Sluggish bowel, sluggish digestion, constipation

Medical: Constipation

English = constipation, constipation


Under constipation (Constipation) one understands a voiding disorder of the Intestines, which is characterized by a lack of bowel movements.

One distinguishes one acute and a chronic Shape of constipation. The former type of constipation sets in suddenly (acute) and lasts only a short time, the latter type of constipation exists over a longer period of time and is characterized by various - not all simultaneously existing - features.

These include a bowel movement frequency of less than three times a week, hard stool, heavy pressing, feeling of blockage or incomplete evacuation, and manual assistance (with the hand) when emptying.

In the case of children, the definition "constipation“Some difficulties, as defecation is very different from person to person and very different from the person nutrition depends. With normal food, older infants have bowel movements about one to three times a day without constipation; in small children, the frequency is once or twice a day up to once every two days. Schoolchildren defecate about once or twice a day if they are not constipated.

In general, however, with these strong inter-individual fluctuations, one can say that a change in previous bowel habits (frequency, consistency) provides an indication of constipation. As long as a baby drinks adequately, does not vomit and grows or gains weight appropriately, suspicion of illness is unfounded.


Chronic Constipation: This form of constipation is a common condition, affecting around 10% of the adult population in industrialized countries. Generally, more women than men suffer from constipation. Older people and young children are also more affected. In those over 60 years of age, constipation occurs in 20 to 30%. The number increases with age and the number of unreported cases is high as not all constipation sufferers see a doctor.

In children 3% suffer from constipation, with 90 to 95% of them having a functional problem (mostly poor nutrition) causing constipation.

Constipation is a so-called civilization disease (in western countries); it is less common in Africa.

Classification / causes in adults


Acute constipation: Acute constipation develops within a short time and suddenly comes to light. In the case of temporary or situational constipation, a short-term change in diet, change in living conditions (e.g. bedridden or traveling), acute infections or hormone fluctuations can be the cause. Also certain Medication can cause acute constipation (drug-induced constipation). Acute constipation can also be a sign of one Intestinal obstruction (Ileus), one stroke or a disc prolapse be.

With an intestinal obstruction, the passage through the intestine is blocked. The cause can either be a mechanical obstacle (for example narrowing = Stenosis; mechanical ileus), bowel entanglement, bowel twisting, strangulation of the bowel, or paralysis of bowel peristalsis (paralytic ileus; paralysis = Paralysis).

A stroke (Apoplexy, circulatory disorder of the brain with destruction of brain cells) or a disc prolapse (Disc prolapse) can cause blockages if the annoy or whose centers of origin in the brain, which are responsible for the digestive processes, are affected.

Chronic constipation: With regard to chronic (= long-lasting) constipation, a distinction is made between three forms:

  1. Ecological constipation = slow transit constipation
  2. Anorectal constipation = outlet obstruction
  3. Idiopathic constipation = unknown cause

At a ecological constipation the transport time of the food residues in the intestine is extended. Typically, the time from ingestion to elimination is two to five days; if the passage lasts more than five days, one speaks of one ecological constipation. By a decreased Intestinal peristalsis (Mobility of the intestine) the food pulp is only moved slowly forward. However, since water is withdrawn in the process, the stool becomes hard, resulting in constipation.

The lower bowel motility resulting in constipation can have various causes. A disturbance of the nerves supplying the intestine or Muscles (For example Multiple sclerosis), a hormonal disorder (for example Hypothyroidism = Hypothyroidism, Diabetes mellitus or pregnancy), Drug side effects (among others opiate, Anticholinergics) or low-fiber diet.

The second form, anorectal constipation, affects rectum (rectum) such as nach (anus) and manifests itself in the failure to defecate despite pressing.
Since when tension is Abdominal muscles for pressing the sphincter muscle at the same time (Sphincter) the anus becomes tense, this prevents defecation, which results in constipation.
Reasons for a anorectal Constipation includes narrowing of the anal canal (Anal stenosis), a prolapse of the rectum while pressing (Rectal prolapse), Changes in rectal or anus motor skills or the sphincter muscle as well as sensory disorders of the rectum.

The idiopathic Constipation as the last form shows neither impaired bowel function nor structural changes in the bowel. The cause of this type of constipation is unknown and there is no organic disorder.

Differences in constipation in adults and children

In both adults and children, constipation is most often caused by poor diet or too little physical activity.
In babies, switching from one diet to the other (for example from breast milk to complementary foods / ready-to-eat porridge) is often a cause of constipation.
In children, emotional stress and pain during bowel movements can also lead to constipation. The pain leads to fear of emptying which can result in constipation. Treatment of constipation is usually the same in adults and children (after infancy). A balanced diet rich in fiber, a sufficient amount of water to drink per day and daily exercise are prerequisites for this.
If none of this shows sufficient effect, home remedies can also be used for children.

Symptoms in adults

Symptoms of constipation

Acute constipation: In principle, the same symptoms occur in acute constipation as in chronic constipation (see below). In contrast to the chronic form, the symptoms arise suddenly and can be quickly ended with therapy or resumption of old habits.

Represents an intestinal obstruction (Ileus) are the cause of the acute constipation, severe abdominal pain, flatulence without a draft (Meteorism) and vomiting (first food, later stool).When listening to the bowel, depending on the form of the ileus, one hears either increased bowel activity or few or no bowel noises ("Grave silence"). The maximum of an intestinal obstruction is reached when a state of shock occurs.

Stroke (stroke) symptoms depend on the location of the circulatory disorder in the brain. Depending on the situation, people affected by constipation may experience paralysis, impaired vision, sensitivity, orientation or coordination.

Read more on the topic: Stroke

In the case of a herniated disc, the location also determines the symptoms accompanying the constipation. Paralysis, sensitivity disorders, weakening of the reflexes and pain are possible.

Chronic constipation: Chronic constipation is characterized by a disorder of defecation. The following symptoms may be possible (ROM III criteria):

  • Less than three trips to the toilet per week
  • Feeling of incomplete emptying
  • Blockage
  • Pressing hard to move stool
  • Hard chair
  • Manual help with defecation
  • Soft stool only when using laxatives
  • Absence of irritable bowel syndrome (functional bowel disease)

If at least two of these symptoms appear in at least every fourth bowel movement in six months in three months, it is called constipation.

In the presence of an underlying disease that causes constipation, typical symptoms of this disease also occur.

Please also read our article on this Pain in the rectum

Complications in adults

Chronic constipation increases the risk of developing other bowel diseases: diverticulosis, diverticulitis, and hemorrhoids. This means mucous membrane protuberances of the intestinal wall (Diverticulosis) that can catch fire (Diverticulitis). These protuberances are formed as a result of the strong pressure during defecation, which is often necessary in the case of constipation. Hemorrhoids are arteriovenous vasodilatation in the area of ​​the anus.

An increased risk of developing colorectal cancer (cancer of the rectum / anus) if there is chronic constipation.

Furthermore, as a complication of constipation, so-called fecal stones (Coproliths, Skybala) form.

By using the abdominal press during bowel movements as a consequence of constipation, in addition to intestinal diverticula (see above), an inguinal hernia (inguinal hernia) or testicular hernia (Inguinal hernia) and over time, with additional loose connective tissue, the rectum or, in women, the uterus tread deeper (Rectal prolapse, uterine prolapse).

Read more on the topic: Testicular hernia

Painful constipation

Constipation can be associated with pain. For example, you may experience pressing abdominal pain. Pain during bowel movements is also not uncommon with constipation. This is because the stool is often very hard when constipated. This leads to irritation of the mucous membrane in the rectum area and ultimately to pain. Very hard stools can occasionally cause light bleeding, especially if there are hemorrhoids.
In order to treat the pain that occurs with constipation, only therapy against the cause of the constipation helps.



In the first place to one constipation to diagnose, take anamnesis (Inquiry about the medical history) and physical examination, in which particular attention is paid to bowel noises, palpable resistance, immune tension of the abdomen, hemorrhoids and a digital rectal examination. This is followed by a blood test, which electrolytes (especially potassium) and thyroid values ​​(TSH) includes. An examination of the stool for invisible (occult) Blood (Hemoccult) supplements the diagnostics.
The other diagnostic options include imaging procedures: Colonoscopy (Colonoscopy), Ultrasonic (Sonography) and roentgen of the abdomen (abdomen overview). If an intestinal narrowing (stenosis) is suspected or to differentiate between ecological and anorectal constipation, a back test is carried out. Radiopaque markers are taken orally for seven days and an X-ray is then taken. The passage duration and any obstacles to the passage can be assessed through the position of the markers.
The last diagnostic tools are functional proctoscopy, defecogram and anal sphincter manometry. In functional proctoscopy, one observes whether there are changes in the intestinal mucosa during pressing (protruding parts of the mucous membrane), the defecogram shows defecation under X-ray control and the manometry measures the development of pressure in the sphincter (Sphincter).
Further diagnosis is determined by the suspicion of a causative disease.


Constipation that is not due to an organic disease can be prevented with an appropriate lifestyle, which is the right one nutrition, much Drink and enough Move includes.

Here you can find general information on the topic bowel movement and how you can stimulate and promote it.


If constipation is triggered by poor diet and lifestyle, the prognosis is good. However, if there is an organic cause behind it, the prognosis depends on the causative disease.

-> Continue to the topic of nutrition for constipation

How can one prevent or treat constipation?

How can I prevent constipation?

There are relatively simple measures that can help prevent constipation as much as possible. Diet plays an essential role here. A diet rich in fiber should be observed.
Dietary fiber is found in whole grain products, grain products, and fruits and vegetables, for example.
A sufficient daily amount of water is also very important to prevent constipation.
For a person with healthy heart and kidneys, the daily intake should be at least 2 liters. Adequate physical activity is also essential for an intact digestive function. This does not necessarily mean endurance sports. Daily exercise such as daily walks, regularly climbing stairs, etc. play a crucial role in the overall fitness of the body and the digestive system.

Home remedies for constipation

There are a number of home remedies that can help you relieve constipation. Some are more effective than others. However, the effectiveness is always individual, not everything helps everyone equally well. A popular home remedy for constipation is, for example, dried plums. They should be soaked for some time beforehand. They can then be consumed on their own or, for example, with muesli or yoghurt. In the best case scenario, the liquid in which the plums were soaked is consumed.
It is generally important to drink enough after consuming dried fruits, otherwise constipation can increase. Plum juice is also said to help stimulate intestinal activity in the case of constipation.
Another popular home remedy is the consumption of a tablespoon of oil, for example olive oil or linseed oil. It is best to take the oil on an empty stomach. In addition, means that contain a lot of fiber such as flaxseed or flea seeds should also help against constipation. They bind a lot of water in the intestine and swell up as a result. The increased fluid in the intestine causes the stool to soften. The seeds can either be soaked or eaten dry (e.g. as a muesli ingredient).
Here, too, it is extremely important to take in sufficient fluids afterwards, otherwise there is a risk of constipation.
Salt water is also known as a remedy for constipation, but this variant is not without risk as too much salt can be dangerous for the body.

Drinking a glass of lukewarm water is also said to help for some people.
In general, a high-fiber diet with lots of fruit and vegetables helps against constipation. In addition to fruit and vegetables, whole grain products, muesli, etc. contain a lot of fiber.

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There are numerous homeopathic remedies that are said to have a good effect on constipation.
These include Acidum sulfuricum (sulfuric acid), Kalium carbonicum (potassium carbonate), Bryonia (beet) and Silicea (silica).

Nutrition and funds from the pharmacy that provide relief

Diet plays an important role in the genesis of constipation. High-fat, low-fiber foods encourage constipation. Insufficient fluid intake can also cause constipation. On the other hand, the intake of sufficient fiber and fluids is a means of preventing constipation. Dietary fiber can be found in fruits, vegetables, whole grain products and grain products such as pasta, rice, oatmeal and nuts.

If none of this is sufficiently effective, you can buy products from the pharmacy to aid digestion. Mention should be made here for example of Movicol ®. This is a powder that is stirred into a glass of water and then drunk. It can be used several times a day. In contrast to other laxatives, Movicol ® should be able to be taken regularly.


An enema is one way to treat constipation. However, this variant is more suitable for pronounced complaints that cannot be treated otherwise. A type of device that is inserted into the rectum guides fluid into the rectum. This leads to hydration and irritation of the receptors in the intestinal wall. In most cases, this in turn leads to emptying relatively quickly. Enemas are usually done in a hospital. However, there are devices for performing enemas in the home. However, performing an enema should be practiced, as improper implementation can lead to injuries.

What helps immediately?

A tablespoon of oil is said to have a quick effect on constipation among home remedies. If possible, it should be taken on an empty stomach. In general, the enema is considered to be the most effective remedy for constipation. Suppositories with various active ingredients that are supposed to counteract constipation also usually work quickly.



Constipation is a bowel movement disorder with no bowel movements. Other characteristics such as hard stool consistency, infrequent defecations, strong pressure or a feeling of blockage / fullness can also be added. Constipation manifests itself very differently in children, as the frequency of bowel movements depends heavily on the composition of the food.

Constipation is a common condition, especially women, the elderly and children suffer from this condition.
The cause of constipation is usually the wrong, low-fiber and low-fluid diet in connection with a lack of exercise or short-term changes in lifestyle. However, infections and organic changes can also lead to constipation (including mechanical changes, muscle disorders, nerve disorders, stroke, herniated disc, intestinal obstruction).

In children, constipation develops due to mechanical changes in the bowel, in addition to poor nutrition (Ileus as a result of one Volvulus, intussusception, etc.), bowel movement disorders (as a result of innervation disorders, vitamin excess, hypothyroidism), psychological changes or nerve disorders. The cause of constipation in both children and adults can also be drugs (Antiepileptics, anticholinergics, opiates).
Constipation is diagnosed in addition to anamnesis and physical examination based on changes in blood values, imaging methods such as ultrasound (Sonography), X-rays and colonoscopy (Colonoscopy) as well as by means of other special diagnostic examinations.
Therapy and prognosis depend on the cause of the constipation. In functional constipation, changes in eating habits and more exercise come first. High-fiber foods should be consumed and the amount consumed should be increased. Additional fiber intake (linseed etc.) as well as avoiding constipating foods complement the therapy. If these therapeutic measures are not sufficient, there is the possibility of administering evacuation aids (Enema, klyster) or laxatives (Laxatives), which, however, should by no means be taken permanently. If the cause of the constipation is an organic disorder, it must be treated either conservatively (usually with medication) or surgically.

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