Constipation is the frequent passage of hard stools, often with straining, a sensation of incomplete evacuation and perianal or abdominal discomfort.
When a person passes less than three bowels a week or has difficulty in passing stool is constipation. It is due to various disorders. Constipation is a common problem sometimes it responds to taking increased dietary fibre content or bulking agents with adequate fluid intake.
FAQ/ARTICLES INCLUDED/POINTS COVERED
- Concept of Ayurveda
- Causes of constipation
- Most frequently constipation occurs
- Symptoms of constipation
- What are the investigations done on constipation
- What are the complications of constipation
- Treatment
- Line of treatment according to Ayurveda
- Yogasana and pranayama
- Diet and lifestyle of constipation.
CONCEPT OF AYURVEDA
Constipation is considered ‘Vibhandha’ according to Ayurveda. Vibhandha means obstruction. It occurs due to the imbalance of Vata dosha. Apana Vayu is a type of Vata that regulates downward movement. Due to the imbalance of Apana Vayu movement is obstructed and constipation occurs.
CAUSES OF CONSTIPATION
Common causes of constipation
- lack of dietary fibre
- lack of water intake or reduced fluid in the body (dehydration)
- lack of exercise
- Changes in daily routine due to travelling, eating, sleeping and resisting the urge to defecate.
Gastrointestinal tract causes
- Altered motility for example in irritable bowel syndrome
- Structural cause in colonic carcinoma, diverticulitis, Hirschsprung’s disease (congenital absence of ganglion causes failure to relax the internal anal sphincter.
- Obstructed defecation due to anal fissure, Crohn’s disease, colonic atresia, rectocele etc…
Non-Gastrointestinal causes:
- Neurological causes such as multiple sclerosis, parkinsonism, spinal cord Injury, stroke etc…
- Metabolic or endocrine causes such as hypercalcaemia, hypothyroidism, hyperparathyroidism etc…
- Other medications
MOST FREQUENTLY CONSTIPATION OCCURS
- Older age due to less active, slower metabolism and less muscle contraction of the gastrointestinal tract.
- Women due to pregnancy and after childbirth due to hormonal changes constipation occurs, it is relieved by some laxatives.
SYMPTOMS OF CONSTIPATION
- The Stool becomes hard and dry.
- Bowel movement is painful and difficult to pass stool.
- Feeling that not fully emptied your bowel.
- Stomach aches and cramps.
- Distension and bloating of the abdomen.
- Hard stool with straining
- Perianal and abdominal discomfort.
WHAT ARE THE INVESTIGATIONS DONE ON CONSTIPATION
It is not necessary to investigate, most cases are responses to dietary fibre supplements and laxatives.
Middle-aged or elder patients with short history also having rectal bleeding, pain or weight loss must be investigated.
- Barium enema
- Colonoscopy
Others include:
- digital rectal examination
- proctoscopy and sigmoidoscopy
- Routine biochemistry: full blood count, calcium and thyroid function are examined.
If normal for one-month dietary fibre supplements and laxatives continued
If symptoms persist examine the colon by barium enema or colonoscopy done for any other structural disease.
WHAT ARE THE COMPLICATIONS OF CONSTIPATION
- Haemorrhoids (piles): it is due to the congestion of venous plexuses around the anal canal. Swollen and inflamed vein.
- Anal fissure: superficial tear in the anal mucosa most commonly in the midline posteriorly, with spasm of the internal anal sphincter.
- Faecal impaction: obstruction of hardened stool in the rectum or lower colon due to chronic constipation.
- Rectal prolapse: due to chronic constipation a part of the large intestine comes out through the anus.
- Diverticulitis: inflammation or infection of one or more small pouches in the digestive tract.
TREATMENT
- Dietary fibre supplement
- Laxatives are given such as
- bulk forming laxatives
- stimulant laxative
- faecal softeners
- osmotic laxatives.
- If other causes are affected they should be managed.
- Infants also suffer from constipation, they may not have bowel movements for 5-7 days. prunes act as a laxative for infants. After that also there is no bowel movement consult a doctor for further management.
LINE OF TREATMENT ACCORDING TO AYURVEDA
- Nidana Parivarjana: avoid the causative factors like low fibre diet, physical inactivity, low water intake etc…
- Shamana Chikitsa (palliative treatment): Triphala Choornam, Gandharvastyadi Eranda Tailam, Sukumara Eranda Tailam, Abhayarishtam, Hinguvashtaka Choornam.
- Samshodhana Chikitsa (bio cleansing therapy)
- Snehapana and Snehana (internal medication and external oil application)
- Swedana(fomentation therapy)
- Virechana (purgation therapy)
- Vasti (enema therapy)
- Phalavarti (medicated suppositories)
YOGASANA AND PRANAYAMA
- Sarvangasana
- Vajrasana
- Katichakrasana
- Pavanamukthasana
- Kurmasana
- Savasana
PRANAYAMA
- Anulomvilom
DIET AND LIFESTYLE OF CONSTIPATION
- Avoid taking tea, coffee and alcohol
- Drink warm water early morning.
- Eat fruits and vegetables rich in fibre content.
- Eat whole grains such as whole wheat rice, brown bread etc…
- Drink plenty of liquids
- Do regular exercise
- Don’t suppress your natural urges.
- While sitting on the toilet the position will be rising feet, leaning back and squatting position it relieves from obstruction.
