Is constipation intestinal inflammation

Solving constipation: what helps with sluggish bowels?

Status: 07.05.2021 11:13 a.m.

When the bowel is sluggish, emptying it is usually difficult and painful: around one in five suffers from constipation. Proper diet and exercise will help resolve constipation.

Predominantly women and elderly people occasionally suffer from constipation. Constipation (or medical constipation) is when there is no bowel movement for four days, strong pressure is required to empty the bowel and there is a permanent feeling of incomplete emptying. If this happens regularly for more than three months, then it is a chronic form of constipation. In severe cases, there is no bowel movement for up to two weeks.

Frequent Causes of Constipation

The most common form of constipation (ecological constipation or slow-transit constipation) is characterized by the fact that the bowel moves only a little and its contents are pushed forward only slowly. The stool thickens and becomes hard as a result.

This intestinal movement disorder can be based on metabolic disorders such as diabetes mellitus, hypothyroidism or pathological changes in the intestine, such as the increased storage of collagen in the intestinal wall. Nerve and connective tissue diseases or side effects of medication are also possible causes, for example with psychotropic drugs, beta blockers, sleeping pills and sedatives, aluminum-containing acid binders, iron supplements and diuretics. Those who frequently use laxatives can numb their intestines to nervous stimuli. A low-fiber diet, insufficient fluid intake and lack of exercise also have a positive effect on constipation.

Changes in diet or time cause constipation

There are other forms of constipation with other causes: Anorectal constipation, for example, is due to changes or disorders in the rectum and anus - such as narrowing of the intestinal outlet, bulging of the rectum or impaired coordination of the internal and external sphincters. Often there is no cause at all to be found: Doctors then speak of idiopathic constipation. Many people suffer from constipation for two or three days at the beginning of a trip, but this should not be considered chronic, even if it happens with every trip. The reason here is usually only a temporary adjustment disorder to an unfamiliar daily routine and foreign foods or spices. Even after a fast or diarrhea, it can take a few days before normal bowel movements return.

Symptoms of constipation

Many of those affected initially suffer from a feeling of fullness, general malaise, shivering and a bloated stomach. Defecation is difficult, often painful. Usually small and hard portions of faeces ("sheep droppings", "rabbit dumplings") are only excreted by pressing hard. If you have very infrequent bowel movements, you may experience stomach pain and nausea.

Permanent constipation can have serious consequences

Dreaded complications are hemorrhoids and incontinence. If the potassium balance gets mixed up due to the disturbed digestion, it can lead to cardiac arrhythmias. There is also the possibility that the intestinal wall gets small holes due to the chronic pressure and protuberances form there, which can become inflamed (diverticulitis). The possible consequences of chronic constipation also include:

  • Anal fissures
  • Rectal prolapse
  • Ileus (intestinal paralysis, intestinal obstruction)
  • Formation of hardened dung balls (skybala), coprostasis (end stage of severe constipation)

Medical Diagnosis of constipation

Because of the multitude of possible causes, the anamnesis is particularly extensive. Since constipation can be stress-related, questions are asked about the living conditions and the family, as well as the professional or school situation. It is important to record the eating habits and the question of taking medication.

The physical exam includes listening, tapping and palpation of the abdomen and palpation of the rectum. Blood and urine samples are taken to clarify the mineral and electrolyte status - they may provide information on metabolic disorders, possible potassium deficiency or overconsumption of laxatives. A stool blood test can show bowel inflammation or tumors. With an abdominal ultrasound (abdominal sonography), the doctor tries to detect pathological changes such as narrowing of the intestine or accumulation of air. If colon polyps, constrictions or tumors are suspected, a colonoscopy is unavoidable. An X-ray examination with a contrast enema, a computed tomography (CT) or magnetic resonance tomography (MRT / MRI) or a colon transit test are rarely necessary for clarification. Gynecological, urological or neurological examinations can complete the picture.

That helps: fiber, plenty of drinking and exercise

Therapy depends on the cause. If triggers such as illness or medication are ruled out, then there are two magic words for clearing constipation: fiber and exercise.

We recommend around 35 grams of fiber per day for complaints with constipation, in severe cases it should even be 40 to 50 grams. That means: Sufficient whole grain products, flaxseed, vegetables and fruit should be on the menu. The switch should not be made abruptly from little to a lot of fiber, but the intestines should be gently accustomed to the "extra work". And: Be sure to drink enough with it. Dietary fiber swells and needs fluid to do so.

Acacia fibers or flea seeds are natural swelling agents. A tablespoon of this, taken with a glass of water before a meal, can also help you get the daily amount of fiber you need.

Exercise therapy for constipation

In order for the intestine to get going again, it has to be moved. Exercise speeds up digestion. People should aim for at least 10,000 steps per day. In addition, correct posture can make bowel movements easier: Studies show that the natural squatting position effectively counteracts constipation, because the rectum is stretched, making it easier to empty.

Experts on the topic

Dr. med. Matthias Riedl, specialist in internal medicine, diabetologist, nutritionist
medicum Hamburg MVZ GmbH
At the straw house 2
20097 Hamburg
(040) 807 979-0

Dr. Anne Fleck, specialist in internal medicine, rheumatology
Moderator, author and healthcare consultant


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