Coprostasis in adults. Coprostasis in cats: causes, signs and treatment. In children, symptoms develop slowly

With a latent or prolonged variant of the anomaly, there is a decrease in the frequency of bowel movements up to 2-3 times a week, constipation is eliminated after the application of enemas. Manifestations often occur in schoolchildren and adolescents. Stagnation of feces causes chronic intoxication, which is characterized by dizziness, headaches, pale skin, fatigue.

Congenital developmental anomalies

Rectal atresia manifests itself already in the first day of a newborn's life: meconium does not pass, there is no stool, there is no anus. This condition is diagnosed by neonatologists immediately after childbirth. False constipation (pseudo-constipation) is pathognomonic of cleft lip and palate. With this defect in the structure of the facial skull, milk and mixtures flow into the respiratory tract or pour out of the mouth. Fecal retention is associated with malnutrition.

For dolichosigma, the appearance of persistent constipation after 6 months of life is typical, which is due to the introduction of complementary foods. At first they disturb sporadically and last from 2 to 3 days, then the duration and frequency of stool retention increases. The stool is large in diameter, looks like a "spruce cone", has a sharp fetid odor. In 30% of children, constipation occurs between 3-6 years of age.

Helminthiases

Chronic diseases of the gastrointestinal tract

The appearance of constipation is characteristic of gastroduodenitis and peptic ulcer. These causes cause dysmotility of the gastrointestinal tract, as a result of which partially digested food lingers in the intestine for a long time. Constipation is short-lived, defecation resumes after 2-3 days on its own or after setting an enema. The symptom is repeated regularly, it is provoked by errors in the diet, stress.

Prolonged constipation in children, developing against the background of sharp pains in the abdomen, tenesmus, are typical for ulcerative colitis. With the urge to defecate, blood and mucus are released from the anus, the retention of feces during an exacerbation reaches a week. The symptom is sometimes replaced by profuse diarrhea, the feces are liquid and fetid, contain blood impurities.

Intoxication

With lead poisoning, constipation in a child may be the only symptom. Sometimes there is diffuse pain in the abdomen and a single vomiting. The retention of feces is also caused by endogenous causes: intoxication with protein breakdown products, release of toxins by microbial cells. Constipation is prolonged, the urge to stool is often absent. The symptom occurs against the background of a general serious condition requiring emergency medical care.

Complications of pharmacotherapy

Most often, persistent constipation is caused by the abuse of laxatives without the advice of a doctor. Uncontrolled intake of these drugs inhibits the natural reflex to empty the intestines, rectal muscle fibers stop responding to impulses from the spinal cord. Independent defecation is difficult or impossible. Constipation is also provoked by other medicinal causes: the appointment of anticholinergics, chemotherapy drugs.

Rare Causes

• Endocrine pathology Key words: hypothyroidism, diabetes mellitus, pheochromocytoma.
• Pediatric botulism.
• Damage to the nervous system: cerebral palsy, neuro-arthritic diathesis.
• Volumetric formations: single polyps of the rectum, juvenile polyposis, intestinal cancer.
• enteropathy: celiac disease, lactase deficiency.

Diagnostics

Children who have delayed stools are examined by a pediatrician. If necessary, a pediatric gastroenterologist is involved for consultation. The specialist collects a detailed history of the disease and identifies predisposing factors, dietary changes, concomitant diseases. To verify the cause of constipation, an instrumental examination of the gastrointestinal tract and laboratory methods are prescribed. Most informative:

• Finger examination. Assessment of the condition of the rectal ampulla is the first thing to do with constipation in a child. During the examination, fecal stones, volumetric neoplasms, places of greatest pain are determined. Before examination, the abdomen is felt to detect bloating, spasms, and an increase in the size of the sigmoid colon.
• Ultrasonography. Ultrasound of the abdominal cavity is a simple non-invasive diagnostic method that shows signs of inflammatory processes, anomalies in the structure of the digestive tract, and suspicious neoplasms. Additionally, with the help of an ultrasonic sensor, targeted ultrasound of the liver and pancreas is carried out.
• Radiography. Plain radiograph of the abdominal cavity is quite informative, allows you to detect the expansion of intestinal loops and signs of intestinal obstruction. To check the condition of the colon, barium irrigography is prescribed, which is performed after an enema. Sometimes radiography of the passage of barium through the gastrointestinal tract is used.
• Coprogram. Microscopic examination of feces includes the determination of undigested food particles, fatty acids, erythrocytes and leukocytes. Mandatory bacteriological culture of feces to exclude dysbacteriosis. The stools are examined for helminth eggs and the presence of protozoal infections.
• Laboratory indicators. With persistent constipation in a child, a biochemical blood test, liver tests are performed to exclude concomitant hepatobiliary disorders. If endocrine diseases are suspected, the hormonal profile is examined. Sometimes a highly specialized blood toxicology study is indicated.
• Additional Methods. To exclude organic pathology and tumors of the intestine, sigmoidoscopy or colonoscopy is recommended. To diagnose Hirschsprung's disease and UC, a biopsy of the intestinal wall is taken during the study. If there are signs of disorders of the nervous system, a consultation with a neurologist, EEG and EchoEG is needed.

Treatment

Help before diagnosis

Short-term (up to 2 days) constipation that occurs during normal health does not require specific treatment. To normalize the stool in infants, it is necessary to add fruit and vegetable purees to the diet, older children are given more fresh or stewed vegetables, healthy dairy products. Effectively increase physical activity, which promotes bowel function and improves motility.

During potty training, it is important for parents to be patient, not to yell at the child and not force him to defecate. When stool retention is accompanied by changes in the color or consistency of feces, general malaise, pain in the abdominal cavity, this indicates pathological causes. Be sure to consult a doctor who knows how to treat constipation in a child correctly.

Conservative therapy

Constipation in children in most cases is secondary to the underlying pathology, so their treatment is aimed at eliminating the root cause. Children with long-term absent stools are prescribed cleansing enemas. In severe illness, when defecation continues to be delayed despite following a special diet, the treatment regimen includes:

• Laxatives. In pediatric practice, soft drugs (lactulose, sennosides) are mainly used, which do not have side effects. Lactulose promotes the growth of beneficial intestinal microflora, therefore it is recommended for dysbacteriosis.
• Prokinetics. Effective for hypotonic constipation, when there is insufficient contraction of the smooth muscles of the gastrointestinal tract. Coordinate the work of all parts of the digestive tract, accelerate the movement of feces.
• Antispasmodics. In the spastic variant of constipation in children, these drugs effectively relax the smooth muscles and facilitate defecation. The drugs also quickly relieve pain in the intestines.
• Rectal candles. Suppositories with glycerin are indicated as mild laxatives. They soften the feces, make the process of defecation painless. With severe pain in the anus, candles with anesthetics are injected.

Physiotherapy

With hypotension, galvanization, pulsed currents, and other stimulating methods are prescribed. With intestinal hypertonicity, paraffin applications are shown on the abdomen. To eliminate intestinal hypotension, massage courses with elements of exercise therapy are used, which are aimed at accelerating intestinal motility and increasing the processes of neuromuscular transmission. If the chair is absent under the influence of a psychogenic cause, a consultation with a child psychologist is required.

Enterolith, coprostasis

Version: Directory of Diseases MedElement

Other types of intestinal lumen occlusion (K56.4)

Gastroenterology

general information

Short description

intestinal stone(enterolith) - calculus Calculi - stones, dense formations found in the abdominal organs and excretory ducts of the human glands.
formed in the intestines as a result of calcification Calcinosis (syn. calcification, calcification) - the deposition of calcium salts in body tissues
clotted food debris.

Coprostasis a condition resulting from chronic constipation characterized by lack of bowel movements (or insignificant bowel movements - up to 100 g of stool for adults) for at least 48 hours and painful attempts to implement it, in combination with signs of intestinal obstruction. Coprostasis is not an independent disease, but is only a clinical sign that accompanies some diseases.
Coprostasis with signs of intestinal obstruction should be distinguished from constipation.

Note

- "Foreign body in the small intestine (bezoar)" - T18.3

- "Foreign body in colon" - T18.4

Classification

Enteroliths. Conditionally divided into true and false (see section "Etiology and pathogenesis")

Coprostasis. There is no acceptable classification. One of the etiological classification options is given below.

1. Alimentary coprostasis.

2. Mechanical coprostasis (organic lesions of the colon).
3. Neurogenic coprostasis (functional and organic diseases of the central nervous system).
4. Toxic coprostasis (chronic intoxication, including drugs).
5. Coprostasis in endocrine pathology.
6. Reflex coprostasis (for various diseases of the gastrointestinal tract and small pelvis).

Etiology and pathogenesis

Enteroliths

1. True enteroliths. They are very rare and are calculi of feces and bile acids, which, as they enter the distal small intestine, are impregnated with precipitated calcium salts. Stones may be composed almost exclusively of magnesium carbonate alone; may contain 80% carbonate and other calcium salts; "fat-wax masses", probably formed from excessive consumption of very fatty foods containing refractory animal fats, or due to insufficient digestion of fats.
True enteroliths are formed mainly in the area of ​​congenital anomalies and acquired defects of the small intestine.

2. False enteroliths form around fragments of undigested food (bones, seeds, bezoars) in any part of the intestine.
Moving through the intestines and fixing in the jejunum or in the ileocecal intestine, enteroliths can cause complete or partial obstruction.

Enteroliths should be distinguished from:
- biliary stones formed in the gallbladder and entered the intestine through biliary digestive fistulas, which can also cause obstructive intestinal obstruction (" " - K56.3);

Urinary stones from the renal pelvis that have entered the intestine through the pelvic-intestinal fistulas;
- appendix stones (" " - K38.1)

Lead to the formation of enteroliths:
- diverticula of the small intestine (congenital and acquired) - the main cause;
- intestinal fistulas (small-intestinal, small-colonic);
- blind loop syndrome (after anastomosis surgery);
- congenital malformations of the intestine (Hirschsprung's disease) Hirschsprung's disease is a congenital malformation of the rectum (sometimes the distal colon) due to denervation of all elements of the intestinal wall and blood vessels. In this case, the passage of intestinal contents through the affected areas is disrupted, which leads to its accumulation in the overlying part of the colon and its gradual stretching.
);
- intestinal hypotension of any etiology;
- prolonged errors in the diet;
- taking large doses of antacids for a long time;
- Multiple intestinal stenosis.

Fecal obstruction
Coprostasis occurs due to the formation in the large (most often in the rectum or sigmoid) intestine of solid immovable fecal fragments that block the intestinal lumen and cause a clinic of intestinal obstruction.

The most common causes:
- diseases of the central and peripheral nervous system;
- prolonged uncontrolled use of drugs (anticholinergics, antipsychotics, drugs, antidiarrheals);
- dehydration and malnutrition;
- congenital anomalies of the intestine;
- intestinal diseases.
(See also the "Classification" section).

Epidemiology

Age: mostly elderly

Sign of prevalence: Rare

Sex ratio (m/f): 0.9

1.True enteroliths that cause intestinal obstruction are rare. It is believed that older people with reduced gastrointestinal motility and a high risk of diverticular disease are susceptible to the disease. However, cases of intestinal obstruction due to fecal stones have been described in children.

2. Fecal obstruction It is described mainly in the elderly, but there are cases of the disease in childhood. Compared to obstruction Obstruction - obstruction, blockage
caused by enterolitis, fecal obstruction is much more common.

Factors and risk groups

- elderly age;
- the presence of diverticula A diverticulum is a protrusion of the wall of a hollow organ (intestine, esophagus, ureter, etc.) that communicates with its cavity.
and hernia;
- constipation;
- mental disorders;
- malnutrition;
- the use of drugs that affect intestinal motility.

Clinical picture

Clinical Criteria for Diagnosis

Abdominal pain; bloating; vomit; nausea; dehydration; tachycardia; oliguria; palpable tumor in the abdomen; splashing noise on auscultation; dehydration; tachycardia

Symptoms, course

Obstruction caused by enterolitis
A history of diverticulosis or exacerbations of diverticulitis, signs of malabsorption may be present. Malabsorption syndrome (malabsorption) - a combination of hypovitaminosis, anemia and hypoproteinemia, caused by malabsorption in the small intestine
, operations on the gastrointestinal tract, cholecystitis Cholecystitis - inflammation of the gallbladder
.
The clinic can develop acutely with complete obstruction or subacute with incomplete obstruction or enterolith migration through the intestine. Enterolith usually causes obstruction of the jejunum.
Manifested by sudden pain in the abdomen of uncertain localization or pain near the navel. The pains are cramping in nature.
In the subacute course, there are several pain attacks of lesser intensity in history or a gradual increase in pain over several days.
Vomiting is the second most common symptom. With small bowel obstruction, vomiting is persistent, repeated, leading to dehydration, possibly with an admixture of bile.
Bloating, gas and stool retention are constant signs.

Coprostasis
It develops gradually against the background of chronic constipation in history. Most often there is a clinic of colonic (low) obstruction. The frequency of symptoms can vary significantly depending on the etiology of coprostasis, the age and mental status of patients, and the duration of obstruction.

Main symptoms:
- stool retention or a small amount (less than 100 g / day for adults) for a period of at least 48 hours; observed in 65-100% of cases;

Abdominal pain - 32-99%;

Vomiting - 23-48%;

Bloating - 48-65%;

Splashing noise during auscultation - 46-51%;

Palpable tumor - 18-65%.

Other common symptoms can also include:

Dehydration;

Strong tension when trying to defecate;

Pressure on the bladder or loss of control over bladder function (frequent urge to urinate when trying to have a bowel movement);

Lower back pain;

Tachycardia Tachycardia - increased heart rate (more than 100 in 1 min.)
;

An episode of scanty diarrhea (rare).

During palpation examination, symptoms of peritoneal irritation are not detected, it is possible to palpate a seal in the sigmoid colon.

Digital examination of the rectum is of great diagnostic value. Quite often, relaxation of the sphincters is detected Sphincter (syn. pulp) - a circular muscle that compresses a hollow organ or closes any hole
and gaping anus. In the ampoule of the rectum, dense fecal masses are determined, through which it is impossible to pass a finger; they are immovable, pressure on them causes some soreness. When fecal constipation is located in the sigmoid colon or even more proximal, the rectum is free of contents.
In some cases, rectal examination reveals slight bleeding. Possible (in the early stages) a single diarrhea and discharge of a small amount of gases.

Diagnostics

Diagnosis of coprostasis, taking into account the data of rectal examination, does not cause difficulties. However, imaging may be useful in the differential diagnosis and diagnosis of complications.

1. Plain radiography allows you to identify the classic signs of obstruction:
1.1 For enterolith:
- bloating of the small intestine with desolation of the distal sections;
- the shadow of a stone in the projection of the jejunum or caecum;
- liquid levels.
1.2 For coprostasis:
- bloating and fluid levels in the small and large intestines;
- shadow of fecal masses filling the entire intestine (relatively uniform darkening with a contour corresponding to the contour of the intestine, most often the sigmoid and rectum).

2. Irrigoscopy Irrigoscopy - X-ray examination of the colon with retrograde filling with a contrast suspension
with coprostasis it is not performed, with enterolitis, CT and ultrasound are preferable.

3. CT scan is the gold standard for diagnosing diverticulosis Diverticulosis - the presence of multiple diverticula (protrusion of the wall of a hollow organ, communicating with its cavity); seen more often in the gastrointestinal tract
intestines.

4. ultrasound has high sensitivity in the diagnosis of enteroliths, but is often difficult due to intestinal distention.

Laboratory diagnostics

There are no specific laboratory tests to support a diagnosis of enterolith ileus or coprostasis.

The detected changes usually indicate dehydration due to vomiting (hypochloridemia, hypokalemia, hemoconcentration), initial nutritional deficiency (hypoalbuminemia), development of complications (high ESR and leukocytosis, blood in the feces).
However, all the necessary tests for differential diagnosis with diseases of the pancreas, cholelithiasis cholelithiasis - cholelithiasis
, infectious colitis and others should be performed.

Differential Diagnosis

- other types of intestinal obstruction;
- biliary ileus Ileus - a violation of the passage of contents through the intestines; manifested by stool and gas retention, acute abdominal pain, vomiting, often symptoms of intoxication and dehydration (dehydration)
;
- intestinal tumors;
- bezoars Bezoar - a foreign body in the stomach, formed from swallowed indigestible food particles; may mimic a stomach tumor
and foreign bodies;
- chronic constipation.

The main role in differential diagnosis belongs to imaging methods.

In children, coprostasis, ascariasis, adhesions and bands most often lead to obstructive obstruction, and rarely - tumors. In recent years, due to the improvement of preventive work, the number of children with obstructive form of intestinal obstruction has decreased.

Coprostasis is observed in children of all ages, but in infants and infants it is more common. In young children, coprostasis, as a rule, is functional. Sometimes it can be caused by anal fissures, malformations of the digestive tract (elongated sigmoid colon, Hirschsprung's disease, etc.).

Clinic and diagnostics. Coprostasis causes colonic obstruction. Fecal lumps formed in the large intestine gradually increase in size, form conglomerates, harden, turning into fecal stones. The clinic of intestinal obstruction develops gradually. First, liquid intestinal contents and gases bypass fecal stones, then the patency stops partially or completely. The pains increase gradually and are cramping in nature. Vomiting does not appear immediately. It is always with an admixture of greenery and bile. The entire abdomen increases in volume. Peristalsis of the dilated intestinal loop is determined through the anterior abdominal wall. Intestinal noises are increased in the initial period of development of obstruction, in the future, due to intestinal fatigue, they increase periodically. The abdominal wall at the moment of peristalsis over the place of the obstacle becomes tense. The rest of the time, the abdomen is soft and accessible to deep palpation. Above the womb or more often in the left iliac region, a dense, bumpy, mobile and painless tumor formation is determined. Symptoms of irritation of the peritoneum, if inflammation does not join it, are absent.

The diagnosis is made on the basis of the anamnesis, when parents indicate a tendency to constipation in the child, and the clinical picture. The diagnosis is clarified with the help of a digital examination of the rectum, in which fecal stones are found in the rectum. If it is necessary to carry out a differential diagnosis with a tumor of the abdominal cavity, an irrigography with a barium suspension is performed.

Treatment start with conservative methods. In the presence of toxicosis, the patient is removed from this state by intravenous administration of fluid and stabilization of the activity of the cardiovascular system. Then a siphon enema is performed with a 1% sodium chloride solution to avoid fecal intoxication. The total amount of saline for a siphon enema ranges from 2 to 4 liters. The task of the first siphon enema is to restore partial patency in the colon and reduce intoxication. One should not strive to remove a fecal stone as a result of a single siphon enema.

The correct technique for conducting a siphon enema is extremely important. A child, especially a small one, must be well wrapped up and overlaid with heating pads. With a low location of the fecal stone, if it is not possible to wash it well with a siphon enema, you can try to gently knead it and partially remove it with your fingers. In difficult cases, it is permissible to gouge a fecal stone with a blunt metal probe through a sigmoidoscope. This procedure requires great care.

After removal from a serious condition, an examination is carried out aimed at identifying the cause of coprostasis.

With the aim of prevention coprostasis patients are recommended to take a glass of cold water on an empty stomach, kefir at least 200 ml per day, vaseline oil 1 tablespoon or dessert spoon 3 times a day. They improve the condition of abdominal massage along the colon, physiotherapy exercises aimed at strengthening the anterior abdominal wall, stretching the anus. Dietary nutrition with the inclusion in the diet of a large number of vegetables, fruits, coarse cereals, prunes, etc. is important.

Surgery is resorted to only as a last resort, when all conservative measures have been exhausted, and obstruction remains. A colostomy is performed to eliminate the phenomena of obstruction, followed by continuation, if necessary, of conservative therapy aimed at removing the fecal stone.

Constipation in children is common, as up to 10-12 years of age, the gastrointestinal tract is still developing.

Until this period, it is not resistant to various kinds of bacteria, it forms its own positive microflora. Less common in teenagers.

Most often, coprostasis occurs in infants, especially during the introduction of complementary foods.

But what medications can be given to them? What symptoms may indicate intestinal obstruction?

Constipation in children: what is it?

According to ICD 10, the constipation code is 59.0. The disease is indicative of intestinal obstruction caused by compaction of feces or low moisture content in them.

It is an intestinal disorder when defecation in an infant is less than 3 times a day, in children from 3 years old - less than 1 time per day, from 7 years old - less than 1 time in 2 days.

Conventionally, constipation in children is usually classified into:

1. functional(most often occurs in infants and is due to improper functioning of the large intestine);
2. organic(indicates congenital anomalies of the gastrointestinal tract that impede the passage of feces);
3. episodic(provoked by dehydration of the body, for example, when the temperature rises or after an infection);
4. false(defecation occurs rarely, but without any difficulty, indicates increased digestibility of mother's milk and is not a disease);
5. spicy(is an intestinal disorder due to a disturbed diet);
6. chronic(repeated manifestation of the acute form over a short period of time).

Doctors say that most often constipation in children occurs against the background of a small amount of water consumed, as well as an increase in the ratio of heavy protein foods in the diet.

In infants, constipation in most cases is a normal reaction of the gastrointestinal tract to the occurrence of microflora. Occurs most often with the introduction of complementary foods.

Now you know in general terms what it is.

What can cause coprostasis?

The main causes of constipation in infants are:

As for teething, constipation in this case occurs against the background of an increase in the activity of intestinal enzymes, and at the same time with an increase in body temperature (due to this, the removal of moisture from the body is accelerated).

Most often it happens in children over the age of 1.5 years. Doctors in this case recommend giving the child small amounts of kiwi, plums, boiled prunes (they are rich in fiber and contribute to the removal of solid feces).

In older children (closer to school), constipation occurs against the background of:

1. increase in the diet of protein foods;
2. eating disorders (eats a lot of sweets, refuses porridge, soup);
3. dysbacteriosis;
4. insufficient physical activity;
5. overweight;
6. pathology of the gastrointestinal tract;
7. gastritis.

A separate category also includes the so-called intoxication constipation, which is a consequence of poisoning or eating too "heavy" food with which the children's intestines simply cannot cope.

As a rule, such delays in defecation are single and are eliminated by a banal change (at least temporarily) of the diet.

Now you are aware of what can cause coprostasis in a small child.

Symptoms of the disease

• The main sign that a child suffers from constipation is is delaying bowel movements, too dense and dry feces. Small pink blotches can also be observed in them - this is due to mechanical damage to the rectal mucosa during excessive stress.
• Myself child is restless, often cries, may categorically refuse to eat.
• Body temperature during constipation is usually normal. The exception is the period of teething. Against this background, the child may also experience an allergic reaction - this is a sign that toxins enter the bloodstream through the intestinal mucosa. Acne, a red rash (similar to prickly heat) appears.
• Constipation may also alternate with severe diarrhea. when the stool becomes watery and streaked with mucus. This indicates severe intoxication, dysbacteriosis or an increase in the concentration of acetone.

How to help a child if he suffers from an illness?

If constipation occurs against the background of the introduction of complementary foods, then this is the result of an improperly selected diet. In this regard, it is advisable to consult with your doctor at all. But you don't have to give up food.

It is better to use special "children's" suppositories - they differ in a small convenient size. These are sold at any pharmacy.

If constipation occurs in a child with artificial feeding, then doctors recommend trying other milk formulas with a minimum protein content. Unfortunately, there is no universal artificial complementary food that is suitable for absolutely all babies - you have to select it experimentally. Along with this, the baby can be given probiotics and prebiotics, but only on the direct instructions of the pediatrician - this will help normalize the intestinal microflora.

Often, constipation also occurs with mixed feeding, when the first complementary foods are introduced.

To avoid problems with the intestines, doctors recommend adhering to the following rules:

1. start complementary foods no earlier than 4 months (the best option is from 6-7 months);
2. to begin with, fruit juices are introduced, literally a few drops for each meal;
3. the amount of complementary foods is increased to 50 ml per day for the next 3-4 months;
4. then introduce vegetable puree (creamy or apple) into complementary foods;
5. meat, cottage cheese, eggs are introduced only after 8-9 months.

But in breast milk, the baby should not be denied. Weaning from the chest should be somewhere from 1-1.5 years, not earlier.

The basis for the prevention of constipation for children is:

If constipation occurs too often, then you should visit a pediatrician and a gastroenterologist to rule out intestinal pathologies.

The work of the digestive tract in a baby normalizes at about 3-4 years, after which he will be able to eat everything that his parents eat (within reason, of course). Up to this point, you should carefully compose his diet, sifting out from it those foods that cause constipation or intestinal upset.

Related videos

The opinion of the famous pediatrician Evgeny Komarovsky on the treatment of constipation in children:

Stagnation of contents in the large intestine (coprostasis).

Coprostasis is the overflow of the large intestine or its individual sections with food mass.

Etiology. Prolonged feeding with coarse, low-nutrient feed, lack of vitamins in feed, lack of mineral supplements. Year-round feeding with dry food in the absence of green and succulent food in the diet. Lack of exercise and water. The development of the disease is facilitated by malformations of the teeth, old age, emaciation due to other diseases (gastrofilosis, helminthiases, etc.)

Secondarily, coprostasis develops as a result of paresis and paralysis of the rectum, with atony of the intestine or its narrowing. Blockage is usually observed in the gastric expansion of the large colon, its upper and lower loops (especially in the pelvic flexure), less often in the caecum.

Pathogenesis. The delay in the passage of contents in the intestine most often occurs in places of its anatomical narrowing.

In the large intestine, such areas are the caecum, pelvic loop and gastric expansion of the large colon, less often the small colon. If the feed masses are liquid, then during the period of peristaltic contraction of the intestinal loop, they quickly pass the narrowed area, thereby eliminating the possibility of stagnation. This does not happen when feeding coarse, bulky foods. In addition, the feed masses can stop as a result of convulsive contraction in any sphincter, or in the whole area of ​​the intestines, which occurs under the influence of certain stimuli. Under these circumstances, the feed masses begin to linger in the affected area, which is located after it. With coprostasis, intestinal contents accumulate relatively slowly, so the reaction from the intestine develops gradually. The formation of stagnation contributes to the weakening of the contractile energy of the intestinal muscles, atony of the intestinal wall. The contents that have accumulated over many days gradually dry out and become dense. Due to the fact that appetite is not disturbed during coprostasis, the amount of stagnant masses gradually increases, spreads to neighboring sections of the intestine, and this leads to the accumulation of such a large amount of content (100-150 kg), which is very difficult to remove from the intestine.

Soreness with coprostasis does not reach such strength as with chymostasis. The accumulated masses compress the blood vessels, thereby disrupting blood circulation. This, in turn, causes indigestion with the development of fermentation in the fodder masses, decay with the formation of harmful products that cause intoxication of the body, inflammation of the intestines. Intoxication develops less intensively than with chemostases.

Symptoms. Periodically recurring bouts of anxiety in the form of so-called “silent colic”: the horse scratches its chest limbs, looks back at its stomach, fans its tail, sometimes lies down and wallows. Sometimes the animal assumes an “observer” position or stands “stretched out”. Fecal excretion is rare or even stops. Feces, if excreted, are dense, dry, covered with mucus on top. Only with prolonged coprostasis of the cecum, diarrhea is possible. Observe tachycardia, shortness of breath, arrhythmia. Urination is reduced, there is protein in the urine, a lot of indican. The general temperature is within normal limits. Especially valuable for diagnosis are the results of rectal examination.

With coprostasis of the caecum in the right iliac region, the caecum is found in the form of a huge motionless body occupying the area of ​​​​the entire right iliac region. At the same time, its posterior wall often adjoins the pelvic region, and the left one partially extends into the left half of the abdominal cavity. At its base, the rectum is sometimes filled with gases, the rest of it is dense or hard. Coprostasis of the caecum is manifested by the anxiety of the animal and proceeds with prolonged and mild colic.

outbursts of anxiety give way to long periods of calm. Signs of colic in horses come on gradually and can last 7-8 hours. A sick animal lies on its side or stands with its head down, even tries to take food. During pain, he looks around at his stomach, stretches out, walks aimlessly, lies down, and gets up. At the onset of the disease, body temperature is normal. In the region of the blind and jejunum, weak peristaltic noises are heard. Defecation is rare. The zone of skin sensitivity in the region of the 11th-13th ribs on the right side is well expressed. As the process develops, progressive depression, increased heart rate and respiration, cyanosis of visible mucous membranes are revealed. Death occurs from intoxication and asphyxia.

With coprostasis of the lower left knee of the large colon in the left half of the abdominal cavity, a large body of a dense or solid consistency is found, going in the direction from the pelvis to the diaphragm. The overflowing lower knee of the large colon is easily recognized by the longitudinally running tenias and pockets located one after the other, while there is no compaction and tension in its upper knee. In this case, the pelvic bend is located at the edge of the pubic bone, sometimes at the bottom of the pelvis in the form of a dense arcuate smooth and mobile body.

Coprostasis of the gastric expansion of the large colon develops up to 20 days. One of the characteristic signs of this disease is the stop of defecation from the very beginning of the disease, as a result of which, after a few days, symptoms of intoxication begin to appear.

a bulbous extension is found in front of the caecum in the upper right half of the abdominal cavity and slightly below the right kidney. It has the appearance of a semicircular large body with a smooth surface, moving simultaneously with respiratory movements and having a dense texture. Movements synchronous with breathing are due to the adjunction of the gastric expansion to the diaphragm.

With coprostasis of the small colon, in front of the pubic fusion on the right or left, a clogged loop of the small colon is found in the form of a dense “sausage-shaped” body as thick as a human forearm. This body is provided with longitudinal stripes and can be easily moved in any direction. With coprostasis of the rectum, it is found crowded and distended with feces, and the same accumulation of feces is noted in the loops of the small colon. The duration of coprostasis is 3-10 days or more. Appetite during illness often persists.

Diagnosis. The leading value belongs to rectal research. The anamnestic data and the clinical manifestation of the disease are also taken into account. Coprostases develop slowly, gradually, with periods of improvement and worsening of the general condition again with a picture characteristic of colic. They can last 1-2 weeks or more. With them there is no acute expansion of the stomach, but there is often flatulence of the intestines.

In the differential diagnostic respect, blockage of the intestines by foreign objects (stones, calculi, etc.), acute expansion of the stomach, obstruction and strangulation (blockage and twisting) of the intestines should be excluded.

Forecast with coprostasis should be very careful. Severe complication may be peritonitis as a result of intestinal rupture.

Treatment. First of all, you need to remove dense feces from the intestines and restore peristalsis. Deep enemas from warm water (at least 20 liters of 1% sodium chloride solution) using a tamponator. If necessary, the enema is repeated after 0.5-1 hour, 5% sodium chloride solution is injected intravenously - 300-400 ml. irradiation with a quartz lamp for 15-20 minutes from a distance of 80 cm. Subcutaneous administration of camphor and caffeine is indicated. Laxatives are prescribed - vaseline oil (300-700 ml) along with a double amount of hot water and the addition of a handful of table salt. You can use vegetable oil instead of vaseline oil. Sabur is most suitable for coprostasis of the caecum and colon; it is administered orally (20.0-40.0) at 3-day intervals. In cases accompanied by complete closure of the intestine - subcutaneously pilocarpine (0.1-0.2) at a dilution of 1:10, arecoline (0.01-0.02) in 5-10 ml of water. Pilocarpine or arecoline is used, however, not earlier than 12 hours after the infusion of warm water into the rectum. You can make a pararenal blockade according to Tikhonin. After the elimination of coprostasis, treatment of intestinal inflammation is indicated. Ichthyol, sulgin, ftalazol and other drugs are prescribed in generally accepted doses. Diet therapy: soft meadow hay, root crops, green fodder. For the prevention of flatulence, ichthyol is prescribed inside.

Prevention. Restriction in the diet of coarse, fiber-rich, indigestible foods. Prepare animal feed, use mixtures of coarse, concentrated and succulent feed. Regular feeding and watering. Regular exercise.

Bibliography:

Internal diseases of animals / Under the general. ed. G.G. Shcherbakova, A.V. Korobov. - St. Petersburg: Publishing house "Lan", 2002. - 736 p.

Donskaya T.K. Diseases of horses with a symptom complex of colic - St. Petersburg: GIORD, 1999. - 32 p.

Handbook of breeding and diseases of horses / Edited by Honored Scientist of the Republic of Belarus A.I. Yatusevich. - M .: "REAL-A", 2002. - 320 p.

There are many classifications of etiological factors of coprostasis. The most commonly used is the following.
I. Alimentary coprostasis.
II. Mechanical coprostasis (organic lesions of the colon).
III. Neurogenic coprostasis (functional and organic diseases of the central nervous system).

r /> IV. Toxic coprostasis (chronic intoxication, including drugs).
V. Coprostasis in endocrine pathology.
VI. Reflex coprostasis (with various diseases of the gastrointestinal tract and small pelvis).
Coprostasis in organic lesions of the colon. Obstipation is one of the most characteristic symptoms of congenital malformations of the large intestine - idiopathic megacolon, Hirschsprung's disease, mobile caecum and sigmoid colon.
In addition, coprostasis also develops in secondary megacolon, as well as in the presence of various mechanical obstacles to the passage of intestinal contents (tumors, strictures, intestinal compression by an adhesive process, conglomerates of lymph nodes, etc.).
The expansion of all or part of the colon (megacolon) is often accompanied by its lengthening (megadolichocolon). In this case, there is a pronounced thickening of the intestinal wall. Most often, however, these congenital changes occur in the sigmoid colon - dolichosigma. Dolichosigma accounts for 15% of all congenital pathology of the gastrointestinal tract.
Dolichosigma can occur without severe symptoms in childhood, however, in the presence of concomitant pathology of the gastrointestinal tract, it is accompanied by persistent obstipation.
prostasis develops in such patients more often in adolescence or even adulthood.
With bends of dolichosigmoid, as well as with mobile sigmoid and caecum, pain may occur in the right or left half of the abdomen with irradiation to the epigastrium or umbilical region.
In the diagnosis, the dominant role is played by X-ray examination of the large intestine, as well as colonoscopy and sigmoidoscopy.
Clinical manifestations of idiopathic megacolon develop at different age stages, depending on the type of disease. Childhood megacolon occurs in the first year of life. In addition to the characteristic coprostasis, fecal incontinence often develops. The rectum and sigmoid colon expand.
Coprostasis, which developed at an older age, is characteristic of the adult type of idiopathic megacolon. In addition to it, there is an expansion of the entire colon.
Systematic obstipation for many years is the only symptom of the disease. Spontaneous defecation occurs once every 2-3 weeks. At the same time, the stool is of a dense consistency, its diameter and volume are 1.5-2 times larger than usual. Some time after the onset of coprostasis, pulling pains in the abdomen without a specific localization join.
and significantly weaken or disappear completely after the act of defecation.
The tone of the anal sphincter in the initial stages may be normal or increased. In the future, atony of the sphincter may develop with the addition of fecal incontinence. In some cases, there is a complete gaping of the sphincter. The skin of the perianal area is irritated. The ampulla of the rectum is usually tightly filled with dense feces.
The dense consistency of the feces, as well as their significant volume, require pronounced straining, without which the act of defecation becomes impossible. The result of prolonged (up to 20 seconds) straining is the occurrence of cracks in the anus, hemorrhoids. Painful defecation leads to incomplete emptying of the bowel.
Often there are false, or constipation, diarrhea. Their appearance is associated with the release of a large amount of secretion by the irritated rectal mucosa, which thins the feces.
Compacted feces under the influence of segmental contractions of the intestine are compressed into coprolites, which lead to stretching and gaping of the anal sphincter. Fecal masses liquefied by rectal mucus flow around coprolites, bypass the gaping sphincter, and irritate the skin of the perianal zone. Fecal incontinence is often mistaken for diarrhea by patients themselves, so it is necessary to carefully ascertain the history of the disease.
there is a pronounced weakening of the reflex of the act of defecation, but it is not completely lost.
Hirschsprung's disease is most often diagnosed in early childhood. This is a congenital malformation of the large intestine associated with the complete absence (agangliosis), insufficient or abnormal development of intramural nerve ganglia and nerve fibers of the intestinal wall.
The result is a violation of the nervous regulation or complete denervation of the colon with the development of the aperistaltic zone and secondary changes in all layers of the intestinal wall (mucosal, submucosal and muscular).
Due to the appearance of the aperistaltic zone, the passage of intestinal contents is disturbed. Fecal masses accumulate in the denervated area of ​​the intestine, causing a significant stretching of its walls. The adductor segment, on the contrary, is strongly reduced, which initially causes hypertrophy, and then leads to hypotension of its muscle layer.
The main clinical manifestation of the disease is the absence of independent stool. After enemas, feces are excreted in the form of a cork. With age, Hirschsprung's disease always progresses. Patients suffer from fecal intoxication. The only method of treatment is resection of the aganglionic area and part of the dilated area of ​​the colon.
Hirschsprung's disease of adults is spoken of with the development of the main symptoms at a young and middle age. This is possible in the presence of a small, distally located aganglionic area of ​​the intestine, as well as with a deficiency of nerve nodes and fibers in the intestinal wall.
Coprostasis can develop in the presence of a mechanical obstruction to the passage of intestinal contents. The most common cause in the latter case is the tumor process of the large intestine.
In addition, compression of the intestine from the outside by a conglomerate of inflammatory lymph nodes, adhesions, or an inflammatory (tumor) infiltrate can lead to a decrease in the lumen of the intestine.
With such incomplete intestinal obstruction, the size of the obstacle does not play a special role: even if it is negligible, reflex spasm of the intestine can lead to complete obstruction of its lumen. A spasm of the intestinal wall can be caused by taking laxatives, a sharp contraction of the abdominal muscles during straining.
Characteristic of mechanical coprostasis in tumors of the colon is the development of constipation diarrhea. For diagnosis, the test for occult blood and endoscopic methods of examining the colon are of the greatest importance.
Coprostasis in intestinal dyskinesias. Intestinal dyskinesia is classified as a functional disease associated primarily with changes in the nervous regulation of the motor function of the colon. According to the type of motor disorders, dyskinesias are divided into hyper- and hypomotor, according to the nature of their occurrence - into primary and secondary.
Primary dyskinesias develop under the influence of psychogenic factors. Often they are accompanied by a general neurotic personality, but in some cases intestinal neurosis occurs in isolation, being the only symptom of instability in a stressful situation.
Like most neuroses, primary intestinal dyskinesia can develop after a single stress or as a result of prolonged exposure to a traumatic factor or situation.
Intestinal dyskinesia occurs in the age group from 20 to 50 years, women suffer from it more often (2-2.5 times).
In the hypermotor form (irritable bowel syndrome), the stool in patients is very hard, fragmented, looks like dry small balls - the so-called sheep.
As a rule, with an objective examination of any pathological changes in the composition of the stool, it is not possible to identify. Obstipation for some time can be replaced by diarrhea with a frequency of stools up to 3 times a day. Often, patients complain of pain in the left iliac or umbilical region, aggravated after eating. Spasmodic, painful areas of the intestine are determined by palpation.
Sometimes a rather rare form of intestinal dyskinesia develops - mucous colic. It is characterized by severe spastic pains in the abdomen, combined with the release of mucus in the form of films through the anus.
With hypomotor dyskinesia, independent defecation is significantly difficult, but the stool can be large in volume, also without pathological impurities. Usually there is a decrease in the tone of the entire large intestine.
Intestinal dyskinesia in persons prone to neurotic reactions proceeds in waves, and exacerbations usually coincide in time with the impact of a traumatic factor.
Clinical manifestations of coprostasis in dyskinesia of the colon are quite characteristic and differ little from coprostasis of another etiology. Prolonged absence of spontaneous defecation leads to a feeling of distention and fullness in the abdomen, turning into dull pain, patients note empty urge to stool, sometimes with the discharge of scanty dense feces without complete relief.
Patients may complain of a very different nature associated with reflex effects emanating from the intestines, including weakness, fatigue, insomnia, decreased performance, an unpleasant aftertaste in the mouth, and bloating.
Various vegetative dysfunctions, emotional lability can be noted. X-ray and endoscopic methods of research play an important role in the diagnosis.
With hypermotor dyskinesia, irrigoscopy or the method of double contrasting with a barium suspension reveals a spasmodic area of ​​the intestine that looks like a cord, a deep segmented haustration, defined as multiple constrictions. The passage of the contrast agent is accelerated, disordered.
There is incomplete emptying of the sigmoid colon.
With hypokinetic dyskinesia, in addition to reducing the tone of the intestine or its individual segments, the smoothness of haustration and the expansion of the intestinal cavity are determined.
Rectoromanoscopy or colonoscopy with hypermotor dyskinesia reveals the presence of peristalsis, moist mucous membrane, and individual spasmodic areas of the intestine. With hypomotor dyskinesia, peristalsis is not visible, the mucous membrane is dry and dull, the distal intestine may be collapsed.
Despite the functional nature of the disease, prolonged obstipation itself can lead to the development of various organic lesions of both the colon and other organs of the gastrointestinal tract.
When secondary colitis is attached, an admixture of mucus is noted in the stool, more often it is located on the surface of dry fecal balls in the form of whitish threads.
Coprostasis can be complicated by the occurrence of various anorectal diseases - anal fissures, hemorrhoids, paraproctitis. Then signs of rectal bleeding, pain during defecation, inflammatory changes in perianal tissues join the typical symptoms of obstipation.
Reflux of the contents of the large intestine into the small intestine during straining can lead to the colonization of the small intestine with an unusual microflora of the large intestine. The effect of intestinal dysbiosis may be the development of acute or chronic enteritis, cholecystitis, cholangitis.
Increased intracavitary pressure in the colon is one of the causes of intestinal diverticulosis. Fecal stones, which can form even at a young age, often lead to the development of intestinal obstruction.
Chronic coprostasis plays a certain role in oncogenesis: a number of carcinogens, which are products of bacterial metabolism, have the possibility of prolonged contact with the intestinal mucosa as a result of stagnation of its contents during obstipation.
Secondary intestinal dyskinesia occurs as a result of reflex influences from pathologically altered organs of the gastrointestinal tract and pelvic organs. The secondary nature of the disorders is indicated by a clear connection between the exacerbation of the underlying disease and the increase in coprostasis, as well as the disappearance of obstipation in the phase of its remission.
Coprostasis is characteristic of a number of diseases of the stomach - gastritis with normal and increased secretion, peptic ulcer. Often it accompanies chronic cholecystitis, both calculous and acalculous. Obstipation develops in every fifth patient with chronic enteritis and in every second with chronic colitis.
Reflex effects on the colon from the pelvic organs in urolithiasis, appendicitis, chronic salpingo-oophoritis and endometritis also lead to the development of intestinal dyskinesia and coprostasis.
Particular attention is paid to proctogenic dyskinesias in patients with pathology of the anorectal region (proctitis, paraproctitis, sphincteritis, hemorrhoids, anal fissures). Coprostasis in this kind of dyskinesia occurs both due to inflammatory changes in the rectum and anus, and in connection with reflex spasm of the internal and external sphincters.
In such patients, the dominant complaints are pathological difficulty in the act of defecation, pain in the anus, discharge of scarlet blood with stool due to abrasions or cracks, prolapse of hemorrhoids and rectal mucosa.
Obstipation is enhanced by the conscious volitional effort of patients to prevent defecation, which they try to avoid due to severe pain.

What is coprostasis in humans?

Intestinal infections, poor circulation, frequent use of laxatives - all this leads to the fact that a person begins to experience difficulty in emptying the intestines.

Many do not even know what coprostasis is in humans. Although recently, cases of its occurrence have ceased to be a rarity. The eating habits of a modern person lead to the fact that the digestive system begins to work differently. The use of fast food, processed foods and fruits treated with chemicals disrupts the functioning of not only the digestive system, but the whole organism as a whole. After all, everyone knows that all systems are interconnected and if a failure occurs in one place, then the rest of the organs begin to work differently than before.

Coprostasis: symptoms

A downed diet will certainly affect the motor function of the intestine. If a person gets up late, his work of the gastroileocecal reflex is disrupted, which means that the feces move through the intestines, but defecation does not occur.

In order for emptying to occur in a timely manner and at the same time fecal stagnation does not affect health, it is also necessary to consume at least a liter of water per day. Physical activity is of great importance. Lately, people have stopped moving. Children make all movements by running, with age this activity disappears, movements become less and less, and health problems appear. Coprostasis symptoms: abdominal pain, nausea, constipation, heartburn and skin problems.

Causes and signs of coprostasis

Sometimes constipation occurs due to the fact that, due to circumstances, a person had to suppress the urge to defecate, because defecation is a complex conditioned reflex act in which the abdominal press, anal sphincters and rectal receptors work. Stopping reflexes, suppressing them is a step against nature. The culture does not allow us to do whatever the body wants at any time, so we constantly suppress our reflexes, calling it education. But education has its drawbacks, to go against nature - to disrupt the work of the whole organism.

The causes and signs of coprostasis are described in many medical encyclopedias. Signs are the absence of stool for a certain time, abdominal pain, dermatological problems, and so on. The causes of coprostasis are mainly in violation of the diet and the inclusion in the diet of refined foods that do not give the digestive system work.

Alimentary coprostasis

Modern people mainly consume refined foods, which are practically devoid of fiber. This leads to the fact that there is no stimulation of intestinal motility with food. Alimentary coprostasis occurs in people with an incorrect chewing apparatus. In order for the digestive system to work as it should, it is advisable to give up refined foods and follow the daily routine, that is, eat food at a certain time and try to be physically active.

Mechanical coprostasis

When the rectal ampulla is stretched, the defecation reflex is activated. The well-coordinated work of the circular muscles of the sphincters and the abdominal press allows the evacuation of feces from the intestines. If a person is unable to empty his bowels, then he can tighten the muscles of the anus and pelvic floor, as a result of which defecation will not occur. If you do not find an opportunity to empty the intestines in the near future, the feces will stretch the rectum. And if you often suppress the act of defecation, the intestinal receptors will lose their sensitivity.

Mechanical coprostasis leads to the fact that a person's complexion becomes earthy, plaque appears on the tongue, and signs of normochromic anemia also appear.

Toxic coprostasis

If a person has lost his appetite, he is not even interested in his favorite dishes, weakness and fatigue have appeared, and frequent headaches torment him, this means that you need to go to the doctor for help. Toxic coprostasis occurs with chronic intoxication with drugs, heavy metals, and also when a person smokes a lot and takes alcohol. Mercury or lead intoxication is often associated with work, in order to identify harmful substances in the body, it is necessary to donate blood and urine for analysis.

Reflex coprostasis

Violation of the water and electrolyte balance leads to the appearance of diseases such as reflex coprostasis, various dermatological problems and malfunctions of the digestive system. Since potassium ions are formed in the large intestine, hypokalemia leads to coprostasis. This happens with kidney failure and heart disease.

Neurogenic coprostasis

Pathologies of the peripheral and central nervous systems are often complicated by neurogenic coprostasis. Schizophrenia, anorexia nervosa, the depressive phase of presenile and manic-depressive psychoses are accompanied by obstipation. People with these mental illnesses see doctors, usually gastroenterologists. As a result of the examination, it is revealed that problems with emptying the intestines arise due to the disruption of the mechanisms of the nervous regulation of intestinal functions.

Endocrine coprostasis

Diseases such as hypothyroidism, acromegaly, and hyperparathyroidism often manifest themselves as stool retention. Endocrine coprostasis must be treated together with a gastroenterologist and an endocrinologist, only their joint work will give a good result. Treatment of this disease is impossible without correction of the endocrine status. In order to restore the functioning of the colon, you must follow the diet prescribed by your doctor.

Chronic coprostasis

In order for the disease not to become chronic, it is necessary to consult a doctor in a timely manner and undergo a qualitative examination. Chronic coprostasis occurs due to the fact that a person does not pay attention to frequent constipation, it seems to him that everything will pass by itself. Days turn into weeks, then into months, the problem is not solved and does not go away on its own, complications appear in which not only the digestive system suffers, but the whole organism as a whole.

Coprostasis: treatment

In order to be cured of any disease, it is necessary from time to time to go to the clinic and undergo an examination. Coprostasis treatment is most often carried out by a gastroenterologist. However, it all depends on what caused the onset of the disease. To do this, first of all, you need to visit a therapist, take tests, and only then it will be clear in which direction to move on.

Medical preparations

Depending on the cause of the appearance of coprostasis, certain medications are prescribed. It happens that you can get rid of this disease with elementary diet therapy and small physical exertion. There are frequent cases of coprostasis, which appeared as a result of the use of medicines.

Coprostasis: treatment with folk remedies

Nature gives us its riches, and people most often do not know how to use them. Coprostasis treatment with folk remedies is quite possible if the disease has not become chronic. In order to improve the functioning of the intestines, you need to drink water. In the morning on an empty stomach, a glass of cold water, you can with a spoonful of honey, will allow you to start the work of the body and be filled with the energy of the morning. At night, you can drink beetroot juice diluted with water. Flaxseed is also useful for the intestines, which must be ground and added to kefir.