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Ayurvedic Treatment for Constipation

7 Dec 2021 HYN Himalayan Yoga Academy

Ayurvedic Treatment for Constipation

Constipation is the main digestive system disorder and reflects any problems in the digestive tract. Only if our elimination is proper can we be healthy, fit and energetic. For this reason the section on constipation is the most detailed of the disease treatments. According to Ayurveda, normal and healthy colon function is indicated by a lack of tongue coating (except for a normal thin white coating). One should have an easy bowel movement the first thing in the morning. The stool should float( if it sinks it indicates poor digestion and the accumulation of toxins).

Almost everyone suffers from an accumulation of toxins in the colon, evidenced by a coating at the back of the tongue. Toxins in the colon and constipation, however, cannot always be simply treated with purgatives or colonics. These can weaken the tone of the colon and breed dependency. Their action on the system is strong and often traumatic; it can unbalance other organ humor. Symptoms of excessive use of colonics and purgatives include lack of appetite, excessive weight loss, insomnia, diarrhea or continued constipation, palpitations, anxiety and vertigo or feeling faint.

The main cause of constipation on a physical level is dietary-eating food that is difficult to digest. It may also occur as the complication of a fever or infectious disease. Other factors include sleeping late in the morning, or not heeding the urge to go. Our American life-style of getting up quickly and rushing off to work tends to block off the natural urge towards elimination. Sex in the morning causes apana, the downward moving air, to be weakened and can aggravate the condition. Coffee or tea in the morning may promote constipation, as they tend to be diuretic (drying). Our sedentary life-style and lack of exercise are additional aggravations.

Psychological factors behind constipation are insomnia, nervousness, stress, worry, grief and fear, as well as any excess stimulation of the nervous system (like too much television). Medical factors such as being bedridden or taking too much drugs or medications (particularly diuretics) have their effect as well.

GENERAL TREATMENT OF CONSTIPATION

For any form of constipation that is not severe, first improve the digestion with the right use of spices in order to normalize the Agni or digestive fire. Ginger is excellent in this regard but almost all spices can be helpful. Laxatives that tonify the colon or improve colon function, like psyllium or Triphala are safer and often preferable to short-term quick purgatives. Castor oil, though its taste is hard to take , is probably the best herb for severe constipation because it is not as drying to the colon as bitter purgatives. It works well with ginger tea to balance digestive functioning on all levels. Laxative salts can also be helpful much like castor oil. Strong bitter purgatives like senna and rhubarb root are better for acute or severe conditions. Acute constipation is evidenced by fever, thick tongue coating, severe bloating, gas and severe abdominal pain on palpation. It usually indicates Ama, toxemia or some kind of food poisoning (which may be caused by bad food combination). With these herbs fasting or a light diet should be followed for a few days, Care should be taken, however, if this pain is in the lower right abdomen. This can indicate appendicitis, in which case purgatives, though sometimes helpful, can be quite dangerous. In this case of women note any menstrual complications, which can also case lower abdominal pain.

For chronic constipation, particularly in the elderly or in Vata types, make sure that the diet has an adequate intake of oily or bulk foods. These include dairy products, nuts, whole grains, and bran. Raw fruit and raw vegetables are ok if the digestive fire is strong. Many fruit juices are good, particularly prune, grape and cherry, but not apple or cranberry, which can cause constipation. More oils or fats may be needed in the diet. Sesame oil is excellent, as is olive oil.

FORMULAS-TRIPHALA

The famous Ayurvedic compound Triphala is specific for chronic constipation. It is excellent for constipation in any of the three doshas, though not always effective in acute conditions. It is a great colon cleanser as well as as tonic and rejuvenative (rasayana) for the colon. Moreover, it nourishes the bones and nerves and improves the appetite. As a metabolic regulator, it will reduce fat in overweight conditions, while building the blood, muscles and nerves in underweight conditions. Dosage is 5-15 grams once a day in warm water before sleep.

Triphala ensures proper absorption of the prana, or life-force, from the food, which according to Ayurveda occurs in the colon. The colon is not just an organ of elimination but also one of digestion. Its proper function is necessary to provide adequatetive. According to Ayurveda the membrane of the colon (purihadhara kala) takes in the prana or vital force from the food, if it is functioning well, but takes in the apana or waste gases, if functioning improperly. Proper regulation of the colon, which occurs through Triphala, is one of the keys to health and longevity.

OTHER HERBS FOR CONSTIPATION

Aloe gel, 1-2 teaspoons 3 times a day, is another good general treatment for most types of constipation. Aloe possesses both cleansing and lubricating actions, though it is not as tonifying to the colon as Triphala. It is particularly good for constipation that occurs along with fever or along with delayed menstruation.

The Colon Tonic (no.5) is an improved form of Triphala, with a higher dosage of the main laxative in the formula, haritaki. It has a broad spectrum usage-with honey for kapha types, with cool water or ghee for pitta and with warm water for Vata.

In terms of life-style, it is important to arise at down (Vata time and colon time) and to empty the bowels. Often a glass of warm water or warm herbal tea will stimulate peristalsis. Yoga postures or a mild massage of the lower abdomen are helpful. Squatting, rather than sitting on the toilet, is more natural position for elimination and helps relieve blockages and spasms in the intestines that may inhibit normal evacuation.

A good breakfast, particularly of oily or laxative foods such as oatmeal with milk or ghee, may bring about normal evacuation if it has not occurred by that point. Or taking prune or grape juices may do the job. Cold food, like cold cereals with milk, can block normal elimination.

TYPES OF CONSTIPATION

Ayurveda recognizes three states of the colon: mild, medium and hard according to our constitutional condition as Pitta, kapha or Vata.

  • Those with a mild state of the colon tend to have a loose or oily stool. If they become constipated, any mild laxative such as warm milk or psyllium, will usually be sufficient. Constipation seldom becomes chronic. This is more characteristics of pitta tends towards oiliness.
  • Medium state of the colon characterizes kapha. Stronger laxatives may be needed or more long-term usage of moderate laxatives, particularly combining Triphala, trikatu (hot spices) and some use of bitter laxatives.
  • Hard or difficult state of colon characterizes Vata. Constipation is often chronic and difficult to remedy. Strong laxatives like castor oil may be necessary short-term, with a long-term taking of milder laxatives like triphala. Major dietary changes may be required.

Constipation is usually a Vata disorder, particularly when 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 (mucus congestion clogging the colon). Not uncommonly, it is an Ama or toxicity condition. Ama, undigested food, accumulates in the small intestine and is retained in the large intestine owing to blockage of the downward moving air (apana).

CHINESE VIEW OF CONSTIPATION

In Chinese medicine, acute constipation is related to fever and high fire that dries out the stool. It is similar to Pitta constipation in Ayurveda and similarly treated with bitter purgatives. Chronic constipation is related to deficiency of body fluids with progressive dryness in the colon. It is treated with bulk and lubricating laxatives, such as cannabis seeds, and is like the Vata type.

SPECIFIC TREATMENT OF CONSTIPATION

1. VATA TYPE CONSTIPATION

High Vata is characterized by dryness in the colon, intestinal gas, abdominal distention and constipation. The tongue usually has a brownish coating at the back. There may be bad breath or the passing of gas, along with pain, tenesmus and anxiety. Headaches and light-headedness may occur.

Causes are wrong diet with too much dry or light food, irregular eating habits, smoking, taking of drugs, excessive thinking, worrying, fear, and anxiety, over stimulation of the nervous system, and old age. Constipation is involved in many Vata disorders including arthritis, neurosis, epilepsy and paralysis. Treating constipation is a root treatment for many nervous system disorders.

TREATMENT

An anti-vata diet should be followed with proper spices for balancing digestion. Include adequate oils in the diet- sesame oil, olive oil or ghee- to insure lubrication of the colon. Adequate bulk should be taken as well, such as whole grains (oats is best) or bran. Beans, dry grains, cabbage family plants, mushrooms and other light or drying food should be avoided.

Spices to balance digestion, particularly asafoetida and ginger should be taken with food to alleviate gas and promote the downward movement of Vata.

Apply sesame or almond oil externally to the skin, with regular oil massage of the body, but not if there is severe bloating or distention. Sesame oil will lubricate the lungs through the skin and the large intestine through the lungs. Warm milk with a teaspoon of ghee can be taken as a laxative before sleep for mild conditions.

Take Triphala, 5-15 grams (1-3 teaspoon) in warm water before sleep. For stronger laxative action, the amount of haritaki can be doubled or triphala fried in castor oil can be used. For more obstinate constipation, particularly with disturbances of the nervous system, 1-3 teaspoons of castor oil can be taken before sleep.

Laxative salts like Epsom salt are good, 1-2 teaspoons before sleep. They moisten the stool and ease elimination. Lavanbhaskar powder is a good Ayurvedic formula using various salts, as it increases Agni and promotes elimination. Asafoetida 8 (Hingashtak) regulates peristalsis and has a mild laxative action.

Bulk laxatives like psyllium and flaxseed are excellent for mild conditions of Vata constipation. Psyllium husk powder,1-2 teaspoons in warm water before sleep, is the best and seldom causes griping. Aloegel is also useful as a lubricating laxative for vata. It may be a little cold for many Vata types so a small amount of ginger juice or powder should be added to it. Bulk laxatives are heavy and should be balanced by spices (asafetida or ginger), so they do not cause congestion.

Typical Chinese formulas include Cannabis Seed combination as a bulk laxative and Major or Minor Rhubarb temporarily for severe constipation.

ENEMA THERAPY

Enema therapy (basti) is the main method for calming Vata and is specific for constipation. First a cleansing enema is given, particularly when foul-smelling gas occurs. Use Vata-reducing herbs- Triphala, fennel, cardamom or calamus- along with a smaller amount of demulcents like licorice or sesame oil. Prepare about half an ounce of such herbs in a quart of water for the enema and administer it slightly warm in temperature. Follow with an oil enema consisting ½ cup sesame oil in ½ cup warm water, held for a minimum of twenty minutes.

When constipation is accompanied by general debility or by the weakness of old age, tonic herbs can be taken as nutritive enemas. They can be taken in oil, like sesame oil, or as milk decoctions, retaining one cup of the mixture for at least twenty minutes like the oil enemas.

CAUTION

The presence of the stool in the colon upholds the earth element in the body, which is necessary for keeping the air element from riding too high. Excess purgation therapy can cause anxiety, insomnia, palpitations, fainting, heart pain and other symptoms of high Vata. Again, one should proceed gently with Vata.

2. PITTA TYPE CONSTIPATION

Pitta constipation  often occurs during the course or towards the end of a febrile disease. In Ayurveda, purgatives are contraindicated in new fevers but prescribed in old fevers. They are given after the fever is gone to clear out residual heat and toxins.

In Chinese medicine, purgatives are given during high fevers, as another method of draining the fever, but care is taken that the fever is ‘ripe’. Indications of a ripe, or firm, fever are constipation, distention, gas and strong abdominal pain.

Pitta constipation involves irritability, anger, thirst, sweating with body odor, and burning sensations in the rectum. It is characterized by a red tongue with yellow coating and bad breath. The face may be flushed or red. There may be headache or insomnia with violent dreams.

Causes include too much spicy, sour or salty food, and too much meat or greasy food. In constipation the hot attribute of Pitta is aggravated. Hot food, exposure to the sun or heat, or an inadequate intake of fluids are the main aggravating factors.  Pitta type constipation often involves liver dysfunction with congestion or obstruction of the bile. It is not simply a colon problem as it usually is with Vata. Detoxification of the liver may be necessary as well.

TREATMENT

An anti-Pitta diet should be implemented, avoiding too many oils, fats or sweets, which can overtax the liver. Release of anger and letting go of stress is necessary if constipation is due to emotional causes. Often warm milk and ghee or licorice tea will be enough to stimulate evacuation. In india a rose confection is used for this purpose. Only when accompanied with high fever and thirst will constipation be severe in Pitta constitutions.

Most bitter laxatives like rhubarb root and sesame can be used safely when this condition is acute. They also cleanse the liver. Otherwise bulk laxatives may be sufficient. Aloe gel combines both properties and can be taken 1-2 tablespoons before sleep. Taken on a regular basis, 1-2 tablespoons 2-3 times a day, aloe gel will usually prevent constipation in Pitta individuals. In severe cases, take aloe gel powder 1-2 grams before sleep, to which a little coriander or fennel can be added to stop griping.

Ayurvedic herbs include aloe, amalaki, rose, and psyllium. Formulas include Triphala (taken with ghee or aloe juice) and aloe herbal wine. For most Chronic or mild conditions 1-2 traspoons of psyllium husk powder in warm water before sleep is sufficient.

Chinese herbal formulas include Major or Minor Rhubarb decoration, according to whether the condition is strong or moderate. Typical Western herbs include rhubarb root, senna leaf (strong action) and barberry, yellow dock, cascara sargada (mild action).

PURGATORY THERAPY

Purgation therapy (virechana) is the main treatment for high Pitta (fire), because it cleanses heat from the small intestine and liver, as well as the colon. But, for this therapy to work, pitta must first be drawn into the gastrointestinal tract by the appropriate diet, herbs, oil massage and sweating therapy. Otherwise purgation may not be helpful.

Purgation is an important way of eliminating heat and toxins from the body. It purifies the blood as well as the digestive tract. It drains down the excessive fire rising upwards that occurs in infectious or delirious conditions of the head and brain.

Purgation is an important way of eliminating heat and toxins from the body. It purifies the blood as well as the digestive tract. It drains down the excessive fire rising upwards that occurs in infectious or delirious conditions of the head and brain.

3. KAPHA TYPE CONSTIPATION

Kapha constipation is usually due to the system being clogged with mucus. There will be heaviness, lethargy, tiredness and other signs of high kapha. Stools will be copious, whitish or with phlegm. The tongue will be pale and fat with a white or mucus coating. The abdomen may be bloated, along with a feeling of dull pain and there may be edema in the lower abdomen as well.

 The main cause is sluggishness or congestion of the colon. Provoking factors include too much heavy or mucus forming fods, excessive sleeping during the day, sedentary life style, and other kapha increasing actions. It can also occur as a complication of kapha(phlegm) disorders in the upper body-stomach and respiratory disorders with excess mucus draining down through the digestive system. Hence while treating the constipation, other anti-kapha therapies like expectorant or emetic therapy should be considered as well.

TREATMENT

Follow an anti- kapha diet by avoiding heavy, constipating food including sugar, cheese , yogurt, bread, pastries, potatoes , and pork. Fasting is good, for one to three days or longer . Increased physical and mental activity is needed, more aerobic exercise and less sleep.

Light laxative and purgative herbs are indicated. Bitter laxatives can be used in acute conditions like aloe, rhubarb root and senna . Such herbs also helps remove fat and reduce weight. Hot spices, ginger , cayenne and black pepper are needed. A good formula is 3 grams of powedered rhubarb root along with 2 grams of dry ginger, taken in one cup of warm water before sleep.

Bulk laxatives and laxatives oil should not be used as these increase Kapha and will promote stagnation. Cleansing enemas with spicy and expectorant herbs such as ginger, calamus, and bayberry are also helpful.

Ayurvedic formulas include Triphala 2-6 grams along with Tritaka 1-3 grams , taken with aloe juice or warm water before sleep, or the digestive stimulant (no.1) with the Colon Tonic ( no.5).

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