An ideal morning routine generally comprises waking up on time, brushing our teeth, pooping, taking a shower to wake up those sleepy cells, and indulging in an excellent breakfast to fuel our bodies to take on the day. But the problem arises when pooping out waste from the body feels like releasing hard pieces of rock from our rear ends, which leaves us feeling sore in all the wrong places. And the worst part is that the long, painful session may not always yield results (read: stool). So all that pain and strain may be a big waste of time and leave you feeling exhausted.
This is what suffering from constipation feels like. It is the condition that changes our happy Instagram-scrolling poop session into a legit nightmare! So let’s take a dump…I mean a dive into constipation’s inner workings to understand its causes, symptoms, and cures.
In simple terms, constipation refers to the inability or difficulty to pass stool regularly. It is a gastro-intestinal condition that leads to infrequent and painful bowel movements. A person suffering from constipation has less than three bowel movements per week. Constipation is experienced by everyone at least once in their lifetime. But in chronic constipation cases, the person experiences it for weeks at a stretch and sees it as a severe long-term issue. Infrequent bouts of constipation are regular and easily fixed with a few tweaks in diet and lifestyle. The chronic form is more problematic as it leads to prolonged retention of toxins and wastes in the body and is the root cause of other ailments.
The partially digested or undigested food referred to as waste moves from the small intestine to the large intestine (colon). The excess water is absorbed from the waste to give it a solid consistency. Constipation happens when the colon absorbs too much water from the waste, which dries out the stool completely, making it hard and challenging to push out. The slow passage of food through the colon is a contributing factor as it gives the colon more time to absorb water resulting in hard, dry stool.
Although constipation is a universal unbiased condition that affects all sexes and age groups, certain groups of people have a higher risk of constipation than others.
- Older adults above the age of 65 usually fall prey to constipation due to physical inactivity, underlying medical conditions, and a more deficient diet.
- Due to the hormonal changes and pressure exerted by the growing baby, pregnant women have a higher risk of constipation.
- Children usually suffer from constipation due to issues with toilet training and changes in diet.
- While those suffering from severe medical conditions leading to complete bed-rest are also at a higher risk due to medical complications, physical inactivity, and dietary changes.
Constipation is widespread in America and is one of the leading gastrointestinal problems faced by the people. According to a survey conducted by the National Institute of Diabetes and Digestive and Kidney Diseases, about 42 million Americans suffer from the pangs of constipation. Another study conducted by the American Gastroenterological Association shows that 16% of Americans and a third of those closer to 60 suffer from chronic constipation. The National Inpatient Sample Database from 1997 to 2010 shows constipation as the principal discharge diagnosis, and the number of people suffering from it doubled within the decade.
- Lack of fiber in the diet
Fiber or roughage is a plant-based nutrient that cannot be broken down entirely by the human digestive system. It is commonly found in fruits, vegetables, whole grains, nuts, and legumes. It is an essential component of a balanced diet. It promotes healthy bowel movements as they retain water and add bulk to the stool, thereby enabling smooth and effortless exit of stool from the intestine.
A diet lacking in fiber has the opposite effect and leads to constipation as the stool retains less water and has a slower emptying time.
- Lack of physical activity
Exercise combined with a healthy diet is the key to a healthy body. Regular exercise strengthens the gut muscles and increases blood flow, which stimulates intestinal contractions and leads to faster movement of food through the intestine.
Lack of exercise leads to weakened muscles and lower blood flow, which increases the time taken by the food to move through the colon. This leads to more reabsorption of water by the colon from the stool, resulting in dry and hard stool which is difficult to pass.
Dehydration is the state in which the body has minimal water resources. In such a state, the body goes into water-conservation mode and reabsorbs as much water possible from the waste. This leads to dry, lumpy stools that are difficult to pass.
Antidepressants, opioids, calcium-channel blockers, and anticholinergics are different classes of medications that either affects the nerves present in the gut to inhibit movement or relax the abdomen’s smooth muscles to slower intestinal contractions. As such, the food stays in the colon for a more extended period resulting in constipation.
- Irritable Bowel Syndrome (IBS)
IBS is a common disorder of the gastrointestinal tract that leads to bloating, cramping, constipation, etc. It comprises inflammation of the gut, which leads to slower food movement and reduced intestinal contractions.
As the body grows older, many physiological changes occur, which leads to a slower metabolism and digestive problems. Food moves slowly through the digestive tract, so there is a higher reabsorption rate of water, which causes constipation. Also, the reduced amount of physical activity as one gets older contributes to the problem of constipation.
- Difficulty in passing stool
Due to slower intestinal contractions and the hardening of stool, it becomes more difficult to pass stool.
- Passing less stool than usual
The frequency of passing stool reduces drastically and is usually less than three times a week.
- Hard and lumpy stool
Due to the excess reabsorption of water in the colon, the stool is transformed into a hard and lumpy consistency.
- Strained bowel movements
Due to the hardening of stool and its dryness, there is no smooth passing of stool as such greater pressure needs to be applied for its release leading to strained bowel movements.
- Pain and cramping in the abdomen
This is mainly caused due to the excess gas present in the abdomen, leading to its visible distension.
- Changes in diet and lifestyle
Adding more fiber and exercise into one’s diet and daily routine can do wonders for treating constipation. Eating whole fruits and vegetables and incorporating nuts and cereals in meals is a sure-shot way of getting in the right kind of roughage.
Also, exercising regularly boosts the body’s blood circulation and strengthens the gut muscles to improve bowel movements.
Excessive consumption of processed and junk foods should be avoided as they are low in fiber and are loaded with bad fats and sugars.
These are substances that loosen or soften stools and increase bowel movements. They are used widely for the prevention and treatment of constipation. They are over-the-counter options to treat milder forms of constipation.
They can be of different types, depending on their mode of action.
- Stimulants are a class of laxatives that stimulate the intestinal muscles to contract rhythmically. Bisacodyl and Sennosides are common examples.
- Lubricants are another type that lubricates the intestinal passage and enables the smooth motion of stool. Mineral oil is a good example.
- Stool softeners are substances that soften and moisten the stool and aid in its smooth passage. Colace and Surfak are common examples.
- Osmotics are those that hydrate the stool by drawing water to the colon. Polyethylene glycol and Magnesium hydroxide are common examples.
- Bulk-forming laxatives or fiber supplements soften the stool by adding bulk to it by pulling water to the colon. Psyllium is the most common example.
- Other medications
For more severe and chronic forms of constipation, OTC laxatives may not help in solving the problem. That is when it is essential to visit a doctor so that he/she can prescribe specific medications to ease the condition. They tend to show results within the first 24 hours, and their efficiency increases with time. Linaclotide, plecanatide, lubiprostone, etc., are the common constipation prescription medications found in the US. Their mode of action generally involves regulating the amount of fluid in the colon or treating opioid-induced constipation by blocking opioid effects on the nerves present in the gut.
It is like the last resort when nothing else works. This option is mostly availed by people who suffer from constipation due to a blockage or stricture in the colon. The blockage or stricture is surgically removed, which solves the problem and facilitates normal bowel movement.
But it is important to note that the frequent consumption of laxatives and other prescription medications can be counterproductive. The overuse of laxatives allows the body to get used to their action. As such, the person may feel the need to consume laxatives even when they don’t need it. Also, a higher dosage will be required to get the initial effect.
Laxatives can also be very addictive, and the more a person depends on it, there is higher chance of constipation when you stop using them. Overuse also causes dehydration, electrolyte imbalance, and internal organ damage.
The prescription medications are no better as they all have side-effects. Diarrhea, nausea, and abdominal pain are the most common ones, and in some cases, chronic constipation is also seen.
Ayurvedic Perspective on Constipation
Constipation is referred to as Vibandh in Ayurveda and is categorized as a vatic disorder because Vata dosha is the bodily humor that governs movement, elimination, and the nervous system. Aggravation or imbalance of the Vata dosha leads to blockage of the large intestine resulting in constipation. The cold and drying properties of the dosha result in hard and dry stool formation.
Vata dosha can be categorized into five subtypes based on location in the body. Amongst these five subtypes, Apana Vata or Apana Vayu is the one responsible for constipation. Apana Vata means the life force governing expulsion activities. Apana Vata resides in the large intestine and anal portion of the body. It presides over the normal functioning of these organs.
Normal Apana Vata enables water absorption from the digested food and checks the reabsorption of water from the waste to aid in proper stool formation. It also helps in the timely excretion of stool from the body. Imbalance of this Apana Vata disrupts the delicate balance in the large intestine and results in the formation of dry, lumpy stool and its slow expulsion from the body.
According to Ayurveda, the factors that lead to the aggravation or imbalance of Apana Vata are as follows:
- Consumption of foods with dry, cold and rough properties
- Low water intake
- Excessive consumption of astringent and pungent foods
- Physical inactivity
- Excessive use of antacids and antidepressants.
Ayurveda being the science of holistic healing focuses on treating the root cause rather than just the symptoms, and in doing so, it restores the delicate balance between all the elements of the body. Ayurveda is deeply rooted in nature and finds all the solutions to our physical problems in nature. This nature-based approach ensures that our body is not clogged with toxic substances that have harmful effects. It also empowers us to use our bodies in a way that strengthens it.
Dietary Approach to treating Constipation
- Drinking warm fluids
As constipation results from an aggravated Vata dosha, the cold and dry properties of the aggravated dosha can be countered by consuming fluids that warm the body. This intake of warm fluids neutralizes the coldness and dryness present in the body to restore equilibrium and treat the root cause.
Regular intake of warm water, soups, and herbal teas are the best options to replenish the body. Care should be taken to avoid sugary drinks and coffee as they are dehydrating in nature and do not serve the purpose. It is also important to drink these fluids at least 20 minutes before meals and 1 hour after meals not to dilute the effects of the digestive enzymes and acids.
- Incorporating organic oils in the diet
High-quality organic oils such as sesame oil, ghee (clarified butter), and olive oil work wonders in neutralizing the Vata dosha’s dryness. They also lubricate the colon, and the stool formed, allowing smooth passage out of the body.
- Stock up on fruits and vegetables
Consuming a diet rich in fresh fruits and vegetables rich in fiber is an effective way of treating constipation and preventing it. The fiber present in them adds bulk to the stool and reduces water loss. Ripe bananas, apples, peaches, prunes, raisins, berries, cauliflower, cabbage, celery, spinach, etc., are the most promising options. These fruits and vegetables also pacify the aggravated Vata dosha with their hydrating properties.
- Vata pacifying herbs
Herbs have always been an integral part of Ayurvedic healing as they offer gentle support to restore the body and mind balance and help in awakening the senses. Vata is composed of the space and air elements that are cold and dry, herbs having warming and grounding properties are best suited for calming any imbalance of the Vata dosha. Amongst the many Vata pacifying herbs available, there are four that particularly stand out and have proven their constipation treating properties time and again.
- Triphala meaning three fruits is an Ayurvedic herbal formulation comprising equal parts of amla (Phyllantus emblica), bibhitaki (Terminalia bellirica) and haritaki (Terminalia chebula). Amla has laxative properties and helps to treat inflammation. Bibhitaki is also a natural laxative and contains dietary fibers. Haritaki acts as a lubricant and helps loosen the stool. Triphala is generally consumed once in the morning after waking up and once before going to bed. It is available in tablet and powder forms. ½ -1 teaspoon of the powder is added to a glass of warm water, or two tablets are taken at once with warm water.
- Psyllium husk is an excellent source of both soluble and insoluble fibers. It serves as an efficient bulking agent and promotes healthy bowel movements. Before consumption, the husks (1-2 teaspoons) should be soaked in either warm water or milk glass. It is important to hydrate well while consuming psyllium husk. Psyllium is also found in capsule form that can be swallowed with a glass of water. Care should be taken to consult an Ayurvedic practitioner before adding this herb to your routine as it comes with specific dos and don’ts.
- Flaxseeds or linseeds are an essential source of dietary fibers and omega-3-fatty acids. They are useful in speeding up intestinal movement to increase bowel movement frequency and help in treating constipation. Flaxseeds are generally consumed in powdered or ground form. It is crucial to gradually add flaxseeds to your diet, starting with one teaspoon and then going up to 2 teaspoons per day. The powder can be added as a garnish or sprinkler to any other food item.
- Dandelion root is an excellent source of fiber and aids in treating constipation. It also contains enzymes that promote digestion and reduce bloating. One teaspoon of this powder can be boiled in water and consumed 3-4 times a day. Tablets are also available, which can be gulped down with a cup of warm water.
It is important to note that these herbs are safer than OTC and prescribed medications available. But they should be included in your diet only after proper consultation with an Ayurvedic practitioner or doctor because sometimes they may irritate the colon’s lining and lead to diarrhea and muscle cramps in an effort o counter constipation.
The Yogic approach to treat constipation
- Viparita Karani
Commonly known as the ‘leg up the wall’ pose, provides a good stretch for the abdominal muscles and strengthens them to promote intestinal peristalsis and relieve constipation.
Also known as the ‘wind-relieving’ pose, improves digestion and relieves intestinal gas accumulation, thereby treating constipation.
Commonly known as the peacock pose, improves digestion and intra-abdominal pressure, thereby helping to treat constipation.
Also known as the plow pose, increases blood circulation in the pelvic region and strengthens the intestinal muscles to relieve constipation.
So go ahead and reclaim those happy poop sessions, because with these Ayurvedic cures constipation will soon be a thing of the past.