BACKGROUND: In spinal cord injuries disturbed defecation, constipation and their concomitant disorders are frequent clinical symptoms. They may severely impair the quality of life of the affected patients. The presented case study and two more case reports, summarized in table form, outline therapeutic difficulties and therapy options in the treatment of constipation in paraplegic patients.CASE REPORT: A 69-year-old male patient with tetraplegia below C4 suffered from disturbed defecation, constipation with recurrent co-prostasis and pronounced meteorism which impeded breathing. Padma Lax was applied for several months, and constipation and the concomitant meteorism were noticeably reduced. CONCLUSION: The herbal preparation based on a formula from Tibetan Medicine may offer new therapeutic options in the care and treatment of patients with severe constipation. This report could also give first indications for controlled clinical studies in tetraplegic patients.