Проблемы, связанные с актом дефекации — дело интимного характера. Многие люди испытывают какие-либо нарушения, но стесняются обратиться к специалисту. Затягивание и игнорирование проблемы ухудшает прогноз при многих патологиях. Так, чувство неполного опорожнения кишечника может сигнализировать о серьезных сбоях в организме. Кроме того, это состояние вызывает дискомфорт, снижает качество жизни.
Причины неполного опорожнения
Это распространенное нарушение часто случается с жителями мегаполисов и связано с низкой физической активностью, а также неудовлетворительным качеством употребляемых продуктов. Кроме неприятных физических ощущений, состояние, при котором кишечник будто не опорожняется полностью, вызывает психоэмоциональные расстройства. Человек боится попасть в неловкое положение, поэтому не может выходить далеко из дома. Навязчивые мысли и страх делают его заложником туалета.
Нарушение могут вызывать причины физиологического и психологического характера. Неполное опорожнение также может спровоцировать поведенческий фактор и наследственная предрасположенность.
Наиболее частые причины проблемы:
- синдром раздраженного кишечника;
- внутренние геморроидальные узлы;
- раковые опухоли и полипы;
- воспалительные заболевания слизистой кишечника (проктит, колит);
- врожденные дефекты строения кишки;
- послеоперационные спайки, перекруты;
- гормональные нарушения (диабет, ожирение, изменения в работе щитовидной железы).
У женщин причины могут быть связаны с гинекологическими заболеваниями и спайками органов малого таза. Поведенческий фактор тесно связан с образом жизни, сложившимися стереотипами. Пожилой возраст, неправильное питание, отсутствие четкого режима дня, гиподинамия тоже приводят к застойным явлениям, снижению метаболизма. Это нарушает процессы выведения шлаков и очищения организма.
Симптомы
В норме стул появляется раз в 1-2 дня. Если дефекация происходит реже, это расценивается как запор, частое появление стула — понос. Ощущение неполного опорожнения вызывает чувство неудовлетворения дефекацией.
Сбои в работе кишечника сказывается и на других органах.
Когда человек страдает длительное время, симптомы становятся серьезнее и мучительнее. Наиболее характерны такие жалобы:
- чувство тяжести в области живота;
- переполнение кишечника;
- боль в животе слева;
- ложные позывы;
- запоры со слизью в кале;
- постоянное урчание, не связанное с приемом пищи;
- появление крови в каловых массах.
Боль в кишечнике проходит после дефекации. При запоре появляется небольшое количество твердого кала с примесью слизи. Кроме того, человек может испытывать беспокойство и раздражительность без видимой причины, нарушается сон. Возможна головная боль, шум в ушах. Снижается аппетит, появляется тошнота.
При хроническом течении во время рецидивов возникает синдром общей интоксикации. Снижается работоспособность, постоянно присутствует усталость, слабость. Чувство неполного опорожнения после дефекации может быть и при поносе. Тогда стул будет водянистым и слизистым.
Диагностика
Для постановки диагноза важен анамнез пациента. Необходимо исключить врожденные аномалии кишечника и генетическую предрасположенность к проблеме.
Врачу важно знать, как долго наблюдаются нарушения, проводились ли операции на брюшной полости, есть ли сопутствующие заболевания. Возможно, недостаточное опорожнение прямой кишки связано с неправильным питанием.
Для диагностики существуют обязательные виды обследования:
- пальцевое исследование прямой кишки;
- клинические анализы крови и мочи;
- биохимические исследования крови;
- копрограмма, кал на скрытую кровь;
- УЗИ брюшной полости.
Если есть подозрение на инфекционные заболевания, назначают бактериологический посев кала на микрофлору и чувствительность к антибиотикам. Эти анализы помогают выявить возбудителя.
Дополнительное обследование позволит определить синдром раздраженного кишечника, но для диагностики требуется определенная подготовка. Нужно не принимать антибиотики, слабительные, препараты железа и калия. Питаться стоит понемногу, дробно. Не рекомендуется употреблять продукты, провоцирующие вздутие, следует отказаться от кофе и алкоголя.
В особых случаях, когда диагноз затруднен, используют другие методы обследования.
Для исключения кишечной непроходимости и врожденных нарушений делают обзорную рентгенографию с контрастным веществом. С помощью специальных аппаратов проводят визуальный осмотр толстой кишки — это колоноскопия, ирригоскопия, ректороманоскопия. Перечисленные процедуры позволяют обнаружить опухоли, спайки, кровотечения или воспалительные процессы.
Лечение
Необходимые методы терапии врачи назначают после выяснения причин недуга и постановки диагноза. Неполное опорожнение прямой кишки — лишь симптом. Лечить же предстоит заболевание, вызвавшее такое состояние.
Обращаться следует к семейному доктору или терапевту, скорее всего, потребуется консультация проктолога и гастроэнтеролога. Понадобятся рекомендации диетолога, врача физиотерапевта.
Питание
Правильное сбалансированное питание — залог успеха в лечении такого нарушения:
- обогащение рациона клетчаткой;
- дробный прием пищи;
- интенсивный питьевой режим.
Порции должны быть небольшими, принимать их необходимо 5-6 раз в день. Полезны продукты, богатые клетчаткой, поскольку они улучшают моторику кишечника.
Суточное количество выпитой жидкости должно составлять не меньше 2 литров. Обязателен первый стакан воды утром натощак.
В рационе должны присутствовать кисломолочные продукты — йогурт, кефир.
Некоторые пациенты реже испытывали спазмы после добавления в меню киселя, крепкого чая, сухарей.
Недопустим алкоголь, жирные, копченые, острые блюда. При покупке готовых продуктов следует помнить о содержании в них консервантов, ароматизаторов и красителей. Их стоит избегать. Все продукты должны быть качественными и свежими.
Образ жизни
Посильные и регулярные физические нагрузки просто необходимы каждому человеку. Нужно четко соблюдать режим дня, достаточное время уделять прогулкам. Обязателен полноценный ночной сон.
Нужно приучить себя к ежедневному очищению кишечника по времени.
Тогда каловые массы не будут скапливаться, а выделяющиеся токсины не отравят организм. А также нужно отказаться от курения и алкоголя.
Важно ограждать себя от стрессовых ситуаций. Расстройство опорожнения чаще встречается у психически неустойчивых людей. Они склонны к самоанализу, малейший конфуз и неприятности могут вызвать психологический срыв. При таким пациентам необходимости нужно обратиться за консультацией к психотерапевту.
Лечение препаратами
Медикаментозная помощь направлена на устранение симптомов. При ощущении неполного опорожнения необходимы средства для нормализации микрофлоры кишечника и борьбы с газообразованием: Хилак Форте, Панкреатин, Эспумизан. Чтобы не допустить вздутия, используют Симектион.
Безболезненно опорожнить кишечник помогут прокинетики. Это свечи с глицерином, препараты Бисакодил, Мотилиум, Дюфалак.
В качестве обезболивающих средств назначают Но-шпу, Дицетел, Папаверин, свечи Спазмомен, особенно если есть признаки геморроя. Когда неприятные ощущения связаны с поносом, можно принять Лоперамид, Смекту.
Физиотерапия
Лечебные процедуры дают хороший эффект. Чаще назначается электростимуляция кишечника, мониторинговая очистка, а также массаж. Из водных процедур рекомендуются жемчужные ванны, гидромассаж. При неврологических проблемах применяют акупунктуру.
Хирургическое вмешательство
В некоторых ситуациях необходимо хирургическое вмешательство. Порой это единственный выход: при кишечной непроходимости, раковых опухолях и полипах. Операцию делают пациентам с врожденными дефектами, спайками кишечника, а также при геморрое.
Народные советы
При ощущении неполного опорожнения кишечника болевой синдром хорошо устраняет отвар ромашки или мяты. Масло мяты перечной снимает спазмы гладкой мускулатуры, способствует отхождению газов.
От поноса можно использовать экстракты таких растений, как бузина, кровохлебка, а также пшенную кашу. При запорах принимают алоэ, голубику, сок лука.
Возможные осложнения и профилактика
Хронический патологический процесс приводит к органическим изменениям стенок прямой кишки. Отсутствие стула и застойные явления вызывают отравление всего организма. Возникают его яркие симптомы: частые головные боли, нарушение сна, раздражительность, снижение аппетита.
Уплотненные каловые массы травмируют анальный сфинктер при опорожнении, появляются прожилки крови в фекалиях, образуются трещинки на слизистой. Присоединившаяся инфекция приводит к гнойным воспалениям, язвам.
Хронический процесс провоцирует рост каловых камней, что опасно частичной или полной непроходимостью.
Появление крови в кале говорит о кровотечении или прободении кишки, что требует немедленной хирургической помощи. Проблемы с дефекацией — причина постоянных потуг. В этот период задерживается дыхание, возникает головокружение, повышается давление. Это опасно для людей с заболеваниями сердца и сосудов.
Частое использование свечей и других лекарственных препаратов вызывает привыкание. Кроме того, препараты имеют противопоказания к применению.
Основная составляющая профилактики проблем с кишечником — здоровый образ жизни. Это понятие подразумевает физическую активность, отказ от вредных привычек. Необходимо ввести достаточное количество воды и клетчатки в питание. Для укрепления нервной системы, предупреждения стрессовых ситуаций и психологических расстройств в комплексе полезно принимать витамины группы B.
Нарушение пищеварительных функций желудка, которое проявляется запорами, дискомфортом, диареей и другими симптомами, рано или поздно встречается практически у каждого человека.
Эти признаки характерны для синдрома неполного опорожнения кишечника.
Геморрой и неполное опорожнение кишечника
Чувство неполного опорожнения кишечника является симптомом геморроя и других проктологических заболеваний (ректоцеле, полипов, кондилом и пр.).
При этом снижается качество жизни пациента, поэтому следует налаживать работу пищеварительного акта, устраняя причины нарушения.
В основном проблема возникает у жителей крупных городов, связана с низкой физической активностью в обычной жизни.
Что провоцирует нарушение
Выделяют несколько причин, которые могут вызвать неполное опорожнение кишечника.
- стрессы и нервные потрясения, в основном склонны к этим факторам нервные, мнительные люди с повышенной возбудимостью;
- наследственность и возраст пациента;
- перенесенные инфекции пищеварительных органов с дальнейшим дисбактериозом;
- травмы;
- нарушение режима питания и распорядка;
- малоподвижность;
- гормональные дисфункции (избыточный вес, сахарный диабет, гипотериоз, климакс или предменструальный синдром);
- гинекологические болезни, влияющие на рефлекторную нарушенность деятельности кишечника;
- недостаток клетчатки в потребляемых продуктах.
По мнению многих специалистов, заболевание удается вылечить только при комплексной терапии у проктолога, психолога и гастроэнтеролога. Все разновидности неполного опорожнения кишечника по течению делятся в соответствии с выраженностью симптомов.
Сопутствующая симптоматика
Состояние пищеварительных органов имеет важное значение в жизни человека, где регулярные и комфортные дефекации влияют на работу внутренних органов, состояние кожи, тонус и состояние нервной системы.
Однако у пациента время от времени могут появляться недомогания, тянущие боли в нижней области живота, нарушения стула. Такие симптомы характерны для неполного опорожнения кишечника.
Основными симптомами заболевания являются:
- запоры или диарея;
- метеоризм;
- переполнение живота;
- ложные позывы с болями;
- острые болевые ощущения с правой части внизу брюшной полости;
- кровоточивость в форме нитевидных вкраплений.
Появление всех симптомов связывается в основном с волнением или после стресса, долгого нервного или физического перенапряжения.
Иногда к кишечным расстройствам добавляется головная боль, отсутствие сна, ощущение недостатка воздуха, слабость, шум в ушах, частое мочеиспускание.
Одним из симптомов геморроя является чувство неполного опорожнения кишечника и чувство тяжести. В зависимости от стадии и характера течения болезни, проявление симптомов может быть разной интенсивности и продолжительности.
Что делать?
Основной целью лечения является повышение качества жизни пациента, нормализация его эмоционального и психологического состояния. Для лечения заболевания назначаются диагностические, традиционные и народные методы.
Диагностируется неполное опорожнение кишечника с помощью специальных тестов, исключая все болезни с подобными проявлениями.
Так, специалист назначает следующие исследования:
- анализ кала;
- биохимию крови;
- ирригоскопию (рентгенологию кишечника с заполнением контрастным веществом);
- колоноскопию (осмотр кишки на расстояние до 1 м);
- ректороманоскопию (исследование эндоскопом).
Перед проведением диагностики пациент должен пройти специальную подготовку.
Сначала нужно исключить самые известные и простые причины нарушения пищеварительных функций. Пациенту назначается строгая диета, лекарственные препараты, ограничиваются пищевые раздражители (алкоголь, кофе, жирные и острые блюда).
Исключаются следующие вещества и продукты:
- антибиотики;
- слабительные препараты;
- лекарства с калием и железом;
- продукты, образующие газы (изделия из муки, капуста).
Добавляются в рацион блюда из рыбы, мяса, выполненные на пару; фрукты, овощи; пшеничные отруби, хлеб с мукой грубого помола. Добавляются продукты с высоким содержанием клетчатки. Назначается дробное питание небольшими порциями. Желательно пить минеральные воды без газов.
Медикаментозные назначения
Также специалист назначает слудеющие препараты:
- Для улучшения пищеварительных функций, снижения газообразования. Улучшить пищеварительные функции у кишечника можно с помощью ферментативных средств и прибиотиков. Важно поддержание микрофлоры с помощью Хилак форте и Эспумизана.
- Закрепляющие средства при диареи (Лоперамид, Смекта) или расслабляющие при запорах (прокинетики Мотилиум, Координакс, Дюфалак, Мукофальк, Сеннаде, Бисакодил).
- Спазмолитики для устранения спазмов в кишечнике (Дицетел, Дюспаталин, Папаверин, Но-шпа, Бускопан).
- При метеоризме назначается Симектикон, Димектикон.
Эспумизана.При наличии дисбактериоза лечение направлено на его устранение.
Диарею можно вылечить народными методами с помощью бузины, кровохлебки и пшенной каши. Запоры устраняются с использованием сока алоэ, голубики или лукового сока.
Устранить боли в животе можно отваром ромашки и мяты. Рекомендуются сухари, крепкий чай, черничный отвар, кисель. При вздутии назначаются кисломолочные продукты с пребиотиками (йогурты, кефиры).
При невропатических болях врач назначает антидепрессанты. Кроме пробиотиков, фитотерапии и ферментов в лечении может применяться акупунктура. Для отхождения газов и снятия спазмов гладких мышц способствует масло перечной мяты.
Возможные осложнения
Постоянно возникающие запоры могут привести к серьезным изменениям организма с появлением головной боли, снижением работоспособности, слабостью, раздражительностью. Но могут проявляться и другие осложнения.
Задерживающиеся в кишечнике каловые массы уплотняются и при прохождении через анальное отверстие, повреждают его, образуя трещины, гнойные воспаления, язвы.
Постепенно может развиваться хроническое воспаление в толстом кишечнике, геморрой. Могут появляться каловые камни, приводящие к полной или частичной непроходимости.
При длительных нарушениях пищеварительных функций организма развиваются разные заболевания кишечника.
Профилактические мероприятия
При регулярно возникающем неполном опорожнении кишечника пациент должен изменить режим жизни, повысить физическую активность, выбрать оптимальный рацион питания с приемом пищи 4-5 раз, скорректировать распорядок дня, снизить количество переживаний и стрессов.
Для снижения восприимчивости к стрессу назначаются психологические тренинги. Следует отказаться от потребления средств для терапии кишечных болезней.
Лечение можно будет считать эффективным, если не будет выявлено в дальнейшем основных симптомов, устранится болевой синдром, нормализуется стул, улучшится самочувствие пациента.
Основную роль в лечении неполного опорожнения кишечника имеет повышение качества жизни и психоэмоционального состояния человека.
Синдром неполного опорожнения кишечника — чувство неудовлетворения дефекацией, когда человек даже после посещения туалета ощущает переполнение прямой кишки. Отклонения в функционировании толстого кишечника напрямую сказываются на общем самочувствии, а также на работе других органов. Нормальной частотой опорожнения кишечника принято считать один раз за 1-2 дня. Более редкий стул расценивается как запор, а более частый – диарея (понос). 
Причины
Существует достаточно много факторов, приводящих к описанному симптому, но наиболее частыми из них являются следующие:
- Синдром раздражённого кишечника (СРК). Это функциональное заболевание, характеризующееся отсутствием какой-либо органической патологии и проявляющееся различными пищеварительными расстройствами (понос или запор, вздутие, хронические боли в животе без чёткой локализации, тошнота, частые ложные позывы в туалет).
- Внутренний геморрой. Заболевание проявляется расширением вен внутренних геморроидальных узлов терминального отдела прямой кишки, переполнением их кровью, нарушением микроциркуляции и увеличением.
- Новообразования кишечника. Чаще чувство неполного опорожнения кишечника вызывается наличием раковой опухоли прямой или сигмовидной кишки, а также множественными полипами. Большое образование создаёт препятствие для прохождения каловых масс с последующим развитием обтурационной непроходимости.
- Синдром инертной кишки. Возникает на фоне воспалительных заболеваний кишечника, при сахарном диабете, порфирии, болезни Паркинсона. Формируется прогрессирующий колостаз, при котором продукты обмена не выходят из кишечника даже при использовании слабительных препаратов.
- Воспалительные заболевания (инфекционные или аутоиммунные колиты, сигмоидиты, проктиты). Бактериальное, вирусное или другое поражение слизистой оболочки кишечника приводит к её раздражению и усилению перистальтики, что проявляется ощущением переполнения и дискомфортом.
- Особенности анатомического строения кишки. Долихосигма, сужения, спайки после операции, перекрут, врождённые дефекты – вот неполный список патологий, характеризующийся переполнением кишечника вследствие затруднения эвакуации его содержимого.
- Нарушение нервно-гуморальной регуляции кишечной стенки (неврологические заболевания, особенности психотипа личности, травмы позвоночника, эндокринные патологии).
Новообразования кишечника. Чаще чувство неполного опорожнения кишечника вызывается наличием раковой опухоли прямой или сигмовидной кишки, а также множественными полипами. Большое образование создаёт препятствие для прохождения каловых масс с последующим развитием обтурационной непроходимости.Клиническая картина
Помимо ощущения неполного опорожнения кишечника отмечаются и другие симптомы. Их количество, характер, особенности проявления будут зависеть от основной патологии. Наиболее распространены следующие жалобы:
- боли в животе, чаще в левой паховой области;
- метеоризм (повышенное газообразование);
- запоры (реже диарея);
- болезненность и дискомфорт во время дефекации;
- чувство постоянного переполнения кишечника;
- тошнота, урчание в животе, снижение аппетита;
- нарушение сна, внимания, беспокойство, раздражительность;
- кровянистые выделения из ануса во время или после дефекации (рак, полипы, геморрой);
- при длительном протекании заболевания присоединяются симптомы общей интоксикации (слабость, постоянная усталость и т. п.).
боли в животе, чаще в левой паховой области;Диагностика
Врач в первую очередь выясняет продолжительность заболевания, связь с приёмом пищи, наличие сопутствующей патологии, перенесённые операции на брюшной полости, частоту стула, его характер. Все обследования можно разделить на лабораторные и инструментальные, а также обязательные и дополнительные.
Обязательные исследования
- Пальцевое исследование прямой кишки для уточнения поверхностного поражения слизистой.
- Общий анализ крови, мочи, биохимия крови, копрограмма, анализ кала на скрытую кровь, посев при подозрении на инфекцию. Эти методы позволяют обнаружить воспаление, дисбактериоз, кишечное кровотечение, особенности переваривания пищи, работу органов внутренней секреции.
- УЗИ органов брюшной полости.
Дополнительные исследования
- Обзорная рентгенография брюшной полости. Проводится в случае подозрения на кишечную непроходимость, врождённую анатомическую патологию кишечника.
- Колоноскопия, ректороманоскопия – методы визуального осмотра слизистой толстого кишечника с помощью специальной аппаратуры. Данные обследования могут выявить новообразования в просвете кишки, источник кровотечения, спайки, воспаление и другую патологию. Можно взять биопсию и получить материал для гистологического исследования.
- Ирригография — рентгеноконтрастное исследование кишечника. Позволяет оценить его проходимость, выявить опухоли, язвы.
- МРТ, КТ, консультация узких специалистов могут понадобиться после получения результатов обязательных обследований.
Лечение
Проводится лечение основного заболевания, которое привело к появлению синдрома неполного опорожнения кишечника.
Диета
Основа любой терапии заболеваний органов пищеварения – это правильное питание. Для улучшения моторики кишечника и профилактики запора необходимо употреблять достаточное количество чистой воды в сутки (2,5-3 литра). Также в рацион включают продукты, богатые клетчаткой: злаки, овощи, зелень, фрукты, отруби, сухофрукты. Все они улучшают моторную и эвакуаторную функцию кишечника и способствуют полному опорожнению прямой и сигмовидной кишки.
Важно ограничить употребление жирной, острой, мучной пищи, газированных напитков. Приём пищи должен быть не реже 3 раз в день.
Образ жизни
При склонности к запорам нужно изменить привычное поведение: регулярно заниматься спортом, плавать, побольше ходить пешком, наладить режим посещения туалета в одно и то же время ежедневно (лучше после завтрака). По возможности отказаться от вредных привычек (курение, алкоголь).
Кишечник – это стрессозависимый орган! Эмоциональные потрясения, перепады настроения, психическая неуравновешенность напрямую сказываются на моторной функции кишки!
Медикаментозное лечение
В зависимости от симптомов могут быть назначены следующие препараты:
- Спазмолитики для уменьшения абдоминальных болей (Но-шпа, Папаверин, Дюспаталин, Бускопан) курсом до 2-3 недель.
- Слабительные средства для приёма внутрь или в микроклизмах (Микролакс, Дюфалак, Нормазе).
- Прокинетики для улучшения сократительной способности кишечника (Мотилиум, Церукал).
- Пробиотики для нормализации микробиоценоза (Хилак форте, Бифиформ, Линекс).
- Пеногасители и сорбенты для устранения метеоризма (Эспумизан, Смекта, Полисорб).
- Седативные препараты (Персен, Новопассит, мелисса, валериана).
Спазмолитики для уменьшения абдоминальных болей (Но-шпа, Папаверин, Дюспаталин, Бускопан) курсом до 2-3 недель.Физиотерапия
Неплохой эффект даёт:
- электростимуляция кишечника;
- массаж брюшной стенки;
- жемчужные ванны;
- гидромассаж.
Хирургическое лечение
Показано в случае:
- кишечной непроходимости;
- раковой опухоли;
- полипов;
- спаек;
- врождённых дефектов;
- геморроя.
кишечной непроходимости;Иногда хирургическая коррекция даёт шансы на полное излечение.
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