Constipation, constipation, sluggish digestion Medical: constipation English = obstipation, constipation Constipation is a disturbance in the emptying of the bowel, which is characterized by a lack of bowel movement. A distinction is made between an acute and a chronic form of constipation. The first type of constipation starts suddenly (acute) and lasts only a short time, the latter type of constipation exists for a longer period of time and is characterized by different – not all simultaneously present – characteristics.
These include a bowel movement frequency of less than three times a week, hard stool, strong pressing, feeling of being blocked or incompletely defecated and manual help (by hand) with defecation. In children, the definition of “constipation” poses some difficulties, as defecation varies greatly from one individual to another and is highly dependent on diet. With normal food, older infants have bowel movements about one to three times a day without constipation, while 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 interindividual variations, it can be said that a change in previous stool habits (frequency, consistency) provides an indication of constipation. As long as a baby drinks adequately, does not vomit and grows or gains weight appropriately, the suspicion of a disease is unfounded.
Chronic constipation: This form of constipation is a common clinical picture. About 10% of the adult population in industrialized countries is affected by constipation. In general, more women than men suffer from constipation.
Older people and small children are also more frequently affected. In people over 60 years of age, constipation occurs at 20 to 30%. The number increases with age and the number of unreported cases is high, as not all constipation sufferers consult a doctor.
In children, 3% suffer from constipation, whereas in 90 to 95% a functional problem (mostly wrong diet) causes constipation. Constipation is a so-called disease of civilization (of Western countries); in Africa it occurs less frequently. Acute constipation: An acute constipation develops within a short time and suddenly appears.
In the case of a passagonal or situational constipation, a short-term change in diet, changes in living conditions (for example, bedriddenness or travel), acute infections or hormonal fluctuations can be the cause. Certain drugs can also trigger acute constipation (drug-induced constipation). Acute constipation can also be a sign of intestinal obstruction (ileus), a stroke or a herniated disc.
In the case of an intestinal obstruction, the passage through the intestine is blocked. The cause can be either a mechanical obstruction (for example constriction = stenosis; mechanical ileus), intestinal constriction, intestinal twisting, strangulation of the intestine or paralysis of the intestinal peristalsis (paralytic ileus; paralysis = paralysis). A stroke (apoplexy, circulatory disorder of the brain with loss of brain cells) or a herniated disc (discus prolapse) can cause blockages if the nerves or their centers of origin in the brain, which are responsible for digestive processes, are affected.
Chronic constipation: With regard to chronic (= prolonged) constipation, three forms can be distinguished: In the case of constipation, the transport time of food residues in the intestine is extended. Normally, this time from food intake to excretion is two to five days; if the passage time is longer than five days, it is referred to as constipation. Due to reduced intestinal peristalsis (mobility of the intestine), the food slurry is only slowly moved forward.
However, since water is removed, hard stool is produced, resulting in constipation. The reduced intestinal mobility resulting in constipation can have various causes. Possible causes are a disturbance of the nerves or muscles supplying the intestine (for example in multiple sclerosis), a hormone disorder (for example hypothyroidism, diabetes mellitus or pregnancy), side effects of medication (including opiates, anticholinergics) or a low-fiber diet.
The second form, anorectal constipation, affects the rectum and the anus and is characterized by failure to defecate despite pressing. Since the sphincter muscle of the rectum is tensed when the abdominal muscles are tensed for pressing, defecation is prevented, resulting in constipation.Reasons for an anorectal constipation include narrowing of the anal canal (anal stenosis), a prolapse of the rectum during pressing (rectal prolapse), changes in the rectal or anal motor function or the sphincter muscle, and sensitivity disorders of the rectum. The idiopathic constipation as the last form shows neither a disturbed intestinal function nor structural changes of the bowel. The cause of this type of constipation is unknown, no organic disorder is found.
- Kologene constipation = slow transit obstipation
- Anorectal constipation = outlet obstruction
- Idiopathic constipation = unknown cause