Bowel emptying disorders

Intestinal emptying disorders include constipation, encopresis, fecal incontinence, and diarrhea. The physiological frequency of bowel movements varies with age.

Constipation

Constipation is defined as the difficulty of emptying stiff stools and the inability to spontaneously defecate. This is partially subjective. It can be an isolated problem (dyschezia) or a symptom accompanying another disease (organic, secondary constipation). It is very important to distinguish organic constipation from functional constipation.

 For more information see Constipation.

 For more information see Constipation (pediatrics).

Definition of constipation according to the Roman criteria II (1999)

Some of the following must apply:

• less than 3 stools per week;
• solid stool in more than 25% of defecations;
• feeling of incomplete emptying in more than 25% of defecations;
• the need for manual maneuvers to facilitate more than 25% of defecations (digital stool evacuation, pelvic floor support).

Pathogenesis

Decreased water content in the stool, prolonged passage time through the digestive tract, and/or the presence of a mechanical barrier in the terminal part of the digestive tract contribute to constipation.

Therapy

Regimen and dietary measures

• Regular daily eating regime, sufficient fluid intake, and enough fiber in the diet (whole grains, fruits, vegetables).
• Plenty of exercise, belly massage, and no laxatives.
• Training of defecation reflex with the use of physiological gastrocolic reflex (after waking up a glass of water, usual morning tasks, breakfast, with an interval of 20–30 minutes attempted defecation).

Pharmacological treatment

Lactulose, saline laxatives, laxative minerals, enemas, drugs stimulating colonic motility.

Supposed constipation

• Improper judgement or psychological disorder.

Pseudoobstruction

• It occurs with low food intake.

Encopresis

• Involuntary bowel emptying (into clothes, to the floor)

Soiling

• involuntary leakage of stool in chronic constipation
• stagnant stool in the rectum escapes
• may be mistaken for diarrhea

Diarrhea

Diarrhea can be characterized as frequent bowel movements. This is a symptom with considerable subjective variation. Diarrhea is a common manifestation of various digestive disorders. Diarrheal diseases cause up to 20 million deaths a year worldwide, with young children most at risk.

 For more information see Diarrhea.

 For more information see Diarrhea (pediatrics).

 For more information see Differential diagnosis of diarrheal diseases.

 For more information see Therapy of diarrheal diseases.

Links

Literature

• HRODEK, Otto – VAVŘINEC, Jan, et al. Pediatrie. 1. edition. Praha : Galén, 2002. ISBN 80-7262-178-5.

• ŠAŠINKA, Miroslav – ŠAGÁT, Tibor – KOVÁCS, László, et al. Pediatria. 2. edition. Bratislava : Herba, 2007. ISBN 978-80-89171-49-1.