Constipation Treatment in Ayurveda
Since ancient times different societies have published medical opinions about how health care providers should respond to constipation in patients. Doctors in history have treated constipation in reasonable and unreasonable ways, including spatula mundani (a surgical device invented in the 17th century to treat extreme cases of constipation where purgatives had failed).1
Constipation is a common functional gastrointestinal disorder, with a prevalence in the general population of approximately 20%. In the elderly population, the incidence is higher than in the younger population with elderly females suffering more often from severe constipation.2 Approximately 3% of children have constipation, with girls and boys being equally affected. With constipation accounts for approximately 5% of general pediatrician visits and 25% of pediatric gastroenterologist visits. During the postpartum stage, women are at increased risk of being constipated. Multiple studies have shown the prevalence of constipation to be around 25% during the first three months.1
Constipation is a condition in which you may have fewer than three bowel movements a week; stools that are hard, dry, or lumpy; stools that are difficult or painful to pass; and a feeling that not all stool has passed. Constipation is not a disease, but may be a symptom of another medical illness and may last for a short or long time.3
People more likely to become constipated include older adults, people who eat very little fiber, women, especially during pregnancy and after giving birth, and people who have certain health problems including gastrointestinal disorders. Complications from constipation may include hemorrhoids, anal fissures, or fecal impaction.1 Laxative such as osmotic, bulk-forming, stimulant, stool softeners, etc. is the remedy for constipation.
Symptoms of constipation 4
- Difficult and painful bowel movements
- Bowel movements fewer than three times a week
- Hard or small stools
- Feeling bloated
- Feeling sluggish
- Abdominal pain
Causes of constipation5
- The slow movement of stool through your colon.
- Delayed emptying of the colon.
- Functional gastrointestinal disorders such as irritable bowel syndrome etc.
- Certain medicines viz. antacids (containing aluminum and calcium), antispasmodics, anticholinergics, anticonvulsants, etc.
- Dietary supplements such as iron supplements etc.
- Lifestyle causes include consumption of an insufficient fiber-rich diet, less drinking of water or dehydration, not enough physical activity, etc.
- Disorders such as Parkinson’s disease affect the brain and spine.
- Metabolic disorders such as diabetes and hormonal disorders such as hypothyroidism.
- Intestinal obstructions and anorectal blockages or tumors.
- Anatomical defects in the digestive tract.
Types of constipation6:
Constipation is broadly classified into two types:
- Primary constipation
- Secondary constipation
Primary constipation: Constipation that occurs without any clear cause
Secondary constipation: Constipation that occurs as a result of lifestyle factors, or an underlying cause such as diabetes, hypothyroidism, or the effect of certain medications
Primary constipation is further divided into three types:
- Normal transit constipation: This is a condition in which a person perceives themselves to be constipated, but the consistency of their stools is normal, and may experience abdominal bloating and pain.
- Slow transit constipation: In this, people do not experience the normal stimulation of the bowels, called peristalsis, after eating. Hence, food moves through the digestive tract more slowly than usual, and stools take longer to pass through the colon and will have less frequent bowel movements.
- Outlet constipation: occurs as a result of damage to the pelvic floor muscles or nerves making it difficult for a person to pass stools due to pain, and needing to use the hands to assist bowel movements.
Tests advised in constipation 7
- The doctor checks the abdomen for swelling, tenderness or pain, masses or lumps
- Performs a digital rectal examination (DRE)
- Blood tests
- Stool examination to look for any presence of blood or signs of infection
- Flexible sigmoidoscopy
Colorectal transit studies
Constipation – An Ayurvedic View
Vibandha is correlated with constipation in Ayurveda. This is not described as a separate disease. It has been described as one of the complications of purificatory therapies such as Vamana (emesis) and Virechana (purgation), as a symptom of Parikartika (fissure-in-ano), a disease caused due to nutritional deficiency and one of the complications of immediate hemostasis in Raktarshas (bleeding piles).8 The other names for Vibandha are Malavrodha, Vitgraha, Malavstambha, Kabja.9
According to Charaka, if one holds the urge to defecate it causes colic pain, headache, retention of feces and flatus, cramps in the calf muscles, and distension of the abdomen.8
Constipation Treatment in Ayurveda8
Constipation (Vibandha) treatment in Ayurveda is the Virechana (purgation). Oleation and sudation are the prior therapies to be done before purgation.
Three types of Virechana are explained in Ayurveda:
- Sukha virechana (causing easy purgation): drug to be used is Trivrut (Operculina turpethum)
- Mrudu virechana (causing mild purgation): a drug used is Aragvadha (Cassia fistula)
- Tikshna virechana (causing strong purgation): Milk of Snuhi (Euphoria nerifolia)
Laxatives used in Ayurveda have a great role in treating constipation
Types of laxatives:
- Anulomana (carminative): Drugs digest the undigested food residue by inducing or restoring normal peristaltic movements of the intestine and help in the expulsion of formed gas, thus, reducing flatulence.
- Bhedana (purgative): These are strong laxatives that enhance bowel movements by absorbing the water into the formed stools from the surrounding tissues and softening the stools for easy passage
- Rechana (catheritics): These drugs accelerate the defecation
- Sramsana: These laxatives act on the intestinal wall and increase muscle contraction, thereby expelling the undigested food residue and stool is passed.
Ayurvedic medicines for constipation
Various ayurvedic medicines are used in treating constipation. The selection of medicines depends on the cause of constipation rather than simply using purgative medications. Medicines are only effective when the right diet and lifestyle are followed.
- Avipathi choorna
- Triphala choorna
- Lavana Bhaskara choorna
- Panchasharkara choorna
- Panchasama choorna
- Hingwashtaka choorna
- Vaishwanara choorna
- Amrutaprasha ghritha
- Chchagaladi ghritha
- Sukumara ghritha
Diet and Lifestyle in constipation
Green gram, leafy vegetables, wheat, an old variety of rice, red variety of rice, fiber-rich diet viz. radish, tubers like carrot, and adequate drinking of water help in relieving constipation.
Physical exercise, proper sleep, and proper bowel habits to be followed.
Home remedies for constipation10,11
- Triphala is a good remedy. Powder of these drugs with some lukewarm water is beneficial.
- One-fourth teaspoon of Triphala + half teaspoon of coriander seeds + one-fourth teaspoon of cardamom seeds. Grind all together and have twice a day.
- Milk and ghee: one or two teaspoons of ghee mixed in hot milk at bedtime is effective.
- Bael fruit: Eating a half cup of bael fruit pulp and a teaspoon of jaggery every day in the evening before dinner.
- Bael sharbat along with tamarind water and jaggery added to it.
- Licorice root: A teaspoon of licorice root and jaggery mixed with warm water.
- Roasted fennel: A teaspoon of roasted fennel with warm water at bedtime.
- Figs or Anjeer: Anjeer soaked in warm water is beneficial in constipation.
- Raisins: Raisins soaked in water at bedtime relieves constipation.
- Flaxseed: Take one teaspoon of flax seeds and boil it in a cup of water for 2-3 minutes. Allow it to cool, strain, and drink the water.
- Castor oil: One teaspoon of castor oil on empty stomach with water or milk is beneficial.
When to see a doctor?12
Consult a doctor if symptoms do not go away or if you notice the following:
- Bleeding from the rectum
- Blood in your stool
- Pain in the lower back
- Persistent abdominal pain
- Persistent bloating of the abdomen
- Unexplained weight loss
- Sudden change in bowel movements
Constipation in Ayurveda is a symptom seen in many diseases, even as a complication of improper administration of purificatory therapies. Present-day lifestyle modification with nutritious food intake containing fiber along with adequate drinking of water, sound sleep, and stress-free life is the need to tackle this commonest condition affecting a large population. Simple home remedies can be effective in getting relief from the symptoms of constipation.
“This article does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on this website. If you think you may have a medical emergency, immediately call or visit your doctor.”
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References and citations