Author: Leo
Key words: nephropathy
Dialysis patients with constipation is not a small problem, should cause patients and health care workers full attention, dialysis and constipation is mutual influence, to develop good bowel habits, the best 1-2 times a day, help to ensure good dialysis adequacy, Improve the quality of life of dialysis patients.
Dialysis crowd constipation and the general population of constipation treatment is still very different, such as the most commonly used to deal with constipation is a large intake of liquid off, for oliguria or anuria dialysis patients fluid overload can lead to edema, Heart failure and pulmonary edema, so dialysis patients are not allowed to increase the amount of liquid to relieve constipation.
Second, often encourage the common constipation crowd to eat high-fiber food methods, is not suitable for dialysis patients. Contains fiber foods are generally fresh fruits, vegetables and bran foods that are rich in potassium and phosphorus in these foods, and excessive use of dialysis patients can occur or aggravate hyperkalemia and hyperphosphatemia.
Hemodialysis patients with constipation and the occurrence of multiple factors, should be based on their own characteristics from the following aspects to maintain the stool:
1 to relax the mind, adjust the schedule, to develop regular bowel habits is essential. For uremic itself caused by constipation, under the premise of adequate dialysis, to guide the diet program, practice effective defecation movements, the establishment of normal defecation reflex.
2 according to the doctor's request to control dialysis interval weight gain, if constipation should be timely and blood purification center physician communication. For patients with excessive dehydration during dialysis, such as dialysis during the dry mouth, hoarseness, muscle spasms, abdominal pain, inconvenience, hypotension, etc., need to re-evaluate the dry weight, reduce the amount of ultrafiltration.
3 patients with less activity can carry out some suitable for their own aerobic exercise, such as doing gymnastics, playing tai chi, walking, etc., to promote gastrointestinal motility, improve digestive function, special patients can do abdominal exercise and massage.
4 to avoid abuse of laxative drugs, pay attention to the adverse reactions of laxative drugs. At present, laxative drugs can be divided into six categories: fluency laxatives, fecal softeners, fiber supplements, lumps of laxative agents, irritating laxatives, osmotic laxatives, etc., dialysis constipation patients should be under the guidance of doctors, Choose the appropriate laxative drugs, if necessary, but also with the gastrointestinal motility drugs, but should minimize the dependence on drugs.
Dialysis patients can usually use fecal softener, especially for bed rest or sedentary, stool hard knot patients, commonly used drugs are docetyl sodium. Lubricant laxatives, can change the hardness of feces, to prevent intestinal mucosal absorption of water. But long-term use may hinder the absorption of fat-soluble vitamins, preferably less or occasionally used, should be taken before going to bed.
Permeability, lubricity, volumetric and irritant laxatives have a long-term use of some adverse reactions. Such as: irritant laxatives, containing anthraquinone glycosides in the intestine by bacteria eventually decomposed into anthrone, anthrone has a strong cytotoxicity, damage the intestinal wall plexus, leading to electrolyte imbalance and colon melanosis. Abuse can produce dependence and resistance, causing laxative constipation.
Permeability laxatives are common sorbitol, polyethylene glycol, lactulose and salt laxative (magnesium), etc., can increase the intestinal osmotic pressure, intestinal water increased, easy to discharge feces.
However, laxatives or laxatives should be used with caution, use, you must monitor the value of the electrolyte, not long-term use. The use of drug enema should also be used with caution and the need to avoid the use of large amounts of saline and water enema, as liquid and saline through the small intestine can cause fluid load and sodium imbalance.
In short, dialysis patients with constipation is not a small problem, should cause patients and health care workers full attention, dialysis and constipation are mutual influence, to develop good bowel habits, the best 1-2 times a day, help to ensure good dialysis To improve the quality of life of dialysis patients.
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