition is of great help to the treatment of chronic constipation
.
Chronic constipation is often easily overlooked, including family members, relatives and friends.
They do not have enough awareness and attention to the hazards of chronic constipation
.
At the same time, some patients' lack of understanding of the disease will also delay the diagnosis and treatment of the disease
.
Studies have shown that parental cognition plays an important role in the pathophysiology and prognosis of chronic constipation in children, neuroticism and parents with depressive symptoms and parenting attitudes and nurturing behaviors of parents are associated with constipation severity; in this case, family-based cognitive interventions may be beneficial
.
Therefore, families and society should fully recognize and understand such diseases, create a relaxed atmosphere, increase patients' confidence in facing the disease, and receive regular treatment in a timely manner
.
Summary: Patients with chronic constipation first need to adjust their diet and life>
.
References: [1] Expert consensus on chronic constipation in China (2019, Guangzhou) [2] Chinese Medical Association, Journal of Chinese Medical Association, etc.
Guidelines for primary diagnosis and treatment of chronic constipation (practice version 2019) [J].
Chinese general practitioners Journal, 2020, 19(12):1108-1114.
[3] Anam Omer, et al.
An update on prucalopride in the treatment of chronic constipation.
Therap Adv Gastroenterol.
2017;10(11):877–887.
Expert profile Prof.
Xiaocang Cao, Chief Physician, Professor, Department of Gastroenterology, General Hospital of Tianjin Medical University, Master Supervisor of Tianjin Medical University, Ph.
D.
, Department of Medicine, Peking Union Medical College, Tsinghua University, Post-doctorate at Texas State University School of Medicine, and post-doctoral visiting at Lille University School of Medicine, France scholars
.
Member of the Digestive Endoscopy Committee of the Inflammatory Bowel Disease Group of the Gastroenterology Branch of the Chinese Medical Association, Deputy Director of the Youth Committee of the Behavioral Medicine Branch of the Chinese Medical Association, member of the Clinical Epidemiology Collaborative Group of the Gastroenterology Branch of the Chinese Medical Association, and Digestive Disease of the Chinese Medical Equipment Association Member of the Inflammatory Bowel Disease Group of the Academic Society Committee, member of the Inflammatory Bowel Disease Professional Committee of the Chinese Medical Doctor Association Anorectal Physician Branch, member of the Anorectal Intractable Disease Professional Committee, member of the Inflammatory Bowel Disease Expert Committee of the Digestive Endoscopy Professional Committee of the Chinese Society of Integrative Medicine, Beijing Member of the Inflammatory Bowel Disease Expert Committee of the Medical Award Foundation, member of the Standing Committee of the Inflammatory Bowel Disease Alliance of Wu Jieping Medical Foundation, member of the Standing Committee of the Intestinal Microecology Professional Committee, member of the Standing Committee of the Stem Cell Engineering Technology Branch of the Chinese Society of Biomedical Engineering, and Inflammation of the Gastroenterology Branch of the Tianjin Medical Association Deputy Director of the Sexual Bowel Disease Group Research direction: biological therapy and cell therapy for autoimmune diseases of inflammatory bowel disease and digestive tract immune disease, especially dedicated to the clinical application of mesenchymal stem cell transplantation
.
His research results have won awards from international conferences such as the American Gastroenterology Annual Meeting and the European Union Gastroenterology Annual Meeting, and he has published dozens of papers in SCI journals and Chinese series journals
.
Xie Dong is a clinical pharmacist in the General Hospital of Tianjin Medical University, a clinical pharmacist who specializes in gastroenterology in the National Clinical Pharmacist Training Base, and an MTM pharmacist certified by the American Pharmacists Association (APhA)
.
Li Aixin, Pharmacist, Hengshui Third People's Hospital
