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DOI: 10.1055/s-2008-1067563
© Georg Thieme Verlag KG Stuttgart · New York
Tabuthema Obstipation: Welche Rolle spielen Lebensgewohnheiten, Ernährung, Prä- und Probiotika sowie Laxanzien
Constipation: Which Role Play Life-Style, Nutrition, Pre- and Probiotics or Laxatives?Publication History
Publication Date:
21 October 2008 (online)
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Zusammenfassung
Schätzungsweise jeder fünfte Deutsche leidet zumindest zeitweise an Obstipation. Obstipation liegt vor, wenn der Stuhlgang oft hart ist, meist stark gepresst werden muss, immer wieder das Gefühl einer unvollständigen Darmentleerung vorliegt, die Defäkation häufig nur mit manueller Unterstützung möglich ist oder es seltener als 3-mal pro Woche zu Stuhlgang kommt. Ältere Menschen leiden häufiger an Obstipation als jüngere. Etwa 2 Drittel der Betroffenen sind Frauen, 1 Drittel Männer. Diverse Grunderkrankungen sind durch das Symptom Verstopfung gekennzeichnet. Obstipation kann aber auch eine Nebenwirkung zahlreicher Medikamente sein. Oft ist jedoch keine Ursache erkennbar. Die Obstipation ist dann funktioneller Natur. Gerade die funktionelle Obstipation schafft Raum für Spekulationen, z. B. ob die Obstipation ein Ernährungs- oder Lifestyle-Phänomen ist. Eine sichere Abklärung von ernsthaften organischen Ursachen ist in jedem Fall notwendig. Die Diagnostik spielt bei Obstipation daher eine wichtige Rolle. Die Behandlung der chronischen Obstipation erfordert neben gesunder Ernährung und Lebensführung vielfach auch Laxanzien. Die Bedeutung von Probiotika in der Therapie wird zunehmend diskutiert. Klinische Studien lassen positive Effekte von bestimmten Probiotika auf die Stuhlfrequenz und die Schmerzreduktion vermuten. Der vorliegende Beitrag gibt einen aktuellen Überblick über Fakten und Vermutungen zur Epidemiologie, zu den Ursachen und zur Diagnostik und Therapie der Obstipation.
Abstract
It is estimated that every fifth German adult is at least temporarily affected by constipation. In the case of constipation, the feces are usually hard, bowel movement frequently has to be forced, there is very often a feeling of incomplete bowel movement, the bowel movement many times is only possible using manual assistance or defecation happens less than 3 times a week. Elder people suffer more often from constipation than younger ones. Approximately two thirds of affected persons are women, one third are men. The causes of constipation are manifold. A number of diseases are associated with the symptom of constipation. In addition, constipation is a common side-effect of many different drugs. Often, the cause of constipation remains obscure. In this case constipation is called a „functional” disease. Functional constipation in particular provides room for speculation, e. g. to which extent constipation is a nutrition problem or a life-style phenomenon. Therefore, a careful check-up for severe organic reasons of constipation is definitely necessary. The diagnostic means to assess constipation are of crucial relevance. Treatment of chronic constipation requires healthy nutrition, healthy life-style and in most cases laxatives. The role of probiotics in the therapy of constipation is discussed controversially. Clinical studies suggest positive effects of particular probiotics on the defecation rate and pain reduction. This review provides an overview on recent facts and speculations on the epidemiology, the causes, the diagnosis and therapy of constipation.
Schlüsselwörter
Obstipation - Ernährung - Lifestyle - Laxanzien - Prä- und Probiotika
Key words
constipation - nutrition - life-style - laxatives - pre- and probiotics
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Prof. Dr. med. Stephan C. Bischoff
Institut für Ernährungsmedizin, Universität Hohenheim
Fruwirthstraße 12
70593 Stuttgart
Email: bischoff.stephan@uni-hohenheim.de