notes by dr Claudio Italiano
Never start this diet if you are not sure of the diseases we are suffering from:
often colon cancer is hidden behind constipation.
Always contact your doctor.
In the case of constipation, first you must exclude pathologies that determine constipation or subocclusion, so think about implementing a diet rich in water, that is hydropinic, for example, magnesian- sulphurous water which you must drink away from meals and an old-fashion diet, that is, high in fiber, due to foods that are not completely assimilated and that, therefore, create a fecal mass; we recommend the adoption of the so-called "high residual diet". In fact, the food fibers contained in the food absorb a large amount of water and consequently greatly increase the intestinal content.
Since the colon is reached about 1200 ml of liquids (fibers, sodium and water), if the
quantity of water is greater, then the stools will be richer in water and of
increased volume, polty and soft consistency stools, that is not
like goat's scibale. On the other hand, the fiber diet promotes the growth of intestinal flora
of the fermentative type and not putrefactive, which happens when the stools
stagnate and the diet is fleshy. The intake of water will be about 2 liters
Astringent foods to avoid
They are lemons, rice, medlars, bananas, the, medlars, blueberries apples
Foods useful for constipation
The meat broth (eye to the gastritics that will have acidity); oats or whole
grains for breakfast, oranges, artichoke, prunes, kiwi, carrot; drinking a glass
of warm water just raised can stimulate intestinal activity. The diet must
contain crude fibers or residues (cellulose, hemicellulose, lignin, pectin and
gums); contains wholemeal bread, fruit with peel, take 4 prunes / day, vegetable
soups with legumes and peels, vegetables to be cooked, eg. radicchio, catalonia,
chicory, roots, artichokes, zucchini, drink a lot of water during and above all
meals; you can occasionally use a tablespoon of olive oil or vaseline in the
evening to "soften" the fecal mass and fight the goat feces.
Movement: if you do not do motorbikes, for example if as the undersigned, you
must remain at the P.C. to work for 3 hours / day or worse, work at the bank or
bus, always sitting, then it is obligatory to make bikes at other times of the
day! Or gym, or as I do, stay in the open air, for example to take care of the
vegetable garden or the garden, if you have the passion. Exercise, however
conducted, improves muscle tone, makes you "deflate the belly" and facilitates
intestinal peristalsis. The firmness of the abdominal and perineal muscles
favors the increase of intra-abdominal pressure during defecation. On the
contrary, a sedentary lifestyle leads to a weakening and loss of function of the
diaphragm and of the muscles that constitute the abdominal wall, preventing it
from producing a pressure increase adequate to the defecatory activity. Even the
stride, that is to walk at a good pace or just do a cross-country run, favors
the activation of an automatic reflex that produces contractions of the colon to
push the faecal material towards the anus.
Fiber in% in fiber supplements
bran 44%
fresh / dried vegetables
Beans, lentils, peas 10-25%
dried fruit - Dried figs, raisins, dried prunes 10-15%
Bread and whole wheat pasta 10%
Oil seeds - almonds, walnuts, hazelnuts 6-14%
Fresh fruit - Cherries, apples, pears, peaches, oranges 1.5-2%
Fresh / cooked vegetables - Carrots, celery, tomatoes, peppers, fennel, spinach
- 1-3%
1.5-2% white flours
Other: Oil, white sugar, meats, soft drinks
Almost 0%
You could have
intestinal colic; the diet should be gradually increased, for example, at first
preferred green lettuce or boiled beets, only a poor outline, then increase the
doses of the vegetable side; if you have rectocolites, never use the fibers or
any particularly abrasive vegetables, for ex. the leaves of the artichokes! If
you find it difficult to evacuate, do not be afraid: a good enema of lukewarm
water with the addition of one-two coffee cups of lactulose syrup (eg portolac,
laevolac etc.), practiced lying on the left side (see anatomy of the
sigmo-rectus lying in the left iliac fossa) can be useful as biofeed-back, that
is, it will act as an evacuation stimulus and will function as a kind of rectal
gymnastics; moreover, the water contained in the rectal ampoule softens the
faeces and makes it easy to evacuate e.g. in the patient enticed with
constipation and avoids the discomfort and efforts to ponzare, getting a good
toilet of the last section of the intestine. In the case of lack of effect, in
the most obstinate cases, but always if you are sure of what you do, after
hearing the opinion of your doctor who will exclude acute abdomen, you can
resort to a clismus based on sorbitol (eg clisma fleet or other similar
evacuative enema from 150 ml). However, do not always do it yourself: take your
doctor's opinion. In fact, a stubborn constipation can also hide other pitfalls:
colon cancer.
 CT abdomen: the arrows indicate significant fecaloma in an elderly patient bedraggled, demented, personal case |
If there is a fecaloma for rectal exploration, then try to practice a good
evacuation enema + lactulose per os 10 ml X 2-4 times a day; otherwise proceed
with the special spoon, or with simple digital maneuvers in order to
disintegrate the fecaloma which consists of lumps of condensed and dehydrated
stools. I remember the case of a patient who had a fecaloma as large as the head
of a child and did not know it. For work reasons it remained hours and hours
sitting repressing the defecatory reflex, something very reprehensible and
dangerous.
In other cases, vaseline oil may be used at a dose of 2-4-6 tablespoons a day
for os + enemas with hypertonic or isotonic solution (ie 33% glucose or lukewarm
physiological solution).
The former are drugs that promote or accelerate the expulsion of intestinal contents. They act:
1) irritating the mucosa, and increasing its motility;
2) as surfactants;
3) physiologically by increasing the fecal mass;
4) lubricating the intestine.
Laxatives, on the other hand, are
th
ose with milder action. All are highly risky drugs for the complications they
give: ex. colon from cathartics, granulomatous hepatitis, drug hepatitis.
They are divided into:
- contact catarrhs, with irritative action (castor oil, cascara sagrada, senna,
rhubarb, aloe, gialappa, podofillina, crotontiglio oil, saline cathartics, which
increase faecal volume by liquid recall (sodium picosulfate, magnesium sulphate,
sodium, mannite, mannitol, lactulose, mass such as bran, agar, plantain);
-
cathartic cholinergists, e.g. neostigmine.