A modern view of the problem of constipation
https://doi.org/10.51793/OS.2024.27.2.007
Abstract
Background. PA new chronomedical approach to the classification of one of the most common syndromes in modern medicine, the constipation syndrome, is presented. According to Robert Hegglin "сonstipation is the absence of defecation for 24 hours". In contrast to the previously accepted "Roman Criteria of Constipation" (Rome IV), 2016, which recommended doctors to focus only on the frequency of defecation less than 3 times a week, a more reasonable chronophysiological approach to the criteria of this syndrome is presented. There are 2 more earliest stages of constipation that have not been diagnosed before. The first stage of constipation (mild) is with a frequency of defecation 5-6 times a week. The second stage of constipation (moderate) is with a frequency of defecation 3-4 times a week. The frequency of defecation, presented in the Roman criteria for constipation (less than three times a week), in the modern classification of constipation is presented as the third (severe) stage – with a frequency of defecation 1-2 times a week.
Conclusions. It has been proven that the therapy of patients suffering from constipation is more effective at diagnosing the first and second stages of this syndrome than at the third stage of constipation. The presence of three stages of constipation is confirmed by a progressive (from stage I to stage III) deterioration in the quality of life, an increasing level of anxiety and depression, and an increase in the intake of laxatives from the first to the third stage of constipation. Examples of effective therapy of patients with constipation with the psyllium are presented.
About the Authors
Konstantin A. Shemerovskii
Private educational institution of higher education St. Petersburg Medical and Social Institute
Russian Federation
Russian Federation
Konstantin A. Shemerovskii, Dr. Of Sci. (Med.), Professor,
72, lit. A Kondratievsky Ave., St. Petersburg, 195067.
Raisa K. Kantemirova
Federal State Budgetary Educational Institution of Higher Education St. Petersburg State University; Federal State Budgetary Institution Federal Scientific and Educational Center for Medical and Social Expertise and Rehabilitation named after G. A. Albrecht of the Ministry of Labor and Social Protection of the Russian Federation
Russian Federation
Russian Federation
Raisa K. Kantemirova, Honored Doctor of the Russian Federation, Dr. Of Sci. (Med.), Professor of the Department of Hospital Therapy of the Faculty of Medicine; Head of the Therapeutic Department of the Clinic, Head of the Department of Therapy of the Institute of Training Specialists in Medical and Social Rehabilitation,
7-9 Universitetskaya nab., St. Petersburg, 199034;
50 Bestuzhevskaya str., St. Petersburg, 195067,
Pavel V. Seliverstov
Federal State Budgetary Military Educational Institution of Higher Education S. M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Pavel V. Seliverstov, Cand. Of Sci. (Med.), Associate Professor, 2nd Department (Department of Therapy for Advanced Training),
6, Akademika Lebedeva str., Saint Petersburg, 194044.
References
1. Drossman D. A., Hasler W. L. Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction. Gastroenterology. 2016; 150 (6): 1257-1261. DOI: 10.1053/j.gastro.2016.03.035.
2. Hegglin R. Differential diagnosis of internal diseases. Translated from German. Ed. by E. M. Tareev. Moscow: Ed. "Engineer", 1993. P. 557. (In Russ.)
3. Shemerovskii K. A. Circadian rhythm of rectal reactivity in individuals with regular and irregular bowel evacuation function. Bull Exp Biol Med. 2002; 134 (6): 565-567. DOI: 10.1023/a:1022965212971.
4. Shemerovskii K. A. Chronoenterography: monitoring of circadian rhythm of the intestinal evacuatory function. Bull Exp Biol Med. 2002; 133 (5): 503-505. DOI: 10.1023/a:1019834409733.
5. Shemerovsky K. A., Ganapolsky V. P., Kharin M. A. Regularity of the rhythm of the brain and intestines and the level of happiness. Meditsinskaya sestra. 2022; 5 (24): 15-19. (In Russ.)
6. Zimmerman Ya. S. Clinical gastroenterology. Chapter 12. Chronic constipation. Moscow: GEOTAR-Media, 2009. Pp. 255-277. (In Russ.)
7. Klimov A. N., Nikulcheva N. G. Lipids, lipoproteins and atherosclerosis. 1995. (In Russ.)
8. Shemerovsky K. A. Chronophysiological risk factor for constipation. Rossiisk. zhurn. gastroenterol., gepatol. i koloproktol. 2000; 3: 63-66. (In Russ.)
9. Shemerovskii K. A. Recommendations for diagnosis, correction and prevention of constipation. 2023. 41 p. (In Russ.)
10. Agafonova N. A., Yakovenko E. P. Chronic constipation syndrome in patients abusing irritant laxatives. RMZh. 2010; 28: 1735. (In Russ.)
11. Ivanyuk E. S., Seliverstov P. V., Salikova S. P., Kutsenko V. Р. Role of chronic constipation in development of cardiovascular pathology. Meditsinskii alfavit. 2023; (28): 7-12. https://doi.org/10.33667/2078-5631-2023-28-7-12. (In Russ.)
12. Gubergrits N. B., Belyaeva N. V., Klochkova A. E., Lukashevich G. M., Fomenko P. G. Liver in metabolic syndrome and obesity: how to protect it. M.: Prima Print, 2021. 80 p. (In Russ.)
13. Anderson J. W., Jones A. E., Riddell-Mason S. Ten different dietary fibers have significantly different effects on serum and liver lipids of cholesterol-fed rats. J. Nutr. 124: 78-83, 1994.
14. Ginzburg M. M. Experience of using the drug Mucofalk in complex therapy in patients with obesity and metabolic syndrome. Samara: Research Institute Dietetics and dietotherapy, 2010. 9 p. (In Russ.)
15. Mayevskaya E. A., Mayev I. V., Kucheryavy Yu. A., Cheremushkin S. V., Andreev D. N. Assessment of the effect of lactulose or dietary fiber on the dynamics of indicators lipid profile in patients with functional constipation and nonalcoholic steatohepatitis. Lechaschi Vrach. 2016. 2016; 4: 117. (In Russ.)
16. Fleming V., Wade W. E. A review of laxative therapies for treatment of chronic constipation in older adults. Am J Geriatr Pharmacother. 2010; 8 (6): 514-550. DOI: 10.1016/S1543-5946(10)80003-0.
17. Bakulin I. G. Oganezova I. A., Bakulina N. V. and others. Ambulatornaya gastroenterologiya. A guide for doctors. Moscow: UMI, 2020. 300 p. (In Russ.)
18. Lazebnik L. B., Turkina S. V., Golovanova E. V. and others. Constipation in adults. Eksperimentalnaya i klinicheskaya gastroenterologiya.2020; 3 (175): 10-33. (In Russ.)
19. Shemerovsky K. A., Seliverstov P. V. Bradyenteria syndrome as an inducer of polypragmasia. In the book "Days of rheumatology in St. Petersburg – 2022". All-Russian Congress with international participation. St. Petersburg, 2022. Pp. 167-168. (In Russ.)
20. Shemerovsky K. A., Kantemirova R. K., Seliverstov P. V. Depression and polypragmasia in bradyenteria syndrome. In the book "All-Russian Congress with international participation Days of Rheumatology in St. Petersburg – 2023. Pp. 188-189. (In Russ.)
21. The incidence of colorectal bradyarrhythmia syndrome in the elderly Patients. Meditsinskii alfavit. 2022; 18: 45-47. (In Russ.)
22. Shemerovskii K. A., Seliverstov P. V., Ivanyuk E. S. Colorectal bradyarrhythmia syndrome as a risk factor for constipation and colorectal cancer. Meditsinskii alfavit. 2022; 28: 7-11. (In Russ.)
23. Shemerovskii K. A., Kantemirova R. K., Seliverstov P. V. Bradyenteria Syndrome and Comorbidity. United European Gastroenterology Journal. 2022; 10: 1081.
24. Shemerovskii K. A., Kantemirova R. K., Seliverstov P. V. Bradyenteria syndrome increases the risk of obesity and hypertension. Terapiya. 2022. Vol. 8. No. S7 (59). pp. 102-103. (In Russ.)
25. Shemerovsky K. A., Kantemirova R. K., Seliverstov P. V., Vasiliev V. V. Non-drug restoration of stool rhythm in young and elderly patients. Universitetskii terapevticheskii vestnik. 2022; 5 (4): 127-128. (In Russ.)
26. Shemerovsky K. A., Seliverstov P. V. Bradyenteria syndrome in the clinic of internal diseases. Eksperimentalnaya i klinicheskaya gastroenterologiya. 2021; 12 (196): 53-61. (In Russ.)
27. Shemerovskii K. A., Kantemirova R. K., Seliverstov P. V. Irregular bowel habit increases the risk of anxiety and depression. Journal of United European Gastroenterology. Volume 11, Issue S8, 31st United European Gastroenterology Week. 2023, PP1083, p. 1160-1161.
28. Shemerovsky K. A., Seliverstov P. V., Bochkarev M. V., Shaidullina S. R. Chronophysiological mechanism of regularity of circadian rhythm of intestinal evacuation function. Eksperimentalnaya i clinicheskaya gastroenterologiya. 2019. No. 5 (165). p. 150-153. (In Russ.)
Review
For citations:
Shemerovskii K.A., Kantemirova R.K., Seliverstov P.V. A modern view of the problem of constipation. Lechaschi Vrach. 2024;(2):36-42. (In Russ.) https://doi.org/10.51793/OS.2024.27.2.007
Views:
303
JATS XML
Email this article 
