Constipation

Constipation is one of the most common gastrointestinal complaints in the world. Those reporting constipation most often are women and adults ages 65 and older.

How it is defined the normal bowel movement?

The following bowel habits are considered as normal;

• Bowel movement once a day
• Bowel movement thrice a day
• Bowel movement once in every three days

According to Ayurvedic medicine, stool [Purisha] is very important since it is a component of trimala [three waste products] a main factor that contributes to decide person’s health. Constipation occurs when there’s a derangement of mainly vata. The clinical definition of constipation is having any two of the following symptoms for at least 12 weeks-not always consecutive-in the previous 12 months:

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· straining during bowel movements

· lumpy or hard stool

· sensation of incomplete evacuation

· sensation of anorectal blockage/obstruction

· fewer than three bowel movements per week

Constipation is a symptom rather than a disease. There are several causes for the constipation. Mainly; dietary habits, impaired bowel movements, suppression of urge of defecation and lower GIT diseases like, haemorrhoids, fissures, anal stenosis etc. People who ignore the urge to have a bowel movement may eventually stop feeling the need to have one, 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.

Constipation occurs when the colon absorbs too much water or if the colon's muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry. Common causes of constipation are;

•  Low fiber in the diet
• Lack of physical activity (especially in the elderly)
• Medications: pain killers (especially narcotics), antacids that contain aluminum and calcium, hypertension medications (calcium channel blockers), iron supplements etc.
• Changes in life or routine such as pregnancy, aging, and travel
• Abuse of laxatives- flushing out of the body important vitamins, minerals and especially the friendly bacteria known as flora.
• Dehydration

There some specific diseases that cause constipation including 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.

Neurological diseases

• Multiple sclerosis
• Parkinson's disease
• Chronic idiopathic intestinal pseudo-obstruction 
• Stroke 
• Spinal cord injuries

Metabolic and endocrine conditions

• Diabetes
• Uremia
• Hypocalcaemia
• Hypothyroidism

How to prevent constipation?

Add plenty of fruits, vegetables and salads in your diet. Chew food thoroughly and eat only when hungry. High-fiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, Brussels sprouts, cabbage, and carrots are good for constipated people. For people prone to constipation, limiting foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods, is also important.

Fiber-both soluble and insoluble-is the part of fruits, vegetables, and grains that the body cannot digest. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines. Insoluble fiber passes through the intestines almost unchanged. The bulk and soft texture of fiber help prevent hard, dry stools that is difficult to pass. Both children and adults often eat too many refined and processed foods from which the natural fiber has been removed. A low-fiber diet also plays a key role in constipation among older adults, who may lose interest in eating and choose foods that are quick to make or buy, such as fast foods, or prepared foods, both of which are usually low in fiber. Also, difficulties with chewing or swallowing may cause older people to eat soft foods that are processed and low in fiber.

Other changes that may help treat and prevent constipation include drinking enough water and other liquids, such as fruit and vegetable juices and clear soups, so as not to become dehydrated, engaging in daily exercise, and reserving enough time to have a bowel movement. In addition, the urge to have a bowel movement should not be ignored.

Liquids add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass. People who have problems with constipation should try to drink liquids every day. However, liquids that contain caffeine, such as coffee and cola drinks will worsen one's symptoms by causing dehydration. Alcohol is another beverage that causes dehydration. It is important to drink fluids that hydrate the body, especially when consuming caffeine containing drinks or alcoholic beverages.

Herbal Remedies for constipation

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Ayurvedic remedies for constipation are different than standard medications. While the traditional laxatives provide relief, they do not cure the underlying causes. On the other hand the particular Ayurvedic remedies tackle the problem from different fronts, balancing the particular effected doshas in the process. Though I mention some of the common remedies here, I highly recommend you to meet your Ayurvedic physician for a better relief from constipation.

• Infusion of Triphala powder [5g in 120 ml warm water] twice a day.
• Ripe bael fruit is regarded as best of all laxatives. It cleans and tones up the intestines and a very effective home remedy for constipation.
• One or two teaspoons of aloe gel can be taken twice a day.

You can find an interesting article about elimination and some good herbal medicines for constipation here;
http://www.kitchendoctor.com/midlife_tuneup/colon_cleanse.php

http://www.ayurvedicbazaar.com/elimination.php

May all beings be healthy!

Dr. Indunil Weerarathne

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