CONSTIPATION

Constipation is a condition of the digestive system where an individual has hard feces that are difficult to expel

As many as one in five people experiences chronic constipation, a condition that’s even more common in women as they get older. It’s something that can easily creep up on you if you’re not paying attention, with many factors, from diet to other health conditions, contributing to the problem. 

Signs and Symptoms :-

  • A feeling that not all stool has passed
  • Bleeding from rectum
  • Blood in stool
  • Constant pain in abdomen
  • Fever
  • Fewer than three bowel movements a week
  • hard, dry, or lumpy stools
  • Inability to pass gas
  • Losing weight without trying
  • Lower back pain
  • Stools that are difficult or painful to pass
  • Vomiting

Causes :-

CONSTIPATION CAUSES
  • Slow movement of stool through your colon
  • Delayed emptying of the colon from pelvic floor disorders especially in women, and colon surgery
  • Functional gastrointestinal disorders, such as irritable bowel syndrome

Medicines and dietary supplements

  • Antacids (containing aluminum and calcium)
  • Anti-cholinergics and antispasmodics
  • Anti-convulsants—used to prevent seizures
  • Calcium channel blockers
  • Diuretics
  • Iron supplements
  • Medicines used to treat Parkinson’s disease
  • Narcotic pain medicines
  • Anti-depressants

Changes in Lifestyle

  • Pregnancy
  • Old age
  • Travelling
  • when you ignore the urge to have a bowel movement
  • Change in medicines
  • if you change how much and what you eat

Dietary Changes

  • Not eating enough fiber
  • Not drinking enough liquids, or dehydration
  • Not getting enough physical activity

Diseases and Conditions

  • Celiac disease
  • Disorders that affect your brain and spine, such as Parkinson’s disease
  • Spinal cord or brain injuries
  • Metabolic disorders, such as diabetes
  • Imbalance of hormones, such as hypothyroidism
  • Inflammation linked to diverticular disease or proctitis
  • Intestinal obstructions, including anorectal blockage and tumors
  • Anatomic problems of your digestive tract

Medicines

Anti-depressants such as amitriptyline, imipramine; Anti convulsants such as phenytoin, carbamazepine, Iron supplements, Antacids with aluminium may cause constipation.
Ayurvedic medicines containing Guggulu and Sallaki as ingredients may contribute to constipation. In such patients, usually Triphala Churna is adminsitered to nullify the side effect.

Herbs 

Ripe Falsa fruit – Grewia asiatica
Fox nut – Euryale ferox
Jamun fruit
Kupilu – Nux Vomica

Diagnosis :-

In addition to a general physical exam and a digital rectal exam, doctors use the following tests and procedures to diagnose chronic constipation and try to find the cause:

  • Blood tests: Blood tests can specifically point out thyroid related problems, such as low thyroid.
  • Sigmoidoscopy: In this test the doctor examines your rectum and the lower portion of your colon.
  • Colonoscopy: This test allows your doctor to examine the entire colon with a flexible, camera-equipped tube.
  • Balloon expulsion test: This test measures the amount of time it takes for you to push out a balloon that has been filled with water and placed in your rectum.
  • Anorectal manometry: This test allows your doctor to measure the coordination of the muscles you use to move your bowels.
Tips to prevent constipation- The following can help you avoid developing chronic constipation.
  • Include plenty of high-fiber foods in your diet, including beans, vegetables, fruits, whole grain cereals and bran.
  • Eat fewer foods with low amounts of fiber such as processed foods, and dairy and meat products.
  • Drink plenty of fluids.
  • Stay as active as possible and try to get regular exercise.
  • Try to manage stress.
  • Don’t ignore the urge to pass stool.
  • Try to create a regular schedule for bowel movements, especially after a meal.
  • Make sure children who begin to eat solid foods get plenty of fiber in their diets
  • 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, white rice, etc.
  • High -protein foods like cheese, red meat, and soybeans can cause constipation, so these must be taken with a bowl of salad and lots of liquids.
  • Meat is constipating and should be avoided.
  • Disturbing psychological factors should be removed, and meals should be taken in a relaxed and calm atmosphere.
  • The food should be warm and freshly -prepared, as cold and stale food slows down the digestive power.
  • Having excessively cold food like ice cream or chilled drinks reduces the bowel movement.
  • Avoid excess of coffee and tea. Some people will not get bowel movement urges unless they have their coffee or tea. This advice is not applicable to them.
  • Milk and dairy products-If you are feeling constipated, consider cutting down on milk and dairy products.
  • Avoid excessive spicy food, heavy non veg, and fried food.

Treatment :-

In the majority of cases, constipation resolves itself without any treatment or risk to health.

The treatment of recurring constipation can include lifestyle changes such as doing more exercise, eating more fiber, and drinking more water.

Usually, laxatives will successfully treat most cases of constipation – but should be used with care and only when necessary. In more difficult cases, the person may need a prescription medication.

It is important to understand the cause of constipation – there could be an underlying illness or condition. Some people with recurring constipation use a daily diary where they record their bowel movements, stool characteristics, and other factors that may help both the doctor and patient devise the best treatment.

Some gastroenterologists comment that there are people who do not allocate enough time for their defecation. Set aside enough time to allow your toilet visit to be unstressed and uninterrupted, and do not ignore an urge to have a bowel movement.

Laxatives : Several types of laxatives exist. Each works somewhat differently to make it easier to have a bowel movement. The following are available over the counter:

Stimulants: These make the muscles in the intestines contract rhythmically. These include Correctol, Dulcolax, and Senokot.

Lubricants:These help the stool move down the colon more easily. These include mineral oil and Fleet.

Stool softeners:These moisten the stool. Stool softeners include Colace and Surfak.

Fiber supplements:These are perhaps the safest laxatives. They are also called bulk laxatives. They include FiberCon, Metamucil, Konsyl, Serutan, and Citrucel and should be taken with plenty of water. If you want to buy bulk laxatives, then there is an excellent selection online with thousands of customer reviews.

Osmotics:These facilitate the movement of fluids through the colon. These include Cephulac, Sorbitol, and Miralax.

Saline laxatives:These draw water into the colon and include milk of magnesia.

Chloride channel activators:These require a prescription and include lubiprostone (Amitiza).

5-HT-4 agonists:They increase the secretion of fluid in the intestines and speed up the rate at which food passes through the colon. They include Prucalopride.

If the constipation does not respond to any treatment, as a last resort, surgery to remove part of the colon may be undertaken. In the procedure, the segment of the anal sphincter or rectum that causes the constipation is removed

Natural remedies- (Diet & Lifestyle Advice)

High Fiber Diet

There are few ways to ease the symptoms of constipation without using medication.

These include:

Increasing fiber intake:
People with constipation should eat between 18 and 30 grams (g) of fiber every day. Fresh fruits and vegetables and fortified cereals have high fiber content.

An apple or banana each day is helpful. Bananas should be ripe (bright yellow

Have a mid-morning soup, preferably prepared with spinach and tomato.

Drinking water:
Drink 7-8 glasses of water each day, preferably lukewarm in winters and room -temperature water in summers

Regular exercise:
Take daily morning and evening walks for at least 20-30 minutes each This can help to make bodily processes more regular, including the passing of stools.

Routine:
Having a place and time of day where you can put aside time to visit the bathroom without forcing a stool.

Bulking agents:
Adding these to your diet can help soften stools and make them easier to pass. Examples of bulking agents include wheat bran.

Avoiding holding in stools:
Responding to your body’s natural urges to pass stools when they happen is key to reducing the impact of constipation.

Elevate your feet:
Place your feet short platform, such as a step, and make sure the knees are above hip-level while passing stools. This can reduce constipation.

Home Remedies :-

Home Remedies For Constipation
  • Take one table spoon of castor oil at bed time until you get relief.
  • Develop a habit of drinking water in the morning. Start with 2 glasses of water, and increase intake up to 6 – 7 glasses. It is more beneficial if this water can be stored in a copper container overnight.
  • Soak 3-4 dried figs after washing them overnight in water. Eat them first thing in the morning, and also drink the water in which they were soaked. They should also be taken in the evening. Try this treatment for 3-4 weeks.
  • Apply 3 to 4 drops of lukewarm castor oil over the navel at night in kids. It will help in clearing the bowel movements in kids (of age 1- 3 years) in the morning.
  • Apply lukewarm sesame oil on the navel during taking bath and put towel (which is dipped in warm water) on the lower abdomen.

Pathology of constipation as per Ayurveda:
Due to the above said Vata imbalancing factors, Apana vata is aggravated and it is blocked in the lower part of the large intestine, which results in constipation. Depending on the grade of affliction, absolute constipation or hard stool are complained by the patients.

Ayurvedic treatment for Constipation (Vibandha):

Mild oleation (Mridu snehana) –
Internal oleation – Abhyantara Snehana – administering 5 – 10 grams of ghee or medicated ghee such as Sukumara Ghrita
External oleation – oil massage with sesame oil / Maha Narayana oil

Laxatives-Sukha virechana and vatanulomana Aushadha

Use of Suppositories – Guda Varti

Herbs useful in mild constipation:

  • Hareetaki -Chebulic myrobalan-Terminalia chebula
  • Aragwadha-Cassia fistula
  • Draksha-Raisins-Dry grapes-Vitis vinifera
  • Patola- Trichosanthes dioica
  • Katuki-Picrorrhiza kurroa
  • Castor oil – Apart from constipation, castor oil in combination with other herbs is used in many diseases. For example: Castor oil with Haritaki is used in treating rheumatoid arthritis. 

Herbs useful in severe constipation:

  • Jayapala-Croton tiglium
  • Danti- Baliospermum montanum
  • Trivrit-Operculina turpethum

Ayurvedic Medicines

  • Avipattikara choorna – A famous herbal powder mix, useful in gastritis, indigestion, urinary tract disorders, liver disorders, alcoholism
  • Abhayarishta – Useful in piles, hemorrhoids, relieves bloating, constipation. Improves digestion
  • Swadishta virechana choorna
  • Trivrit lehyam – Useful in constipation, diseases of heart. Also used in Virechana (Purgation treatment)
  • Abhaya modaka
  • Triphala choorna – Useful in eye disorders, liver and spleen related disorders, a natural anti oxidant.
  • Dantyarishta – used in the treatment of hemorrhoids, constipation, gastric, intestine and spleen related diseases.
  • Drakshadi avaleha – used in jaundice, fatty liver changes, anemia
  • Icchabhedi rasa – Very powerful purgative. Used only in severe conditions
  • Ashwakanchuki rasa – used in the treatment of cold, cough, bronchitis, asthma, fever.
  • Gandharvahastadi kashaya – used in the Ayurvedic treatment of Vata imbalance, bloating, constipation, lack of taste in food.
  • Anthrakutharam Gulika – Ayurvedic tablet used in bloating, constipation and such other abdominal conditions.
  • Sukha Virechana Vati – Also used in Panchakarma treatment
  • Pancha Sakara Churna – Famous medicine in North India, also useful in indigestion
  • Naracha Rasa – used in treatment of ascites and constipation.
  • Kayam Churna – a proprietary Ayurvedic medicine
  • Erandabhrista hareetaki – Haritaki powder is fried in castor oil and is administered.
  • Aragwadharishta
  • Patoladyarishta
  • Padavaladi gana kashaya
  • Rectal suppository – Phala varti

Simple remedies for Constipation:

  • Soak 10-15 raisins in water in the morning and consume it at night.
  • 1 teaspoon of cow’s ghee should be dissolved in one cup (150ml) of warm water.
  • In non- diabetic patients, 1 spoon of sugar candy can also be added (in non diabetic patients) and taken during bed time. This is highly effective against mild constipation.
  • Those who pass the bowel like pencil (hard) or like pellets, Gulkhand is administered during night time along with milk.
  • The fruit pulp of Aragwadha is taken (10grams) along with water or milk. This helps to relieve even chronic kind of constipation.
  • The tender leaves of Castor (Eranda) (2-4) are taken and ground into fine paste. To this pulp of Aloe vera is added. Consumption of this helps people, who frequently suffer from constipation.
  • Regular use of aloe vera pulp in diet prevents hard bowels.

Yogasanas for constipation:-

Pavana Muktasana, Uttana Padasana, and other Asanas and exercises that put pressure on abdomen are very useful in the treatment.

Ayurvedic Medicines

Abhyarishta

Take 3 -4 teaspoons of Abhyarishta with equal quantity of water twice a day after meals.

Panchasakar churna

Take 1 – 2 teaspoons of Panchasakar churna with lukewarm water.

Avipattikar Churna (powder)

Take 1 – 2 teaspoons of Avipattikar Churna (powder) with water or milk twice a day.

Gandhak Vati

Take 1 tablet of Gandhak Vati with hot water after meals.

Virechani Tablets

Take 1 – 2 tablets of Virechani with warm water or milk at bed time.

Gandharvaharitaki / Triphala

Take 1 – 2 tablets of Gandharvaharitaki / Triphala with warm water at bed time.

Tinifat Tablet

Take 1-2 Tablets of Tinifat with water twice a day.

Ayurvedic Herbs :-

  1. Triphala powder or Triphala Churna :- consists of three fruits – Amla or Indian gooseberry, Haritaki (Chebulic Myrobalan) and Vibhitaki(Bellirica Myrobalan). It is a great laxative and helps to regulate digestion and bowel movements.

    2. Raisins (kishmish) :- are packed with fiber and act as great natural laxatives. Soak a handful in water overnight and have them first thing in the morning on an empty stomach.

    3. Guavas (amrood or peru):-  have soluble fibre in the pulp and insoluble fiber content in the seeds.

    4. Lemon (Nimbu) juice:-  is recommended by most Ayurvedic practitioners as a quick and simple remedy for constipation.

    5. Figs (Anjeer) :-  either dried or ripe, are packed with fiber and act as a great natural laxative. For relief from constipation, boil a few figs in a glass of milk, drink this mixture at night before bed.

    6. Flax seeds (Alsi):-  are known for their fiber content, and can very well help you when it comes to constipation.

    7. 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.

    8. Spinach (Palak):-  have properties that cleanse, rebuild and renew the intestinal tract.

    9. Oranges:-  are not only a great source of Vitamin C but also have a large amount of fiber content .

    10. Seed mixtures with 2-3 sunflower seeds, a few flax seeds, til or sesame seeds and almonds ground together to a fine powder can help relieve 

Complications

The complications of constipation can include:

  • Hemorrhoids or swollen veins in the anus: While having a bowel movement if you strain often, it may cause swelling in the veins in and around your anus. Infact, chronic constipation can lead to the development of piles.
  • Anal fissure: Straining to pass stools can cause tiny tears in the anus.
  • Fecal impaction: Hardened stool can accumulate and remain stuck in your intestines if you suffer from chronic constipation.
  • Rectal prolapse: This occurs when due to too much straining over time, during bowel movements, causes a small part of the rectum to stretch and protrude from the anus.

Indications for referral :-

  1. Acute intestinal obstruction
  2. Rectal prolapse
  3. Undiagnosed bleeding from anus and not responding to medication

Caution for laxatives:-

Overuse of laxatives for a long period of time eventually worsens constipation. Hence, when you are prescribed a medicine for constipation, be proactive to change your lifestyle and diet habits, as explained above, so as to prevent dependency on medications.

 

Disclaimer:

All the information in this article and the whole website is only for the purpose of education. They are not intended to diagnose, prevent, treat or cure any disease. Always consult your doctor for any health issues. Self medication is dangerous. The health claims indicated are not approved by FDA.

Reader Interactions :-

Do not consider any advice without consulting your doctor, either in the articles (posts) or in the comment section.

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