{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T16:40:09Z","timestamp":1723740009963},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Was ist Neu?<\/jats:title><jats:p>Diagnostische Strategie\u2002Die Rom-IV-Kriterien f\u00fcr die prim\u00e4re chronische Obstipation helfen, zwischen kurzfristigen Beschwerden und einem chronischen Beschwerdebild zu unterscheiden 1. Im Allgemeinen finden sich in der Altersgruppe der Hochbetagten mehrere Ursachen f\u00fcr eine St\u00f6rung der Def\u00e4kation. Anamnese und Beachtung von Red Flags neben einem geriatrischen Basisassessment erm\u00f6glichen es, die Ursachen einzugrenzen. Die Unterscheidung zwischen einer Low-Transit-Obstipation und normaler Darmfunktion kann die therapeutische Konsequenz entscheidend beeinflussen.<\/jats:p><jats:p>Therapeutische M\u00f6glichkeiten\u2002Bei der medikament\u00f6sen Intervention werden osmotische Abf\u00fchrmittel, stimulierende Abf\u00fchrmittel, Z\u00e4pfchen und Einl\u00e4ufe mit unterschiedlichen Zus\u00e4tzen in erster Linie weiterhin sehr h\u00e4ufig verwendet. In zweiter Linie k\u00f6nnen das Prokinetikum Prucaloprid und seit einigen Jahren Methylnaltrexoniumbromid als ein Vertreter der peripher wirkenden \u00b5-Opioid-Rezeptor-Antagonisten Anwendung finden 2 3. Faserreiche Ern\u00e4hrung vermehrt die Stuhlmasse und pr\u00e4biotische Zusatzkost kann das Mikrobiom g\u00fcnstig beeinflussen. Zus\u00e4tzliche Ballaststoffe haben wahrscheinlich keinen Nutzen bei schwerer Verstopfung, insbesondere bei Patienten mit Low-Transit-Obstipation oder Def\u00e4kationsst\u00f6rungen. Bei Vorbereitungen auf Koloskopien scheint eine zus\u00e4tzliche Bewegungsaktivierung positive Effekte auf die Qualit\u00e4t der Darmreinigung zu haben 4.<\/jats:p>","DOI":"10.1055\/a-1165-1351","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T22:40:46Z","timestamp":1602024046000},"page":"1456-1459","source":"Crossref","is-referenced-by-count":1,"title":["Darmmotilit\u00e4tsst\u00f6rungen bei Multimorbidit\u00e4t: zwischen\u00a0Obstipation und Diarrh\u00f6"],"prefix":"10.1055","volume":"145","author":[{"given":"Klaus Friedrich","family":"Becher","sequence":"additional","affiliation":[{"name":"Klinik Wartenberg, Prof. Dr. Selmair GmbH & Co.KG, Wartenberg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saskia","family":"Rupp","sequence":"additional","affiliation":[{"name":"Klinik Wartenberg, Prof. Dr. Selmair GmbH & Co.KG, Wartenberg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,10,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1053\/j.gastro.2016.03.035","article-title":"Rome IV-functional GI disorders: disorders of gut-brain interaction","volume":"150","author":"D A Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"2332","DOI":"10.1056\/NEJMoa0707377","article-title":"Methylnaltrexone for opioid-induced constipation in advanced illness","volume":"358","author":"J Thomas","year":"2008","journal-title":"N Engl J Med"},{"issue":"S 18","key":"ref3","doi-asserted-by":"crossref","first-page":"9081","DOI":"10.1200\/jco.2007.25.18_suppl.9081","article-title":"Methylnaltrexone treatment of opioid-induced constipation in cancer patients","volume":"25","author":"S B Karver","year":"2007","journal-title":"J Clin Oncol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2478\/fon-2020-0009","article-title":"Effect of walking exercise on bowel preparation in patients undergoing colonoscopy: evidence from systematic review and meta-analysis","volume":"1","author":"Y Y Zhang","year":"2020","journal-title":"Front Nurs"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/j.1365-2036.2009.04169.x","article-title":"Survey of laxative use by adults with self-defined constipation in South America and Asia: a comparison of six countries","volume":"31","author":"A Wald","year":"2010","journal-title":"Aliment Pharmacol Ther"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/j.1365-2982.2008.01245.x","article-title":"Effect of age on the enteric nervous system of the human colon","volume":"21","author":"C E Bernard","year":"2009","journal-title":"Neurogastroenterol Motil"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"e200612","DOI":"10.1001\/jamanetworkopen.2020.0612","article-title":"Factors Associated With Potentially Missed Diagnosis of Appendicitis in the Emergency Department","volume":"3","author":"P Mahajan","year":"2020","journal-title":"JAMA Netw Open"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"149","DOI":"10.5056\/jnm.2013.19.2.149","article-title":"Primary care management of chronic constipation in Asia: the ANMA chronic constipation tool","volume":"19","author":"K A Gwee","year":"2013","journal-title":"J Neurogastroenterol Motil"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"7069","DOI":"10.3748\/wjg.v12.i44.7069","article-title":"Biofeedback therapy for dyssynergic defecation","volume":"12","author":"G Chiarioni","year":"2006","journal-title":"World J Gastroenterol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1053\/j.gastro.2005.11.014","article-title":"Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia","volume":"130","author":"G Chiarioni","year":"2006","journal-title":"Gastroenterology"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1038\/ajg.2010.41","article-title":"Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation","volume":"105","author":"S Mueller-Lissner","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.cgh.2011.03.026","article-title":"Oral bisacodyl is effective and well-tolerated in patients with chronic constipation","volume":"9","author":"M A Kamm","year":"2011","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"2357","DOI":"10.1007\/s10620-016-4147-9","article-title":"Efficacy and safety of prucalopride in chronic constipation: an integrated analysis of six randomized, controlled clinical trials","volume":"61","author":"M Camilleri","year":"2016","journal-title":"Dig Dis Sci"}],"container-title":["DMW - 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