- Constipation refers to the incomplete evacuation or difficulty in passing of stools or passing of hard stools.It is the most common digestive complaint yet, it is treated as a symptom,and not a disease by itself.Constipation occurs among all ages, from newborns to elderly persons.However, this condition is more common among the elderly.In ayurveda, it is referred to as Aanaaha, Koshtha baddhata or vibandha.
- According to ayurveda, it is usually a vata disorder, particularly if it is a long-standing condition or in the elderly. It may also be due to high pitta (heat which dries out the stool)or high kapha(mucous congestion clogging the colon)Proper assimilation of food and elimination of feces are important for maintaining health. Improper elimination from the colon causes retention of waste and morbid matter, which results in systemic poisoning or autointoxication. When the colon does not function promptly, the result is an accumulation of offensive and highly poisonous wastes; ayurveda calls it “aama”. Aama is considered as root cause of most of the ailments as per ayurveda.The normal duration between the times the food is eaten until the faeces is expelled, is normally between 16 to 24 hours. If the residue remains for more than 24 hrs, it gives rise to aama.
Types of constipation
- Occasional constipation-Occasional constipation doesn’t happen every day; it is a short-term condition that may only temporarily interrupt your usual routine.This type of constipation can often be relieved through changes in your diet,exercise regimen and change in lifestyle.
- Chronic constipation-Chronic constipation means straining or having difficulty in passing stools.For instance, many describe chronic constipation as feeling like you need to have a bowel movement, but no matter how long you sit, it just won't happen.With chronic constipation, you may have hard or formed stools, small stools, or a combination of infrequent hard, formed or small stools.Generally,the definition of chronic constipation is a stool frequency of less than three per week that lasts several months.
- Travel-related constipation-People often become constipated when travelling because their normal diet and daily routines are disrupted.
- Age-related constipation-Constipation is more common in children and older age.The reason for this is that children prefer junk foods and a diet low in fiber and in elder people due to vata dominance in this age and in some cases absence of teeth lead to improper chewing and weakened digestion.
- Pregnancy-related constipation-The culprits are the pressure of growing womb(uterus) on rectum,pregnancy hormones,which slow the transit of food through digestive tract,changes in diet due to morning sickness may also lead to constipation.Intake of iron supplements in pregnancy related anemia may worsen the condition.
- Functional constipation-Functional constipation, also known as chronic idiopathic constipation (CIC),is constipation that does not have a physical(anatomical)or physiological (hormonal or other body chemistry) cause.It may have a neurological, psychological or psychosomatic cause.A person with functional constipation may be healthy, yet has difficulty defecating.
- Constitution of the individual (prakriti) especially vata type of prakriti(constitution) are more prone to constipation.
- Habit of suppressing the urge over long periods (vega dhaarana). People who ignore the urge to have a bowel movement may eventually stop feeling the urge, which can lead to constipation. Some people delay having a bowel movement because they do not want to use toilets outside the home. Others ignore the urge because of emotional stress or because they are too busy. Children may postpone having a bowel movement because of stressful toilet training or because they do not want to interrupt their play.
- Absence or non-availability of articles habitually used before defecation, such as smoking tobacco, drinking coffee or tea, frequent use of laxatives and purgatives etc.
- Improper eating habits including eating a lot of food, foods that are heavy and difficult to digest, as well as oily, spicy, fried, and junk foods are the culprits and not eating enough vegetables and salads can also lead to constipation.
- Ingestion of vaata promoting food which is dry (rooksha), powdery (pishtha),cold (sheeta),astringent (kashaaya),bitter (tikta),quickly digestive and residue-free diet. For e.g.Cheese,eggs,and meats,refined flour.Food having such qualities lead to indigestion.
- Eating food in a disturbed atmosphere or in front of the television and being awake late at night all lead to bowel disturbance.
- Very little food or starvation (anashana).
- Plenty of exercising (ati vyaayaama).
- Intestinal obstruction (aantra avarodha)by foreign body or due to intussusceptions.(sammoorchana).
- Worms (krumi) can be one of the causative factor.
- Impacted feces- Specific Diseases that cause constipation include neurological disorders, metabolic and endocrine disorders, and systemic conditions that affect organ systems. These disorders can slow the movement of stool through the colon, rectum, or anus.Slow peristalsis is noticed due to debility during fevers, nervous diseases, tuberculosis, anemia etc.
- Irregular sleeping habits or emotional disturbances (stress, grief, fear or worry) are other causes for the constipation.
- Ingestion of certain medications can cause constipation.Pain killers (especially narcotics), antacids, antispasmodics, antidepressants, iron supplements, diuretics, and anticonvulsants for epilepsy can slow passage of bowel movements.
- Inadequacy of water intake can lead to constipation. Liquids like water and juice add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass.Other liquids, like coffee and soft drinks that contain caffeine seem to have a dehydrating effect.
- Excessive water elimination as in cases of vomiting(chhardi),diarrhea (atisara).
- Lack of exercise can also lead to constipation.For example,constipation often occurs after an accident or during an illness when one must stay in bed and cannot exercise.Profession with sedentary lifestyle is one of the reasons for constipation.
- Laxatives usually are not necessary and can be habit-forming.The colon begins to rely on laxatives to bring on bowel movements.Over time,laxatives can damage nerve cells in the colon and interfere with the colon's natural ability to contract. For the same reason, regular use of enemas can also lead to a loss of normal bowel function.
- Difficult bowel movement
- Dry bowel movement
- Painful bowel movement(anal pain)
- Abdominal pain
- Abdominal distension
- Loss of appetite
- Acid eructation(belching)
- Although constipation is oftenlooked upon as a common problem,if not treated or if treatment is delayed,it can lead to further problems like..
- Anal fissures
- Rectal prolapse
- Fecal incontinence
- Bloody stools
- Anal fistula
- There are several causes for constipation and constipation is also a symptom of several diseases. So while treating constipation, all the possible causes should be kept in mind. Treatment can be categorized in some of the points like diet, change in lifestyle, drugs, yogasanas etc
- In case of constipation one should be very careful with the use of laxatives as they can often weaken the colon due to their strong action.They should be taken only in acute conditions.It is better to use simple diet remedies.A lot can be recovered by proper eating habits.
- Eat whole grains and nuts.Avoid removing bran from the flour because the bran is an insoluble fiber that clears off the intestines and relieves constipation.Avoid refined foods like white flour, bread, pasta, pizza, chocolates,processed food etc.High -protein foods like cheese, red meat, and soyabeans can cause constipation.Meat is constipating and should be avoided regularly.
- The food should be warm and freshly -prepared, as cold and stale food slows down the digestive power. Eating freshly cooked food is helpful.Having excessively cold food like ice cream or chilled drinks reduces the bowel movement.
- Add more fruits to the diet like pears, grapes, oranges,guava, papaya etc
- Spices like cumin,fennel,cardamom,coriander,turmeric powder, carom seeds(ajwain),fennel, ginger etc.should be taken with food to alleviate gas and promote the downward movement of vaata for easy evacuation.
- Pitta type of constipation often involves liver dysfunction with congestion or obstruction of the bile. Hence, hot spicy food should be avoided.
- Include ample fruits, fruit juices, salads, leafy and green vegetables, whole grains, and unpolished rice in your diet. Use whole meal flour and not refined flours.
- It is a better idea, if you can take a glass of warm milk at bedtime after adding a teaspoonful of ghee to it.
- Beans, dry grains, the cabbage family plants, mushrooms and other light or dry food should be avoided.
- Drink 7-8 glasses of water each day, preferably lukewarm in winters and room -temperature water in summers. Have a mid-morning soup, preferably prepared with spinach and tomato.
- Raisins (kishmish) are packed with fiber and act as great natural laxatives. Soak a handful of raisins in water overnight and have this full mixture in the morning on empty stomach. This remedy also works wonders for pregnant woman and even to little infants (in less dosage) without the side effects.
- Lemon (Nimbu) juice is recommended by most ayurvedic practitioners. A warm glass of water with lemon and salt should be taken on empty stomach in the morning,it acts as a cleansing agent for the intestines, the salt content helps in quick and easy passage of stool.Crushed ginger can be added in this drink to aid digestion.
- Figs (Anjeer) either dried or ripe, are packed with fiber. For relief from constipationboil a few figs in a glass of milk, drink this mixture at night before bed. Make sure themixture is warm when you drink it. Using a whole fruit for this purpose is much betteras compared to syrups that are available commercially.
- Flax seeds(Alsi) are known for their fiber content, and can very well help you when itcomes to constipation. You can mix flax seeds in your cereal every morning or just have a handful with warm water early in the morning.
- Spinach(Palak) has properties that cleanse, rebuild and renew the intestinal tract.You can have about 100 ml of spinach juice mixed with an equal quantity of water twice daily. This home remedy is the most effective method to cure even the most stubborn cases of constipation.
- Triphala powder or Triphala Churna,consists of three fruits -Amla(Indian gooseberry),Haritaki (Chebulic Myrobalan)and Vibhitaki (Bellirica Myrobalan).It is a great laxative and helps to regulate digestion and bowel movements.You can either have one teaspoon with warm water or mix the powder with honey.Having this mixture either before going to bed or early in the morning on an empty stomach can relieve constipation almost instantaneously.For those having chronic constipation the powder alone does not help.It is to be taken as a decoction prepared by boiling 20 gm of the powder in 16 times of water and reducing it to one-fourth.The advantage of this powder is that it is not habit forming and a completely natural alternative to chemical laxatives.
- Castor oil(Arandi ka tel)has been used for centuries as a sure shot remedy for constipation and has properties that can kill intestinal worms.All other purgatives produce roughness (rooksahta)while castor oil produces unctuousness (snigdhata).If drinking a spoon of castor oil alone is not something you’d like to do, you could add a tablespoon of it in a warm glass of milk. Have this mixture at night before bed to relieve constipation.
- Apply 3 to 4 drops of lukewarm castor oil over the navel at night for proper evacuation
- There are other classical medicines, which help eliminate chronic constipation by strengthening the intestinal valves and their functions. Some of the constipation herbal mixtures are Agastya rasaayana,pancha sakaara choorna, abhayaadi modaka,sukhsaarak choorna,avipattikar choorna.etc.Kindly note that these drugs must be taken under medical supervision only.
- In cases of chronic and severe constipation,ayurvedic detoxification procedures like Basti karma (enema therapy) Virechana karma (purgation therapy) are recommended under medical supervision.
- Evacuation should be a part of your daily routine.It is very much necessary to form a habit of evacuating early morning.
- Deficient mastication is unquestionably one of the most important causes of constipation.The digestive process cannot be carried out properly when the stomach and the small intestines are called upon to do the triturating and macerating ordinarily done in the mouth.
- Regular physical exercise is also important for having clear bowel. Often a simple stroll in the park can relieve constipation.
- Disturbing psychological factors should be removed, and meals should be taken in a relaxed and calm atmosphere
- Eat light regular meals, and make sure you eat at least 3-4 hours before you go to bed.
- Cut down your mental worries and anxieties. Avoid over-exposure to severe heat or wind.
- Vata excess disrupts apana vayu, the sub-type of vata that supports elimination and stability.These asanas if practised on regular bases in early morning on empty stomach can help in balancing apana vayu.
- Suryanamaskar(sun salutation)
Pranayamas (breathing exercises)
- Excessive mental, emotional and physical stress can worsen the constipation.Practicing meditation will enhance body's ability to recover from stress and acquire health and well being.
Stay healthy !