Functional constipation in patients with injuries of the musculoskeletal system
https://doi.org/10.21518/ms2023-126
Abstract
This paper highlights the problem of functional constipation, its epidemiology, etiology, features of the clinical picture during prolonged immobilization in injured patients, and approaches to therapy. Stool retention in patients undergoing prolonged immobilization is an urgent medical problem, since it occurs in most of these patients. The paper presents a clinical example of managing a patient with an injury to the musculoskeletal system and functional constipation. Functional constipation is associated with a number of pathophysiological processes: genetic characteristics, lifestyle (lack of physical activity) and eating style characteristic of Western cultures (low intake of dietary fiber and water), intestinal movement disorders that can be caused by numerous causes (neurogenic factors , diseases of the endocrine glands, circulatory disorders in the intestinal vessels, taking certain medications), anatomical features (dolichosigma), as well as social factors (late awakening, morning rush, work in different shifts, changes in the usual living and working conditions) and psychological patient features. The possibilities of lifestyle modification in patients with injuries of the musculoskeletal system are very limited, and special attention should be paid to correcting nutrition and observing the drinking regimen. The key point in the treatment of functional constipation in such patients will be the appointment of stimulant laxatives, one of which is sodium picosulfate. At the stages of treatment and rehabilitation, the patient should be recommended measures for modifying lifestyle and nutrition, exercise therapy in accordance with his physical capabilities and clinical recommendations for the treatment of constipation.
About the Authors
Yu. A. Lazareva
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Yulia A. Lazareva, Lecturer of the 2nd Department (Therapy of Advanced Training of Doctors)
6, Akademik Lebedev St., St Petersburg, 194044
D. V. Egorov
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Denis V. Egorov, Cand. Sci. (Med.), Senior Lecturer of the 2nd Department (Therapy of Advanced Training of Doctors)
6, Akademik Lebedev St., St Petersburg, 194044
P. V. Seliverstov
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Pavel V. Seliverstov, Cand. Sci. (Med.), Associate Professor of the 2nd Department (Therapy of Advanced Training of Doctors)
6, Akademik Lebedev St., St Petersburg, 194044
References
1. Bochkareva T.I. Adaptive physical training during the rehabilitation of patients with chronic atonic constipation. Uchenye Zapiski Universiteta imeni P.F. Lesgafta. 2022;(11):51–57. (In Russ.) Available at: https://lesgaft-notes.spb.ru/ru/node/24538.
2. Ivashkin V.T., Shelygin Yu.A., Maev I.V., Sheptulin A.A., Aleshin D.V., Achkasov S.I. et al. Clinical Recommendations of the Russian Gastroenterological Association and Association of Coloproctologists of Russia on Diagnosis and Treatment of Constipation in Adults. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(6):69–85. (In Russ.) https://doi.org/10.22416/1382-4376-2020-30-6-69-85.
3. Lazebnik L.B., Turkina S.V., Golovanova E.V., Ardatskaya M.D., Ostroumova O.D., Komissarenko I.A. et al. Constipation in adults. Experimental and Clinical Gastroenterology. 2020;(3):10–33. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-175-3-10-33.
4. Shemerovskii K.A., Seliverstov P.V. Bradienteria syndrome in the Internal Medicine clinic. Experimental and Clinical Gastroenterology. 2021;(12):53–61. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-196-12-53-61.
5. Kokarev Yu.S. Management of geriatric patients suffering from chronic constipation. Kuban Scientific Medical Bulletin. 2018;25(1):163–171. (In Russ.) https://doi.org/10.25207/1608-6228-2018-25-1-163-171.
6. Sas E.I., Grinevich V.В. Difficult patient. Management of resistant constipation. Meditsinskiy Sovet. 2019;(14):88–92. (In Russ.) https://doi.org/10.21518/2079-701X-2019-14-88-92.
7. Davydova A.Ya., Pomytkina T.E. Chronic constipation in elderly patients: features of therapy. In: Biomedical, clinical and social issues of human health and pathology: materials of the 5th All-Russian scientific conference of students and young scientists with international participation, Ivanovo, April 9–11, 2019. Ivanovo: Ivanovo State Medical Academy; 2019, pp. 71–72. (In Russ.) Available at: https://elibrary.ru/item.asp?id=41397830&pff=1.
8. Lindberg G., Hamid S.S., Malfertheiner P., Thomsen O.O., Fernandez L.B., Garisch J. et al. World Gastroenterology Organisation global guideline: Constipation – a global perspective. J Clin Gastroenterol. 2011;45(6):483–487. https://doi.org/10.1097/mcg.0b013e31820fb914.
9. Livzan M.A., Osipenko M.F. Chronic constipation: from a symptom to diagnosis and effective therapy. Our algorithm. RMJ. 2016;(11):678–681. (In Russ.) Available at: https://www.rmj.ru/articles/gastroenterologiya/Hronicheskiy_zapor_ot_simptoma_k_diagnozu_i_effektivnoy_terapii_Algoritm_nashih_deystviy/.
10. Shemerovskiy K.A. Prenosological approach for prevention of intestinal and extraintestinal pathology. Russian Biomedical Research. 2019;2(1):50–56. (In Russ.) Available at: http://ojs3.gpmu.org/index.php/biomedical-research/article/view/407.
11. Kucheriavyi Yu.A., Andreev D.N., Cheremushkin S.V. Chronic constipation: actuality, problems and modern treatment options. Consilium Medicum. 2017;19(8):116–120. (In Russ.) Available at: https://consilium.orscience.ru/2075-1753/article/view/94941.
12. Shemerovsky K.A., Seliverstov P.V., Shaidullina S.R., Berezina T.P., Yurov A.Yu., Fedorets V.N. The dependence of circadian defecation rhythm regularity on the position of the rhythm’s acrophase in the circadian cycle. Russian Biomedical Research. 2020;4(1):31–34. (In Russ.) Available at: http://ojs3.gpmu.org/index.php/biomedical-research/article/view/553.
13. Drossman D.A., Hasler W.L. Rome IV – Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016;150(6):1257–1261. https://doi.org/10.1053/j.gastro.2016.03.035.
14. Parfenov A.I., Indeikina L.Kh., Belyaeva A.A., Pavlov M.V., Orlova N.V., Atroshchenko A.O. et al. Chronic constipation: guidelines. Moscow: Prima Print; 2016. 52 p. (In Russ.) Available at: https://www.gastroscan.ru/literature/pdf/parfenov-ai-gr.zap.pdf.
15. Bharucha A.E., Dorn S.D., Lembo A., Pressman A. American Gastroenterological Association medical position statement on constipation. Gastroenterology. 2013;144(1):211–217. https://doi.org/10.1053/j.gastro.2012.10.029.
16. Dukas L., Willett W.C., Giovannucci E.L. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol. 2003;98(8):1790–1796. https://doi.org/10.1111/j.1572-0241.2003.07591.x.
17. Chu H., Zhong L., Li H., Zhang X., Zhang J., Hou X. Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in china. Gastroenterol Res Pract. 2014:532734. https://doi.org/10.1155/2014/532734.
18. Gao R., Tao Y., Zhou C., Li J., Wang X., Chen L. et al. Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials. Scand J Gastroenterol. 2019;54(2):169–177. https://doi.org/10.1080/00365521.2019.1568544.
19. Branch R.L., Butt T.F. Drug-induced constipation. Adverse Drug React Bull. 2009;(257):987–990. https://doi.org/10.1097/FAD.0b013e32833080d1.
20. Enck P., Leinert J., Smid M., Köhler T., Schwille-Kiuntke J. Functional Constipation and Constipation-Predominant Irritable Bowel Syndrome in the General Population: Data from the GECCO Study. Gastroenterol Res Pract. 2016:3186016. https://doi.org/10.1155/2016/3186016.
21. Shemerovsky K.A., Seliverstov P.V., Bochkarev M.V., Shaidullina S.R. Chronophysiological mechanism of the circadian rhythm Regularity of the intestine evacuation function. Experimental and Clinical Gastroenterology. 2019;(5):150–153. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-165-5-150-153.
Review
For citations:
Lazareva YA, Egorov DV, Seliverstov PV. Functional constipation in patients with injuries of the musculoskeletal system. Meditsinskiy sovet = Medical Council. 2023;(8):182-187. (In Russ.) https://doi.org/10.21518/ms2023-126
Views:
361
Email this article 