Constipation is the passing of hard, dry bowel motions (stools) that may be infrequent or difficult to pass. It can include having to sit on the toilet for much longer than usual, the sensation afterwards that the bowel hasn’t fully emptied, as well as symptoms like bloating and abdominal cramps.
In some cases constipation can be a symptom of more serious illnesses or disease states that include:
Endocrine disorders such as hypothyroidism, diabetes or hypopituitarism
Obstruction due to hemorrhoids or adhesions
Tumors of the bowel or rectum
Central nervous system diseases such as multiple sclerosis, Parkinson’s disease or stroke
If constipation is chronic or severe, complications can develop, such as:
Fecal impaction – the lower bowel and rectum become so packed with feces that the muscles of the bowels can’t push any of it out
Fecal incontinence – an overfull bowel can result in involuntary ‘dribbling’ of diarrhea
Hemorrhoids or Anal Fissure – constant straining to open the bowel can damage the blood vessels of the rectum or tissues of the anal sphincter
Rectal prolapse – constant straining can lead to a section of the rectal lining being pushed out of the anus
Urinary incontinence – constant straining can weaken pelvic floor muscles, making the involuntary passing of urine more likely, especially when coughing, laughing or sneezing.
So it is important to not ignore constipation!
Not only is it incredibly unpleasant for the sufferer, it is also the symptom of a deeper imbalance that needs to be corrected. The good news is, from an Ayurvedic perspective, it can be treated with relative ease.
The Ayurvedic View
From an Ayurvedic point of view, constipation is predominantly a condition caused by disturbed Vata dosha (Air/Ether). Firstly, any Vata disturbance will cause increased dryness in the body which, in turn, can dry out the wastes (including faeces). This results in delayed transit through the bowel and constipation. But the other doshas can also be involved.
Excess Pitta in the form of heat can also contribute to this drying out effect, especially in combination with a Vata imbalance (hot wind is even more drying than cool wind).
The regular downward movement of Apana Vata (the wind responsible for elimination) can also be obstructed or inhibited by excess Kapha, in the form of mucous, or Ama (undigested food waste) in the bowel. In this case, rather than being dry and pebble-like, stool are more sticky and heavy.
Obviously if constipation is a symptom of a more serious illness, then the primary condition must be treated first, along with symptomatic treatment of the constipation.
However, if constipation is the primary issue, then an Ayurvedic approach to treatment is as follows.
Firstly, all Vata-aggravating diet and lifestyle factors should be avoided as much as possible. These include:
suppression of the urge to pass gas or stool
irregular meal times and sleeping routine
eating on the run
overly sedentary lifestyle and lack of exercise
too much travel
excessive change, instability or stress
Avoid Vata-aggravating foods and drinks including: raw food, green smoothies, excess salads, low-fat foods, cold drinks, cereal, crackers, bread, soy milk, millet, rye, popcorn and under-cooked beans, split peas, lentils and other legumes.
If heat (Pitta) is a problem then Pitta-aggravating foods and drinks should be avoided, particularly alcohol, coffee, chili or hot, spicy food.
Secondly, a diet that supports balanced digestion (Agni) and prevents the buildup of waste (Ama) should be followed at all times, sticking to foods that are warm, light and slightly oily in quality.
And of course, eating a diet with plenty of fiber and drinking enough water is essential. To get enough water simply fill a 1 liter thermos with hot water in the morning and sip it throughout the day, making sure it’s finished by evening. You’ll be getting all the water you need and at the same time the warmth will be calming Vata and stimulating your digestive fire.
If stress or anxiety is an ongoing concern for you or you tend to ‘hold stress in your gut’ this can be a major contributor to constipation and IBS. In this case it can be a great idea to see someone who can give you mindfulness exercises or simple home practices that will help alter this reaction to stress and take the load off your belly.
Home remedies can be very helpful, especially in mild conditions. Bulk laxatives such as slippery elm or psyllium husks are excellent. Simply take either of these (1tsp-1tbsp) in warm water or milk, daily, before bed. If there is sluggishness or heaviness it is a good idea to add a pinch of dry ginger as this will support digestion.
Castor oil can be taken in a dose of 1 tbsp before bed in ginger tea or with lemon juice. This is very useful, especially if the stool is very dry and pebble-like. But, it can have a strong laxative effect and should not be done on a daily basis in the longer-term.
The following home remedy is one of the best for constipation as it promotes digestion, helps with bloating, heaviness and gas and softens the bowel.
Constipation Home Remedy
15 Raisins or Sultanas
2 tsp Fennel seed
1/2 tsp Ajwain seed
3 Cardamom pods
1/2 tsp Fresh grated ginger
Bring all of the ingredients to the boil in 2 cups of water, simmer until reduced to 1 cup and then drink.
Yoga poses such as pashimuttanasana (sitting forward bend) or urdvapashimuttanasana (upside down forward bend) are also helpful – but please remember that a yoga practice should be done under the guidance of a trained and experienced yoga teacher who can take your individual needs into consideration.
If the constipation is persistent or severe then stronger herbal remedies along with Medicated Basti or Herbal Enema Therapy can be administered under the guidance of a trained Ayurvedic Practitioner. These methods of treatment help to not only ‘cleanse’ the bowel of excess waste, they also help to rejuvenate the tissues of the bowel, strengthening the musculature, nourishing the mucous membranes, re-colonising the bowel flora and establishing a new habit of regular and healthy bowel movements.
On that note, it should be mentioned that colonics and colonic irrigation are not a recommended avenue of treatment in Ayurveda. Although they may cleanse the bowel in the short-term, in the longer-term, they can leave the bowel very dry and unsupported, aggravating Vata further and causing more complications. The use of strong laxatives or enema therapy should only ever be done with guidance and after the appropriate preparation has taken place. Given the colon is considered the ‘seat’ of Vata is it critically important to treat this part of the body with the greatest of care, gently coaxing it into new habits rather than shocking it.
So, don’t let constipation become a bummer (sorry, I couldn’t help myself)! Simple dietary and lifestyle changes can have life-changing, immediate effects. And please remember that in Ayurveda, every person is treated as unique and their individual requirements must be taken into account so if you are having persistent trouble, please see an Ayurvedic Practitioner for specific recommendations.