Therapeutic target Normalization of stool frequency and consistency. Therapy recommendations Indications (areas of application) for laxative therapy: Especially elderly patients with constipation, bedridden patients. Patients who should avoid pressing during defecation and thus an acute increase in blood pressure and/or intracranial pressure and/or intra-abdominal pressure (pressure within the abdominal cavity) such as after a cerebral … Constipation: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for suspected ileus (intestinal obstruction), abscesses or tumors. Endosonography (endoscopic ultrasound (EUS); ultrasound examination performed from the inside, i.e., the … Constipation: Diagnostic Tests
Medical history (history of illness) represents an important component in the diagnosis of constipation (constipation). Family history What is the general health of your relatives? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful working … Constipation: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Hirschsprung’s disease (MH; synonym: megacolon congenitum) – genetic disorder with both autosomal recessive inheritance and sporadic occurrence; disorder that in most cases is affects the last third of the colon (sigmoid and rectum) of the large intestine; belongs to the group of aganglionoses; lack of ganglion cells (“aganglionosis”) … Constipation: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by constipation (constipation): Cardiovascular system (I00-I99) Hemorrhoids Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93). Anal fissures – tears in the mucosa of the anus (anus). Intestinal bleeding Intestinal ulcers (intestinal ulcers) Diarrhea (diarrhea) Diverticulosis Ileus (intestinal obstruction) Coprostasis (fecal … Constipation: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? Hernias (fractures)? Inspection and palpation (palpation) … Constipation: Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing of suitable antibiotics for sensitivity / resistance). … Constipation: Test and Diagnosis
Within the framework of micronutrient medicine (vital substances), the following vital substances are used for supportive therapy: Probiotics Dietary fiber The above vital substance recommendations were created with the help of medical experts. All statements are supported by scientific studies with high levels of evidence. For a therapy recommendation, only clinical studies with the highest … Constipation: Micronutrient Therapy
1st order Primary surgical interventions are mainly performed for secondary constipation such as colon carcinoma (colorectal cancer). Surgical therapy for chronic constipation should be considered only after differential diagnosis and exhaustion of conventional therapy. Procedure of choice Colonic resection (subtotal colectomy) – removal of the colon; prior to this, to test the effect, it may … Constipation: Surgical Therapy
To prevent constipation (constipation), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet High-fat, high-protein diet and high intake of refined carbohydrates. Poor in complex carbohydrates and dietary fiber – Especially the insoluble fiber such as lignin, cellulose and some hemicelluloses, contained in cereals, vegetables, fruits, increase stool volume by binding … Constipation: Prevention
Often constipation (constipation) proceeds without symptoms and only the awareness of real or imagined low defecation makes the patient resort to laxatives (laxatives). In some psychologically conspicuous patients, the fear of poisoning themselves internally – so-called horror autotoxicus – can lead to these patients expecting daily bowel movements and – if these fail to occur … Constipation: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The pathogenesis of constipation is diverse. The following components may occur: Disruption of intrinsic (“internal”) motility (movement of the bowel). Lack of luminal factors, such as stretching, chemical and tactile stimuli. Lack of extrinsic innervation (functional supply of nerve tissue to the organ, i.e., nerve cells; cross-sectional lesions). Defecation disorders (disorders … Constipation: Causes