Most of us have faced a situation where we have visited a doctor for some ailment or the other, and the doctor has asked us a number of questions, including whether our bowel movement is regular. This is because a regular bowel movement signifies good health and an efficient digestive system. Infrequent bowel movement, or constipation, not only causes abdominal discomfort and bloating, but could also be a symptom of a deeper malaise. Constipation thus needs to be taken seriously and addressed. Ayurveda and western medicine concur that health and disease begin in the gut.

What Is Constipation?

One is said to be suffering from constipation if one experience

• infrequent passage of stool or
• difficulty during evacuation due to various factors such as hardening of stool, blockage in the passage, straining or bloating.

Of course, the frequency of bowel movement varies from person to person. Some may “go” several times a day, and some not at all in a day. However, fewer than three per week is cause for concern. Constipation can occur due to several factors.

How Does Ayurveda Say About Constipation?

Ayurveda refers to constipation as vibandha, a condition where one experiences fewer bowel movements, hard stools, and painful defecation. Severe constipation (vistambha) can result in an inability to pass stool (malavibandha) and can become a life-threatening condition. While the causes of constipation can range from a poor diet to inadequate water intake, it can also (though rarely) result from serious conditions such as colon cancer.

According to ayurveda, vibandha results from vata (the air element) dosha. The undigested food is ejected from the body as purisha (faeces) with the help of apana vayu or vata which governs the movement of energy from the navel to the root chakra. When the role of the apana vayu is hindered, it causes constipation. While it is not listed as a disease in ayurveda, it is mentioned as a symptom of underlying diseases.

What Are The Causes Of Constipation?

While primary causes of constipation range from slow colonic transit to outlet obstruction, often there are secondary causes like

• low fluid intake,
• dehydration,
• myopathic issues,
• metabolic, and
• neurological disorders.^[1]Bharucha, Adil E., Spencer D. Dorn, Anthony Lembo, and Amanda Pressman. “American Gastroenterological Association medical position statement on constipation.” Gastroenterology 144, no. 1 … Continue reading

Diet plays a huge role causing constipation. Our current lifestyle that is heavily reliant on junk and processed food does not provide our body with the adequate nutrients or fibre. We are also glued to the screen, be it our laptops for work, our television for entertainment, or our phones for social media. We lead a largely sedentary life that involves hours of sitting and no activity. This, too, causes constipation.

Apart from diet and sedentary lifestyle, factors such as stress, travel, age, medication like antacids, anti-histamine,diuretics, and other diseases like anal fissure, renal failure, or rectal or colon cancer can also have constipation as one of their symptoms.

How Can Constipation Be Prevented And Treated?

Constipation can be extremely distressing and can adversely impact one’s quality of life. Here are some easy ways to improve digestive system:^[2]Collins, Brigitte Rosemarie, and Lorraine O’Brien. “Prevention and management of constipation in adults.” Nursing Standard (2014+) 29, no. 32 (2015): 49.

• Improving our diet and veering more towards whole foods instead of highly processed or packaged food that is mostly devoid of fibre. Incorporate wheat, fruits, vegetables, and green gram to improve digestive system.
• Increasing our fibre consumption. Fibres are of two categories: soluble and insoluble. Foods such as oat bran, barley, vegetables are soluble fibres, while wholewheat bread and the skin of fruits and vegetables provide insoluble fibre.
• However, it is important to note that one must refrain from suddenly increasing fibre intake to a great extent. It should be done gradually to allow the body sufficient time to adapt. If this is not done, one may experience flatulence or bloating.
• Being sedentary all day does not help matters. One must exercise or be engaged in some light activity to ensure a smooth bowel movement. Exercise, of course, has a host of other benefits; it is great for cardiac health, muscle toning, weight loss, helps improve digestive system, and boosting one’s mood.
• Often we are so caught up with work and the countless chores that we resist the urge to evacuate our bowel. This is really harmful and can cause constipation in the long run. It is important to establish a routine and try to stick to it.
• Many of us are in the habit of carrying a newspaper or music to the washroom. It is better to remain undistracted and not rush. Ensure privacy, time, and a hygienic environment.
• Dehydration is a major culprit when it comes to constipation and hard stools. Ensure that you drink 1.5 to 2 litres of water regularly. Avoid caffeine; note that several aerated drinks contain very high amounts of caffeine. Drinking lukewarm water helps in bowel movement and improve digestive system.
• How you sit on the toilet matters greatly. You can use a stool to keep your feet elevated and lean back, even squatting can be helpful.
• Avoid self-medication.

Which Yoga Asanas Can Relieve Constipation?

Yoga is a holistic way of achieving wellness. There are several asanas that can help you obtain relief from constipation. Here are a few asanas that are known to be particularly helpful to improve digestive system:

1. Kurmasana Or The Tortoise Pose

• Sit up straight and stretch your legs in front of you on the floor and keep your hands beside your hips, palms facing downward.
• Keep your feet flexed (toes pointing upwards) and spread them a bit more than shoulder-width apart.
• Draw the legs back in by a few inches, your knees should now be off the ground.
• Bend your torso towards your knees with your arms stretched out in front of you.
• Draw your legs back in a little more and bend down so that you can slide both your arms sideways under your knees, one by one.
• Now bend down trying to touch your chin to the floor and stretch your legs in front.
• Ensure that your thighs are rolled inwards and relax your legs.
• Hold this pose for thirty seconds.
• Release the pose slowly by pulling your legs back in and drawing your arms back in. Then slowly lift your torso.
• Make sure your back doesn’t hurt and don’t force yourself into this pose. Be patient.

Avoid: Do not do this asana after surgery or if you are pregnant.

2. Vakrasana Or The Twisted Pose

• Sit with your legs stretched in front of you on the floor.
• Bend your right knee and keep your right foot beside your left knee; the right knee should be off the ground, pointing towards the ceiling.
• Inhale and raise your arms above your head.
• As you exhale, bring your arms down and simultaneously twist your torso towards your right.
• Your right arm should be on the floor behind you and your left palm should be beside your right knee.
• Look back on the right side.
• Repeat on the other side.

Avoid: People with back and hip injury and pregnant women should avoid this pose.

3. Pavanamuktasana Or The Wind-Relieving Pose

• Lie on your back, toes pointing upwards, arms by your side, palms facing down.
• Inhale and slowly draw your legs towards your chest; thighs should be as close to the chest as possible. Hold your knees.
• Exhale and bring your head closer to your knees.
• Hold for five counts and release slowly.

Avoid:

• Those with severe migraine must avoid this asana.
• Never perform this asana on a full stomach.
• Pregnant women must avoid this asana.

4. Surya Anuloma Viloma Or Nadishodhana (alternate nostril breathing)

• Sit comfortably in the lotus pose (legs folded). Close your eyes and rest both hands on your knees.
• Close your right nostril with your right thumb and inhale deeply with your left nostril.
• Hold your breath, keep the right nostril closed and using your middle finger close the left one as well.
• Now slowly remove the thumb from the right nostril and exhale completely.
• Now inhale from the right nostrils and repeat the process.
• Do this for five minutes.

While yoga is extremely beneficial for strengthening your abdominal muscles and for holistic healing, it is always advisable to practice under the supervision of a qualified yoga instructor.

Ayurvedic Herbs That Offer Relief From Constipation

Ayurveda is a completely natural and holistic way of treating imbalances in our bodies. This ancient Indian system of healing and wellness recommends several treatments that one can reach out for to get rid of constipation. The most potent formulations to treat constipation are triphala (which contains haritaki, bibhitaki, and amla) and wheatgrass. Here’s how these herbs can help improve digestive system.

1. Triphala

Triphala is a very commonly used ancient treatment for constipation. This detoxifying formulation is found to improve the frequency of bowel movement, restore regularity. It acts as a laxative and is useful for gastrointestinal concerns.

Tripahala, literally meaning three fruits (tri-three; phala-fruits) contains equal measures of amalaki (amla), harad (haritaki), and baheda (bibhitaki).

The benefits of triphala can be traced to its high antioxidant value which destroys the harmful free radicals in the body, restores gut health, and also has colon-cleansing and enteroprotective (protecting against intestinal damage) properties. A study suggests that triphala helps reduce constipation, abdominal pain, hyperacidity, and flatulence. It improved yield and consistency of stool.^[3]Peterson, Christine Tara, Kate Denniston, and Deepak Chopra. “Therapeutic uses of Triphala in Ayurvedic medicine.” The Journal of Alternative and Complementary Medicine 23, no. 8 (2017): … Continue reading

Let us delve deeper into the key ingredients of this potent formulation:

• Amla: Amalaki or the Indian gooseberry (Phyllanthus emblica) is one of the constituents of Triphala. It is high in fibre and helps improve digestive system and absorption of nutrients. It has traditionally been prescribed to those experiencing nausea, dyspepsia, constipation. A glass of water with amla is an effective treatment for constipation. Amla has a plethora of benefits. It reduces inflammation, improves fertility, and also helps in stress management.

• Haritaki: Haritaki has therapeutic properties and has been mentioned in several ancient Ayurvedic texts. Ayurveda holds this in high regard and calls it the ‘king of medicines’.^[4]Ratha, Kshirod Kumar, and Girish Chandra Joshi. “Haritaki (Chebulic myrobalan) and its varieties.” Ayu 34, no. 3 (2013): 331. Haritaki, too, is well-known for its gut-healing properties. It enhances the secretion of digestive juices and helps in the absorption of nutrients. It aids relief from constipation and flatulence.

• Bibhitaki: Bibhitaki is also a very important herb in Ayurveda. It has dietary fibre and laxative properties which help in providing relief from constipation. Bibhitaki, additionally, helps cure insomnia.

How Can You Consume Triphala?

• Triphala churna (powder): You can place half a teaspoon of triphala powder on your tongue and gulp it down with water. If you don’t like the taste, you can drink a mixture of triphala, water, and honey to sweeten it. This is best consumed before you hit the bed at night.
• Triphala capsule: You can take two capsules twice daily after meals.
• Triphala juice: You can consume two to three teaspoons twice daily after meals. Dilute it with water while taking it.

Precautions

• Triphala is a diuretic and may cause disturbed sleep due to the frequent urge to urinate. If you face this issue, then soak triphala water overnight and have it the first thing in the morning.
• Triphala is known to lower blood sugar levels. So, always have it immediately before or after your meals. If you are already on diabetic medications, then consuming triphala puts you at a risk of hypoglycemia (dangerously low levels of blood sugar). In this case, consult a physician before consuming triphala.
• Those with high blood pressure should check with their physician before consuming triphala.
• Avoid taking triphala if you are on antiarrhythmic medication, HIV medication,sedatives, antidepressants, anti-psychotics, immune-supressive drugs,antifungal medication, or opioid painkillers.
• Avoid taking triphala if you are pregnant.

2. Wheatgrass

Wheatgrass is nothing but the young grass of the common wheat plant that is a powerhouse of nutrients. Wheatgrass therapy is recommended for people suffering from chronic ailments like TB, asthma, hypertension, and constipation. Wheatgrass therapy also helps patients experiencing serious conditions like rectal bleeding and ulcerative colitis.^[5]Mujoriya, Rajesh, and Ramesh Babu Bodla. “A study on wheatgrass and its nutritional value.” Food Science and Quality Management 2 (2011): 1-8.

How To Consume Wheatgrass?

Wheatgrass powder: You can consume wheatgrass powder by adding it into your smoothie or by simply mixing it with water. You can have this drink right after you wake up.

Wheatgrass juice: Mix approximately 30 mL of this juice with 30 mL of water and drink twice a day, preferably before breakfast and dinner.

Precautions

• Pregnant women should not consume wheatgrass without consulting a qualified practitioner.
• Wheatgrass lowers blood sugar levels, so one has to be careful if one is already on medication for diabetes.

How To Manage Constipation In Children?

Constipation is observed in infants when they switch from breast milk to formula. It is then again observed in toddlers during toilet training. Children also become constipated when they begin to attend school, in kindergarten. Constipation is exacerbated due to low water intake and consumption of junk food. Here are a few ayurveda-approved easy ways to tackle constipation in children:

• Water: Ensure they drink a glass of warm water every morning.
• Raisins: You can give them a few soaked raisins in the morning.
• Milk and ghee: They can drink a glass of warm cow’s milk with a teaspoon of ghee before going to bed.
• Avoid junk food: Try to cut down on packaged food.

How To Manage Constipation During Pregnancy?

Constipation is fairly common during pregnancy. Changing hormone levels, vitamin supplements, and the pressure exerted by the uterus cause constipation during this period. Since it is advised that pregnant women refrain from consuming triphala, here are some practices they could follow to get relief:

• Fluids: Increase your fluid intake.
• Whole grains and fruits: Incorporate an adequate amount of whole grains, fruits, and vegetables for providing your body with a good amount of fibre.
• Ghee: Incorporate ghee in your diet can offer you relief from constipation.
• Physical activity: Go for walks or any kind of gentle physical activity for reduction of flatulence and relief from constipation.
• Reduce refined foods: As far as possible, stay away from refined food items like maida, white bread, naan, biscuits, chips, cakes, and so on.
• Psyllium husk: This is a good source of fibre and is generally considered safe for pregnant women. However, do consult your physician before consuming this.

How To Treat Constipation In Senior Citizens?

Many senior citizens are also plagued by constipation and irritable bowel syndrome (IBS). Elderly people are also at risk of suffering from an ischemic cardiac or cerebral attack while straining. Constipation may also be caused by other diseases that they suffer from such as diabetes.^[6]Gandell, Dov, Sharon E. Straus, Maria Bundookwala, Vincent Tsui, and Shabbir MH Alibhai. “Treatment of constipation in older people.” Cmaj 185, no. 8 (2013): 663-670.

Here is how senior citizens can improve digestive system and cure constipation:

• Whole foods: Include more whole foods in your diet and reduce refined foods.
• Water: Increase your water intake.
• Fruits and vegetables: Consume more fruits and vegetables for fibre.
• Medication: If your constipation is caused by nerve or muscle-related issues, then take your prescribed medication for softening stool. In such cases, you may be advised to reduce fibre intake.
• Exercise: Workout regularly under supervision.
• Psyllium husk: Take a soluble fibre supplement like Psyllium husk.
• Tripahala: You can consume laxatives or Rasayana formulations like triphala, but only after consulting an experienced medical professional, as they may have an impact on your blood sugar or your existing medication.

While ayurveda does not list constipation as a life-threatening condition, it can undeniably have a huge impact on one’s day-to-day life. Treating constipation is not merely about consuming one or two products, taking fibre supplements or reaching out for a laxative, it involves closely looking at one’s lifestyle and making modifications wherever necessary. A holistic approach is the best way to treat constipation and keep your gut healthy.