Medically, constipation implies failure to evacuate waste matter from the body, on a regular basis. In ayurveda, it is referred to as Aanaaha. Koshtha baddhata is the other term also in use.
Passage of faeces takes place in two phases. Propulsion from the colon and expulsion from the rectum. Interference with any aspect of this process may give rise to constipation. According to ayurveda, it is usually a vaata disorder, particulary, 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).
Assimilation and elimination are the two basic needs for natural health. Inactivity of the eliminating organ i.e., 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, which not only contaminate the body through absorption with the blood but also upset the whole digestive process. In general, the residue is passed into the colon or lower bowel and stored there until a convenient time comes to expel this refuse from the body. In this colonic garbage pile, there is no antiseptic digestive juice to prevent putrefaction and as a result, the microbes generate toxins with great rapidity. Ayurveda calls it “aama.”
The normal duration between the time the food is eaten until the faeces is expelled, is normally between 16 to 24 hours. If the residue remains for 24 hours or more, it gives rise to aama. There is a simple test to know whether you are constipated or not. Just consume small amount of charcoal and watch the stools thereafter. The black colour will make its appearance eventually in the stools. If it does not make its appearance in 16 to 24 hours, you are suffering from constipation. Also, you should note carefully how long the colour continues to be conspicuous because if it is observed several hours after it makes its appearance, it indicates a true colonic congestion.
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.
The causes of constipation are many—constitution of the individual (prakriti), habit of suppressing the urge over long periods (vega dhaarana), 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., ingestion of vaata promoting food which is dry (rooksha), powdery (pishtha), cold (seeta), astringent (kashaaya), bitter (tikta), quickly digestive and residue-free diet (laghu), very little food or starvation (anasana), plenty of exercising (ati vyaayaama); Intestinal obstruction (aantra avarodha) by foreign body or due to intussusception (sammoorchana), worms (krumi), impacted faeces (pureesha); slow peristalsis due to debility during fevers, nervous diseases, tuberculosis, anaemia etc.; Psychological factors like grief (chinta), sorrow (shoka), hatred (dwesha); ingestion of certain drugs; inadequacy of water intake or excessive water elimination as in cases of vomiting (chhardi), diarrhoea (ateesaara), diabetes (prameha).
Self-Help Guidelines & Ayurvedic Remedies
Treatment is three fold—diet, drugs and daily routine.
Diet: Drink a glass of water early in the morning after washing the face and mouth. It is better, if the water is kept overnight in a copper vessel. Or soak twenty to thirty black raisins in a glass of water at night and drink the water after adding juice and pulp of lemon to it. Some people are in the habit of taking bed tea for this purpose. The reflex action produced by bed-tea is different from the one produced by the cold water.
The latter only produces pressure, thus stimulating the intestines to start their movement for evacuation. Tea, being hot, stimulates the intestines so strongly that its stimulating effect loses its significance after some days and the individual develops constipation apart from the diuretic action, which produces fluid loss thereby causing constipation. In case of vitiation of vaata, oily food should be taken. Adequate oil and ghee should be included to ensure lubrication of the colon. It is a better idea, if you can take a glass of warm milk at bedtime after adding a teaspoonful of ghee to it.
Adequate bulk should be taken as well, such as whole grains or bran. Beans, dry grains, cabbage, family plants, mushrooms and other light or dry food should be avoided. Spices, which balance digestion— asafoetida, ginger, cardamom or fennel, should be taken with food to alleviate gas and promote the downward movement of vaata.
Pitta type of constipation often involves liver dysfunction with congestion or obstruction of the bile. Hence, hot spicy food should be avoided. Adequate fluids should be taken.
If you are having kapha type of constipation, then you have to avoid foods like sugar, cheese, curd, bread, potatoes and pork.
• Wheat is better than rice in case of constipation.
• Eat plenty of fruits and leafy vegetables.
• Use whole meal flour and not refined flour.
• Papaya and sugarcane are very effective in relieving constipation. 9 Avoid fried food. The body takes a long time to digest them.
Drugs: The best evacuant is castor oil. Castor oil is not only useful for bowel evacuation but also has therapeutic and curative values. All other purgatives produce roughness (rooksahta) while castor oil produces unctuousness (snigdhata). The castor oil used should be purified and diluted. Castor oil prepared through ghani or indigenous expeller is found better than the present market preparation. 20-30 ml of this oil is to be taken with warm milk. Triphala powder is very popularly used by the ayurvedic physicians for the treatment of chronic constipation.
It contains three drugs namely—Hareetaki (harad), Vibheetaki (Beleric myrobalan), and Aamalaki (amla). Of these three drugs, hareetaki alone works as a purgative. But while manifesting its action, it produces certain adverse effects like gripping pain and wind formation in the stomach. To avoid these adverse effects and to make it more useful as a tonic, the remaining two drugs are added. Triphala powder is used in two different ways. One or two teaspoonfuls of this powder is mixed with a cup of warm milk and some sugar is added to it. It is to be taken at bedtime and its purgative effect is manifested early morning. For those having chronic constipation and simultaneously a costive bowel, 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 powder is to be filtered and the liquid taken. Since it is strong, two to four teaspoonfuls of honey may be added to it, if needed.
There are other medicines, which help eliminate chronic constipation by strengthening the intestinal valves and their functions. One such drug is known as Agastya rasaayana. Two teaspoonfuls of this drug should be taken regularly, twice a day, along with any hot drink of choice. Other drugs include Pancha sakaara choorna, Abhayaadi modaka, Madhu yashtyaadi choorna etc. These should be taken under medical supervision only.
Pointers
• In cases of severe constipation, ayurvedic detoxification procedures like Vasthi karma (enema therapy), Virechana karma (purgation therapy), Udvartana massage therapy (to strengthen the abdominal organs) are recommended.
• As constipation is a habit, the overcoming of it must become a habit too. One does not feel the urge for it. It should be a part of your daily routine.
• 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.
• Physical exercises are must.
• Cut down your mental worries and anxieties. Avoid over-exposure to severe heat or wind.
• Sukhavirechana vati, Vi to 1 tablet with warm milk at bedtime, is an effective remedy for constipation. Dry ginger powder along with senna leaves powder in equal quantities taken with a cup of lukewarm water at night can help in easy passage of stools.