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Constipation

An Ayurvedic Approach to Constipation Relief

Best ayurvedic treatment for constipation

Constipation refers to bowel movements that are infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.

Constipation has many causes. Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders. Underlying associated diseases include hypothyroidism, diabetes, Parkinson’s disease, celiac disease, non-celiac gluten sensitivity, colon cancer, diverticulitis, and inflammatory bowel disease. Medications associated with constipation include opioids, certain antacids, calcium channel blockers, and anticholinergics. Of those taking opioids about 90% develop constipation. Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person’s family, or it is of new onset in someone who is older.

Symptoms

Complications

  • Straining with bowel movements
  • Excessive time needed to pass a bowel movement
  • Hard stools
  • Pain with bowel movements secondary to straining
  • Abdominal pain
  • Abdominal bloating.
  • the sensation of incomplete bowel evacuation
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Constipation on its own can be uncomfortable but not life-threatening. However, severe constipation can develop into more serious conditions, including:

  • rectal bleeding after continually straining to pass stools
  • anal fissure, or a small tear around the anus
  • hemorrhoids, or swollen, inflamed blood vessels of veins in the rectum
  • fecal impaction, in which dried stools collect in the anus and rectum, leading to an obstruction in the path stool would take to leave the body

Dealing with constipation before it becomes one of these conditions can prevent further discomfort.

Causes

To provide root-cause Constipation treatment, it is important to understand the root-cause first. Basically, weak digestive power is the most common reason and it results from irregular and incorrect eating patterns, not taking in enough fluids, taking a diet that is low in fibre, a sedentary lifestyle, and bowel evacuation habits that are poor. These all lead to incomplete digestion of the food, which is not expelled by the intestines and causes the formation of ama (mucus). Foods that are heavy and difficult to digest, as well as oily, spicy, fried and junk foods are the culprits. Eating food in a disturbed atmosphere or in front of the television and being awake late at night all lead to bowel disturbance. Psychological factors like stress, anxiety, fear, jealousy, and sorrow also play an important role and are addressed during Constipation treatment at Bhagwati Ayurveda.

Treatment

Causes of Constipation

According to Ayurveda, undigested food and occult stool slowly accumulate in the stomach and large intestines respectively and impair Vata Dosha, resulting in obstruction of the digestive tract. When the digestive tract is not clear, the body will not be able to facilitate proper bowel movement, thereby leading to the condition of constipation.

Diet

Constipation can be caused or exacerbated by a low-fiber diet, low liquid intake, or dieting. Dietary fiber helps to decrease colonic transport time, increases stool bulk but simultaneously softens stool. Therefore, diets low in fiber can lead to primary constipation.

Medications

Many medications have constipation as a side effect. Some include (but are not limited to) opioids, diuretics, antidepressants, antihistamines, antispasmodics, anticonvulsants, tricyclic antidepressants, antiarrhythmics, beta-adrenoceptor antagonists, antidiarrheals, 5-HT3 receptor antagonists such as ondansetron, and aluminum antacids.

Certain calcium channel blockers such as nifedipine and verapamil can cause severe constipation due to dysfunction of motility in the rectosigmoid colon. Supplements such as calcium and iron supplements can also have constipation as a notable side effect.

Medical conditions:

Metabolic and endocrine problems which may lead to constipation include hypercalcemia, hypothyroidism, hyperparathyroidism, porphyria, chronic kidney disease, pan-hypopituitarism, diabetes mellitus, and cystic fibrosis. Constipation is also common in individuals with muscular and myotonic dystrophy. Systemic diseases that may present with constipation include celiac disease and systemic sclerosis.

Constipation has a number of structural (mechanical, morphological, anatomical) causes, namely through creating space-occupying lesions within the colon that stop the passage of stool, such as colorectal cancer, strictures, rectoceles, anal sphincter damage or malformation and post-surgical changes. Extra-intestinal masses such as other malignancies can also lead to constipation from external compression. Constipation also has neurological causes, including anismus, descending perineum syndrome, and Hirschsprung’s disease. In infants, Hirschsprung’s disease is the most common medical disorder associated with constipation. Anismus occurs in a small minority of persons with chronic constipation or obstructed defecation. Spinal cord lesions and neurological disorders such as Parkinson’s disease and pelvic floor dysfunction can also lead to constipation.

Psychological:

Voluntary withholding of the stool is a common cause of constipation. The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness. When a child holds in the stool a combination of encouragement, fluids, fibre, and laxatives may be useful to overcome the problem. Early intervention with withholding is important as this can lead to anal fissures.

Congenital:

A number of diseases present at birth can result in constipation in children. They are as a group uncommon with Hirschsprung’s disease (HD) being the most common. There are also congenital structural anomalies that can lead to constipation, including anterior displacement of the anus, imperforate anus, strictures, and small left colon syndrome.

Prevention

Fiber supplements:

Soluble fiber supplements such as psyllium are generally considered first-line treatment for chronic constipation, compared to insoluble fibers such as wheat bran. Side effects of fiber supplements include bloating, flatulence, diarrhea, and possible malabsorption of iron, calcium, and some medications. However, patients with opiate-induced constipation will likely not benefit from fiber supplements.

Laxatives:

If laxatives are used, milk of magnesia or polyethylene glycol is recommended as first-line agents due to their low cost and safety. Stimulants should only be used if this is not effective. In cases of chronic constipation, polyethylene glycol appears superior to lactulose.
Prokinetics may be used to improve gastrointestinal motility. A number of new agents have shown positive outcomes in chronic constipation; these include prucalopride and lubiprostone.
Cisapride is widely available in third world countries but has withdrawn in most of the west. It has not been shown to have a benefit on constipation, while potentially causing cardiac arrhythmias and deaths.

Physical intervention:

Constipation that resists the above measures may require physical intervention such as manual disimpaction (the physical removal of impacted stool using the hands; see fecal impaction). Regular exercise can help improve chronic constipation.

Surgical intervention:

In refractory cases, procedures can be performed to help relieve constipation. Sacral nerve stimulation has been demonstrated to be effective in a minority of cases.

Colectomy with ileorectal anastomosis is another intervention performed only in patients known to have a slow colonic transit time and in whom a defecation disorder has either been treated or is not present.

Because this is a major operation, side effects can include considerable abdominal pain, small bowel obstruction, and post-surgical infections. Furthermore, it has a very variable rate of success and is very case dependent.

Best ayurvedic therapy to prevent constipation