Gastrointestinal tract

Intestinal sluggishness - causes, symptoms and therapy

Intestinal sluggishness - causes, symptoms and therapy

We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

Carrier bowel - disturbed bowel activity with abdominal pain and bloated stomach
Intestinal sluggishness is a common phenomenon. Those affected suffer from abdominal pain, bloated stomach, nausea and even depression. Especially in western industrialized countries, a sluggish bowel is widespread due to a lack of exercise and an unhealthy diet. However, other (organic) causes are also possible.

The gut

Our gut is an extremely complex structure. It consists of a small intestine and a large intestine and winds through the inside of our body in loops up to eight meters long. The appendix, the colon and the rectum are located in the large intestine; the rectum, in turn, divides into the rectum and the intestinal outlet at which the sphincter muscles are seated, i.e. the anus or anus; this anus is one of the most sensitive areas of the body, because here the outer skin meets the inner intestinal mucosa.

We cannot willingly influence the inner sphincter, but we control the outer one ourselves. Constipation means that emptying at the end of the intestine does not work. This emptying, which is a matter of course for us, is a complicated process that we have not yet comprehensively understood. Various nerve pathways from the end of the intestine to the spinal cord and to the brain are involved; and psychological moods also play a role.

If the manure accumulates during transport, this is due to a disturbed coordination of the sensory and movement nerves in the intestine. This includes the nervous system in the intestine itself, the muscles of the intestinal wall and pacemaker cells in the intestines.

When the bowel strikes - case studies

Hendrik (name changed) began studying engineering in Hanover; he had little money and therefore gladly accepted the offer of a fraternity to live in their liaison house for 180.00 DM.

The older residents treated newbies like him like servants, and he felt like a military recruit the Sergeant harassed. Excess alcohol promised at the weekend, but Hendrik couldn't keep up with them either and was the first to vomit in the toilet bowl.

There was also a problem that he didn't reveal to anyone. His intestines squeezed and his stomach ached, but when he sat down on the toilet and pressed, the feces accumulated in the rectum.

After two weeks he went home to his parents, who live in a village in the Lüneburg Heath. He slept in and his mother cooked him up. After eating, he sat on the toilet, his sphincter relaxed, and his intestine finally emptied.

Intestinal sluggishness, commonly known as constipation, complicates bowel movements - the faeces are not completely eliminated or too rarely. It is still a taboo subject and at the same time a complaint that we all know. This was one of the reasons why Hendrik found it difficult to talk about his problem.

Melanie (name changed) has a similar problem. She works as a department head for an urban authority. Her gut works smoothly in her apartment and directly at her work place, but when it is going out at conferences, concerts or in a restaurant, her gut closes the gates - and nothing escapes.

Once again Melanie was in the situation that the pressure on the anus was unbearable, it was at a university party and she asked her best friend if he could stand guard in front of the ladies' room. He was astonished, but did what she asked for. And, she herself hardly believed it, her sphincter relaxed.

Hendrik and Melanie's psyche, brain and intestinal nerves interacted. In both cases, the intestine went on strike in unusual situations, which they also found to be uncomfortable. In both, the sphincters relaxed when they thought they were safe.

Evolutionary self-protection

However, not every constipation is as clearly psychologically determined as with the two. Responses from our gut are first a psycho-biological legacy of our evolution; Eliminating droppings was a risky situation for early humans: anyone who crouched, squeezed the anus muscles and additionally put his hands on his hips was defenseless and thus easy prey for saber-toothed tigers, lions or hostile people.

So it was a necessity to keep a safe place and to keep members of the own group on guard. It can only be speculated, but it is logical that the intestine reacted to potentially dangerous situations - for example through constipation.

However, the intestine inside the body does not decide itself. Our sensory perception rather determines whether a situation could be risky. The sensory organs transmit this mood to the brain, and the brain passes the information on to the nerves in the intestine. He holds the droppings back until he gets the message: everything is fine.

Whether a situation is really dangerous like the saber-toothed tiger in wait or our fear only classifies it as risky is equally important for the physical reaction.

Travel constipation

The travel blockage is unproblematic: We are lying on the Caribbean beach or visiting the Colosseum, it presses in the intestine, but nothing comes. It takes the body some time to adapt to the new climate, to digest the unfamiliar food, and in hot countries we often don't get enough fluids. Sometimes we have alternating diarrhea and constipation. After a few days, however, our intestinal balance normalizes.

Intestinal sluggishness in a foreign country, like Melanie's, can also have psychological causes. Some people are afraid to go to the toilet in a foreign environment, and the body translates this by cramping the intestinal tract.

Occasional constipation is also not dangerous. It has various causes, a lack of fluids is common, and hot soups or dried fruit, for example, help against this.

Chronic constipation

However, a persistently sluggish bowel is a serious problem. We usually empty it at least three times a week. However, if we have trouble stopping the feces for at least a quarter of a year, there is likely to be chronic constipation.

Signs of chronic constipation:

  • We have to press extremely hard to empty ourselves and even help out with our hands.
  • The droppings are hard and form lumps.
  • The intestinal exit feels blocked and hurts from the inside.
  • We notice that a large amount remains in the intestine.
  • These symptoms occur at least every fourth emptying.

An intestinal sluggishness exists even if we empty ourselves daily, but these problems occur.

Basic diseases

Basic diseases can disrupt the interaction of the nerves during bowel movements. These include, in particular, metabolic diseases such as diabetes mellitus that damage the nerves, muscle diseases that affect the intestinal muscles or disorders of the central nervous system.

Bowel diseases usually affect emptying. Anatomical changes in the intestine can also hinder excretion.

Way of life

Lifestyle and working methods influence the intestinal balance. If we move too little, postpone bowel movements and especially when we are stressed, constipation can result. However, these triggers are not the cause of disturbed bowel activity, they only promote it.

An uncontrolled sleep, i.e. changing day-night rhythms, also affect the intestinal functions. Those affected include nurses as well as managers, journalists and business travelers.

However, there are specific factors in these people: professional travelers are at increased risk of travel constipation, those who frequently attend conferences and lectures sometimes postpone their bowel movements, and the same applies to journalists on reports. Here, a doctor should individually decide which problem is present.

Acute constipation

Acute constipation, on the other hand, occurs suddenly without the symptoms being present for a long time. It is often associated with other complaints, namely nausea, fever, “bloated stomach” and abdominal pain. There may be an intestinal obstruction and an emergency doctor should be alerted immediately.

Inflammation of the intestines, circulatory disorders, surgery or radiation therapy can result in scars in the intestine - and these impede bowel movements. Gallstones sometimes occlude the intestine, usually the upper small intestine. Tumors in the abdomen and pelvis also lead to narrowing, and a hernia sometimes pinches the intestine.

Irritable bowel

Irritable bowel syndrome is often accompanied by constipation. Young people are mostly affected; Inertia and diarrhea alternate. The sufferers suffer from feeling of fullness, stomach pressure, flatulence and massive abdominal pain, which are connected with cramps.

The diagnosis is difficult. Allergies to food cause similar symptoms, as do intestinal inflammation, bulges of the intestinal wall (diverticula) and intestinal narrowing. Adequate nutrition is as important as relaxation exercises to cure irritable bowel syndrome.

In irritable bowel syndrome, the digestive organ strikes without the doctor recognizing a physical cause. Nevertheless, the disease is not just psychological; the sufferers have an unusually sensitive intestine, the intestinal nervous system of the affected person responds with pain to air in the intestine, which accumulates again and again as normal.

Mental states, i.e. fear, anger or inner restlessness promote the irritable bowel, trigger it or at least intensify it.

As with other forms of constipation, improper nutrition is no more the cause than cigarettes or alcohol - but a healthy diet contributes to healing.

Other causes of constipation

1) nerves and psyche. In the intestinal system, the nerve network and psyche work together, mediated via the brain. Diseases of the nerves and brain can affect the intestine as well as psychological problems. Spinal cord injuries, such as paraplegia, affect the gut as well as diseases of the central nervous system, multiple sclerosis, stroke or Parkinson's disease.

2) Eating disorders such as anorexia and bulimia have a direct effect on the digestive system. The metabolism is disturbed, and the salt balance gets out of balance. In addition, eating-disordered laxatives misuse and disrupt the intestinal transport.

3) Hormones affect the gut. An underactive thyroid makes it work slower, the thyroid hormones no longer adequately supply the organism, and therefore the nerves switch too late; Constipation is the result, in addition there is an increased sensitivity to cold.

4) Pregnant women often have problems with bowel movements. Your intestines work delayed, due to the high hormone secretion, in addition, the uterus and the embryo press on the digestive organ and constrict it.

5) The cause can be the pill, i.e. contraception with hormones - at least until the body has adjusted to the changed hormone balance. However, if the problem persists, the patient should change the pill or consider other contraceptives.

6) High blood sugar affects the intestine, because too high a level, i.e. varieties of diabetes, damages the nerves of the involuntary nervous system. In addition to constipation, this also leads to impotence.

7) If the kidneys fail, the body is overacidified and the organism lacks vitamin D. The consequence: Calcium from the bones gets into the blood in too high a dose.

8) Potassium deficiency promotes constipation. Kidney weakness is considered a natural trigger, but the excessive consumption of laxatives and drainage also depletes potassium, and this affects not only the intestine but also the bladder; urinating is just as difficult as draining droppings.

9) Amyloidosis is far more serious. This so-called systemic disease, which results from chronic inflammation in the body and damages the entire organism, leads to the fact that protein is stored in the wall of the intestine, which the intestine cannot dissolve. Although amyloidosis is hereditary, it only develops as a result of chronic inflammation in the body, such as rheumatism and some diseases of the lymph and blood.

10) Medications affect the gut as a side effect. Common suspects are agents such as gastric acid inhibitors or codeine and other opioids. Beta blockers for the cardiovascular system and water-driving medicines also affect bowel movements, in the form of constipation or diarrhea.

Remedies for epilepsy and Parkinson's, cramps, weak bladder and insomnia affect the digestive system as well as morphine: Heroin users usually suffer from constipation.

11) Abscesses, scars and fistulas in the anus block the intestinal exit. Injuries, for example cracks in the skin on the anus, which connect the outer skin and intestinal skin, not only make the bowel movement painful, but also make it difficult, especially if the wound swells.

12) An intestinal prolapse in the rectum and its opposite, an inversion of the rectum means that the feces collect in intestinal folds in the body instead of being excreted through the anus.

13) Colon and anal cancer can narrow the intestine so that it is impossible to drain normal feces.

14) An impaired sphincter also blocks bowel movements. The sphincter on the anus coordinates a complex system between the pelvic floor, urethra and rectum. If the rectum or pelvic floor tenses, it means constipation: the pressure in the rectum increases, but the sphincters do not loosen, we press and press involuntarily, but the more we press, the more the anus closes.

15) Anatomical malformations in the pelvis also lead to constipation. These are sometimes congenital, but the pelvis also sinks after pregnancy and with age.

16) Severe constipation sometimes occurs in young women. The indication of this problem is a delayed transport of the stool through the intestine, which can be seen with an intestinal biopsy.

Here intestinal nerves, intestinal muscles and pacemaker cells are equally affected.

Weak nerves

Quite a few of those affected are genetically affected, namely by Hirschsprung disease. The organism then does not supply the nerves in the intestine with enough impulses, and the nerve switch cells are completely absent in the lower rectum.

In severe cases, the intestine is too tight at these points and the sphincter does not loosen. As infants, those affected suffer from extreme abdominal pain or even bowel obstruction. A sample of the intestinal mucosa is part of the diagnosis here.

The disease has to be removed by surgery.

The blocked intestine

The intestine often blocks without a seal. Doctors then speak of chronic intestinal pseudo-obstruction. Simply put: The person affected shows symptoms that indicate an emerging intestinal obstruction; but the cause is different.

Bloated stomach, abdominal pain, vomiting, a kind of heartburn in the chest add to the constipation. Muscles and nerves of the intestine fail.

Numerous disorders can underlie this pseudo-intestinal obstruction, for example diseases of the muscles. The muscles hurt and they are atrophied. The eyelids cannot lift, the heart beats irregularly, and the brain develops slowly. Since the intestinal muscles are also weakened, those affected suffer from chronic intestinal sluggishness.


The doctor asks about the symptoms, especially how long they have been occurring. Then he asks whether constipation and diarrhea alternate, whether the feces change color, are mixed with blood or mucus. It is also clarified whether the patient suffers from abdominal pain or flatulence, whether it is difficult to release the feces, pain or even bleeding. Sometimes he advises the person concerned to keep a toilet diary.

Weight loss, fever and infections are also important indicators of basic illnesses. In addition, other symptoms sometimes play a role: back pain, diseases of the liver, gallbladder and pancreas.

The doctor palpates the abdomen and groin area as well as the anus. He inserts his finger into the anus and feels whether the rectum changes. Laboratory analyzes are also carried out, the abdomen is analyzed with ultrasound, a colonoscopy, tissue removal, computer and magnetic resonance imaging follow.

Different specialists often work together: the gastrointestinal specialist is then just as much in demand as the urologist, the gynecologist and the neurologist. If the transport routes of the intestine are disrupted, even a special field comes into effect: neurogastroenterology.


There are very different methods of curing intestinal sluggishness, depending on the type of disease. In the case of basic diseases such as multiple sclerosis, tumors or anorexia, the root is always the disease, constipation is only a consequence of it, and curing the symptoms is of little use in the long term.

Chronic constipation can be alleviated using medication as well as surgery. Blockages caused by an abscess, scars or cancer are best combated by the surgeon's scalpel. Enemas help the intestine to empty itself.

In the case of psychological triggers, i.e. in cases like Hendrik and Melanie, a psychologist or psychotherapist should be involved.


Anyone suffering from a sluggish bowel quickly thinks of laxatives to treat it. This can make sense for a certain period of time, but in the long run the digestive organ reacts counterproductive: it reacts less to the filling stimuli, and in the long run the constipation increases.

So laxatives

  • do not take constantly
  • dose small
  • After emptying the bowel, wait at least three days before taking it again
  • do not take before trying to switch to an intestinal-friendly diet

Gut-friendly nutrition

The cause of constipation is not the lack of fiber and insufficient drinks. However, fiber and sufficient water alleviate chronic constipation.

Fiber-rich food, additional fiber and lots of water or herbal tea help the intestines. Up to two liters of water per day are generally recommended, in addition, liquid has no effect on the body.

Self-help for intestinal sluggishness

If there is no serious illness, effective home remedies for constipation help. Dried plums relieve the blockages, especially together with a lot of water. Other vegetables and fruits also bring fiber, as do legumes, muesli, dried and fresh blackberries, currants, raspberries and blueberries. Flax seeds with a lot of liquid accelerate the intestinal transport; So if you don't have a sluggish bowel, you should enjoy it in moderation.

All food that clogs should avoid affected people. Stay away from: white bread, French fries, chips, long drawn black tea, meat and products made from white flour.

If self-help remains unsuccessful, i.e. the intestine continues to build up despite an improvement in lifestyle, adequate sleep, friendly nutrition and lots of exercise, we ask a doctor. Because an irritable bowel, an inflammation of the intestine or even cancer in the intestine and anus may trigger the symptoms. (Dr. Utz Anhalt, nr)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch


  • Thyroid center Cologne: underactive thyroid, (accessed 05.09.2019), thyroid center-koeln
  • Stephanie M. Moleski: Irritable Bowel Syndrome (IBS), MSD Manual, (accessed September 5, 2019), MSD
  • V. Andresen et al .: S2k Guideline Chronic Constipation: Definition, Pathophysiology, Diagnostics and Therapy, German Society for Neurogastroenterology and Motility (DGNM), German Society for Digestive and Metabolic Diseases (DGVS), (accessed September 5, 2019), AWMF
  • P. Layer et al .: Guideline for irritable bowel syndrome: definition, pathophysiology, diagnostics and therapy, German Society for Digestive and Metabolic Diseases (DGVS), German Society for Neurogastroenterology and Motility (DGNM), (accessed on September 5, 2019), AWMF
  • Irmtraut Koop: Gastroenterologie compact, Thieme Verlag, 3rd edition, 2013
  • Deborah M. Consolini: Constipation in Children, MSD Manual, (accessed September 5, 2019), MSD

ICD codes for this disease: K59ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.

Video: Inflammatory Bowel Disease IBD (December 2022).