What causes constipation? - Heba Shaheed

譯者: Lilian Chiu 審譯者: Regina Chu

Visiting the bathroom is part of the daily human experience.

上廁所是人類每天一定要做的事。

But occasionally, constipation strikes,

但偶爾，會遇到便秘，

a condition that causes a backup in your digestive system.

它會造成你的消化系統阻塞。

The food you eat can take several days to exit your body.

你吃下去的食物可能要 好幾天後才會離開你的身體。

And for many, constipation can become chronic,

對許多人而言， 便秘可能演變成長期的，

meaning regularly passing lumpy hard stools accompanied by straining.

也就是說，經常要用力排便， 且排出的是有塊狀的硬糞便。

What's behind this unsettling phenomenon?

在這讓人心煩的現象背後是什麼？

Constipation arises in the colon, also known as the large intestine.

便秘發生在結腸中，也就是大腸。

This muscular organ is split into four sections:

這個具有肌肉的器官被分成四段：

the ascending,

升結腸、

transverse,

橫結腸、

descending,

降結腸，

and sigmoid colon,

及乙狀結腸，

which connects with the rectum and anus.

和直腸與肛門連結。

The small intestine delivers stool

小腸會把攝取的食物、

consisting of ingested food, bile, and digestive juices

膽汁，以及消化液所構成的糞便

to the large intestine.

送到大腸。

As this stool moves through the colon,

當這些糞便通過結腸時，

the organ siphons off most of the water it contains,

這個器官會把糞便 所含的大部分水份吸乾，

transforming it from liquid to solid.

把它從液體轉變為固體。

The longer this transmission takes,

花在傳送上的時間越長，

the more reabsorption occurs, resulting in increasingly solid stool.

就會發生越多的再次吸收， 導致糞便越來越硬。

Once it reaches the sigmoid colon,

當糞便達到乙狀結腸時，

a final bout of reabsorption occurs before it enters the rectum,

會發生最後一回合的再次吸收， 然後才會進入直腸，

distending its walls and telling the internal anal sphincter to relax.

使其腸壁擴張， 告訴肛門內括約肌放鬆。

This is the point where you can usually decide whether to physically expel

通常，就是在這個時點，

你可以決定要實際排出 或是暫時先保留糞便。

or retain the stool.

That’s regulated by the pelvic floor muscles,

負責管控的是骨盆底肌肉，

particularly the puborectalis

特別是恥骨直腸肌

and external anal sphincter.

以及肛門外括約肌。

The puborectalis forms a sling-like formation around the rectum

恥骨直腸肌會在直腸周圍 形成一種像彈弓的結構，

called the anorectal angle.

叫做肛直腸角。

And when you voluntarily relax your external anal sphincter,

當你自願放鬆你的肛門外括約肌，

the stool is finally expelled.

糞便就會被排出。

When you’re constipated, however,

然而，當你便秘時，

a desire to visit the bathroom isn't enough to coax your body into action.

去上廁所的慾望就不足以 勸誘你的身體實際行動。

Usually there's two factors behind this problem:

通常，這個問題背後有兩項因素：

the stool’s slow movement through the colon

糞便通過結腸的速度太慢，

and/or pelvic floor dysfunction.

及／或骨盆腔底功能不良。

In the first, stool moves excessively slowly through the intestines,

在第一項因素中，糞便以 太緩慢的速度通過腸道，

causing over-absorption of liquid, which makes the stool dry and hard.

導致液體被過度吸收， 讓糞便變得又乾又硬。

With pelvic floor dysfunction,

至於骨盆腔底功能不良，

stool becomes difficult to eliminate from the rectum

糞便會很難從直腸中排除，

because of tightened pelvic floor muscles, or due to a pelvic organ prolapse,

原因是骨盆底肌肉太緊， 或是骨盆腔器官脫垂，

usually through childbirth or aging.

通常是生產或是老化造成。

Both of these problems make the anorectal angle more acute

這兩個問題都會讓肛直腸角更尖銳，

and it becomes difficult to expel waste.

變得很難將廢物排出。

To identify constipation precisely,

為了要精確地辨識出便秘，

researchers have developed metrics, such as the Bristol Stool Chart.

研究者已經開發出度量工具， 比如布里斯托大便分類法。

Most people who look at that chart

大部分人根據這種分類法，

will be able to tell they’ve experienced constipation before.

就能分辨出他們以前 是否有發生過便秘。

When you’re on the toilet, you should ideally be in a squatting position.

當你坐在馬桶上， 理想的姿勢應該是蹲姿。

With your buttocks firmly on the toilet seat,

你的屁股應該要在馬桶座上坐穩，

you can elevate your feet on a stool

你可以踩著凳子把腳抬高一些，

and lean forwards with a straight back,

並向前傾，保持背部打直，

which straightens the anorectal angle and eases the passage of waste.

這樣做就能拉直肛直腸角， 讓廢物比較容易通過。

Going a day without a bowel movement isn’t necessarily cause for alarm.

一天沒有大便並不需要太過緊張。

But if you are experiencing chronic constipation,

但如果你長期都有便秘的狀況，

simple dietary and lifestyle changes,

簡單做些飲食和生活習慣的改變，

like fibrous vegetables,

比如多吃蔬菜、

regular exercise,

保持運動習慣、

abdominal massage,

做腹部按摩，

and 6 to 8 cups of water per day

以及每天喝六到八杯水，

may help restore your daily trip to the toilet.

都可能可以協助你恢復 每日至少到廁所一遊。