Bowel movements differ from individual to individual. They depent on the type of diet and the general activity of the person. However constipation can be defined as accumulation of toxins in the colon due to improper bowel movements.
Ideally, one should have easy bowel movement in early morning and the stool should float on the water. It the stool sinks, is sticky, or has a very bad smell, this indicates the presence of ama or toxins in the colon.
Developing the proper urge in the morning is very important. The modern lifestyle of getting up late in the morning and rushing to work does not allow this habit to develop, which can lead to constipation. All Vata constitution persons suffer from this problem.
The main cause is dietary, eating a late meal after sundown or eating food that is hard to digest and that produces toxins in the colon. Food without roughage, too much coffee and tea, eating dry substances like legumes, drinking too cold drings and smoking contribute to constipation.
Other factors like not drinking enough water, staying awake late at night, insomnia, stress, nervousness, worry, grief, and fear is also responsible. Many elderly people suffer from constipation.
The tongue is the mirror of digestion. Usually the tongue has a slightly whitish coating when we get up from the bed. But after scraping of the tongue (apractice that should be done in addition to brushing the teeth every morning) this coating disappears.
Vata type- there is brownish coating on the tongue that cannot be removed even by scraping the tongue. There may be sense of uneasiness in the abdomen, pain with gas formation, hard stools, and low digestive fire.
Pitta type – eating too much spicy food, walking in hot sun, and hot drinking enough water, are the main causes. In this type the hard stools are slightly yellowish accompanied with burning sensation .
Kapha type – This is due to obstruction of colon or due to lot of mucous in the intestines. Because of this there is sensation of heaviness in the colon, lethargy, and low digestive fire. The stools are whitish in colour and there may be gas in the abdomen. The tongue is coated with a whitish colour and the person has bad breath.
Acute constipation
For immediate relief, give 60 to 70 ml. Of warm sesame oil enema. Massage the abdomen with sesame oil and carry out light fomentation of the abdomen. If it is not possible, apply glycerin suppository. If the tongue is white coated , it means that there are lot of toxins in the colon. Fasting, anti-ama diets, and herbs to detoxify should be given. When the digestion is improved, then give strong purgatives like senna or rhubarb.
Chronic constipation
Giving laxatives or purgatives cannot treat this, because constant use of purgatives creates dryness in the colon that in turn increases constipation.
Triphala is a combination of three myrobalan fruits : amalaki, haritaki, and bibhitaki. Usually a combination in proportion of 2:1:1 of these three fruits makes a good laxative. This can be given in dose of 1 to 3 gms; at night, with warm water. Triphala also acts as a rejuvenating medicine in old age.
Abhayarishta is also a medicine of choice for this condition. 30 ml. Twice day should be given for 1 month.
Dringing a glass of warm milk with 1 tea – spoonful of ghee every day at night for 3 months is advised. Or drinking 4 teaspoons of warm sesame oil every day at night is also beneficial.
Correction of dietary habits is a must. It is advisable to take lot of green vegetables cooked or uncooked, plenty or fruits, with oily and bulk-forming foods containing high amount of roughage or fiber. Food must be taken at proper time, irregular food habits cause constipation. Working late at night should be avoided. Drinking plenty of water is beneficial. Ayurveda has advised to drink water from copper vessel. Ask the patient to fill up copper vessel with fresh water at his bedside, and drink the same in the early morning, as much as he can. This sets a gastrointestinal colic reflex, which in turn helps the bowels to clean. This with have no immediate effects, but after 3 to 4 weeks the bowels should start functioning properly.
Vata type – is usually found in Vata constitution persons and in elderly patients. As age advances, Vata starts getting aggravated; excessive smokings, taking diuretic drugs, anxiety, and worry increases it more.
Anti – Vata diet with oily food, nuts, cooked vegetables, sesame oil, ghee, plenty of warm water is beneficial. Vata tea containing ginger, licorice, and cardamom; asafetida and trikatu are good to help digestion.
Medicated enema of sesame oil is the best remedy. It should be given on alternate days 60 to 70 c.c. in the evening. If this is not sufficient , give cleansing enema alternately with oil enema. For cleansing enema, use decoction of sida cordifolia, fennel, and cardamom with little sesame oil and honey. When intestines get lubricated, the problem of constipation is relieved. For vata types, bulk laxatives such as bran, flaxseed, and psyllium seeds should be given 1 to 3 gms; with milk or sweet fruit fuites at night.
Pitta type : Anti – Pitta diet should be advised. In this type, constipation is the result of high Pitta due to inflammation. Use cleansing enema of licorice and shatavari. Usually bitter herbs having cooling action are good. Aloe, Echinacea, gentian, rhubarb, and yellow dock are useful. Any one of these herbs can be given in dose of 1 to 3 gms. Every day, till the constipation is relieved.
If there is pain in the abdomen, before giving strong purgatives, take care to rule out inflammation of the appendix. In such cases always avoid giving strong purgatives, as it may lead to perforation, which is very serious condition.
Kapha type – Anti – kapha diet should be given, ask the patient to take basmati rice with bread and raw vegetables with fruits like apples, banana, prune, grape, or cherry. Bulk laxatives should never be given in such type. It is better to give strong purgatives like Epsom salt, senna, or rhubarb. Any one of these can be given in dose of 1 gm. At night every day for 3 weeks.
