CHRONOBIOLOGICAL STRATEGY FOR TREATMENT OF PATIENTS WITH CONSTIPATIONS

Abstract

A new chronobiological strategy for the treatment of patients with constipation is presented. There are four main aspects of this strategy: physiological, pathological, general biological and therapeutic. The physiological aspect of the chronobiological strategy is the need for a fundamentally new approach to determining and understanding the natural daily rhythm of defecation. Defecation is one of the fundamental circadian (every day) biorhythms, whose normal frequency is regular and is at least 7 times a week. The pathological aspect presupposes a new definition of constipation as a violation of the circadian rhythm of defecation. Three stages of severity of constipation are suggested: mild - with a stool frequency of 5-6 times a week, moderate - 3-4 times a week, severe - with a stool frequency 1-2 times a week. The regular dependence of the regularity of the rhythm of defecation on the moment of realization of this rhythm is established. Regular bowel movement is associated with the morning bowel movement, and irregular defecation is associated with the absence of the morning phase of defecation. It is emphasized that the main factor in restoring the regularity of the rhythm of defecation is a conscious correction of the way of life to restore the daily bowel habit to morning defecation. The therapeutic aspect of the problem of constipation is based on the personal account of the whole complex of factors that lead to defecation irregularity and the need to use the most effective and safe drugs that have a degree of evidence of 1A.