By Roohi Saluja February 2005 Although adopting a salubrious lifestyle can cure constipation, what’s even more important is to learn to let go…br/> Types of constipation There are two types of constipation: simple and severe (without a known cause) • Simple constipation: This is usually due to improper diet and lifestyle. People with simple constipation do not suffer from major illnesses and get relief from improving their diet or by the use of substances that increase the volume of the stool. • Severe constipation: This usually occurs in young women. It starts in childhood or adolescence. Psychological factors and ignoring the natural urge to pass stool play a significant role. A person with this type of constipation that has an unknown cause related to it, is normally difficult to treat. In some cases, high fibre intake may even worsen the symptoms. People with severe constipation without a known cause have decreased bowel movements and abnormal contraction of the muscles around the anus. Source: Health Update, a monthly health bulletin for Health Education and Learning Packages (HELP) How do I know whether my constipation is simple or serious? More than 80 per cent people have simple constipation. Your doctor is the best person to judge the causes and the type of your constipation. Some of the most common questions asked by your doctor will be: • What are your normal habits for passing stools in terms of frequency, volume and timings? • What is the duration of constipation? • What is the consistency of the stools? Do you need to strain a lot while passing stools? Do you have a feeling of either fullness in the abdomen or incomplete evacuation? • Have you ever taken medicines for constipation? If yes, for how long and which medicines? Do these medicines relieve constipation? • Do you have any other complaints in the abdomen? • Are you normally stressed? • Do you take medicines regularly? If yes, how often and which medicines? • Do you have any other health problems? After taking a detailed history, the doctor will examine you to find out if you have any other diseases. He/she will examine your anus for any deformity or injury around it. The doctor may also do a manual examination of the rectum to find out if there are abnormalities of the rectum. Your doctor may suggest some laboratory investigations, if necessary. As acute abdominal pains knifed through her preoccupation with work pressures and business presentations, 32-year-old business consultant Pooja Malik winced as she recognized her old foe. Pooja was suffering from thyroid imbalance and constipation. In ancient Indian tradition, avoidance of meat is recommended to prevent an overload on digestive capability, especially in cases of sluggish metabolism when ingested food is not properly eliminated. Partially digested meat rots in the intestine. Being heavy, it stays back in the intestinal folds, turning toxic. This has harmful effect on the entire system. A direct link between heavy meat intake and colon cancer is now well-established in medical research. “Constipation is a symptom, rather than a disease,” says Anita Anand, Delhi-based Bach Flower therapist and clinical psychologist. She continues, “Bach Flower therapy understands constipation as an irregularity of bowel movements, normally arising due to an inability to accept an emotion.” Dr Sanjiv Sharma, senior doctor at the Batra Hospital, Delhi, elaborates, “It’s not easy to define constipation because of the wide range of acceptable bowel movements. However, constipation can be said to exist when the frequency of passing the stools is less than thrice a week. Other subjective complaints like hard stools, excessive straining, lower abdominal fullness and the sensation of incomplete evaculation are also some of the determining symptoms.” What’s perhaps even more crucial is the fact that while many people complain of constipation, a large section of them only unknowingly ‘feel constipated’. Says Dr N.K Sharma, naturopath and director of the Delhi-based Natural Cancer Research Foundation, “Constipation is not just a state of no motions. It means koshtha baddhata that is, a blockage of the intestines.” An ineffectual desire to pass stool, occasional bleeding, gas formation, reduced appetite, frequent headaches, body pain and vertigo are some of its most common symptoms. Bach Flower therapy relieves the pressure on emotions that in turn, eases the bowel movements. Walnut, white chestnut and scleranthus are highly beneficial. For a homely touch, take one tablespoon of corn syrup mixed in 8-ounce water for immediate relief. Aloe vera juice, ginger tea and bel fruit gently clean up your digestive system and tone the intestines. But what works best is a complete retuning of your lifestyle. Dr Sanjiv Sharma says, “Initial therapy usually incorporates dietary corrections with an increased emphasis on fibre and water intake.” Treat yourself to fibrous foods like figs, raisins, sultanas (munakka), corn, oats, porridge; green, leafy vegetables like peas, beans, spinach, sprouts and a daily generous helping of salad. But if these fail to tantalise your taste buds, try plums, prunes, apricots, ripe bananas, mud apple, papaya and guava (eaten with seeds). Dr N.K Sharma advises, “Increase dependence on whole wheat flour and unpolished rice, and reduce the ingestion of proteins, fats and maida. The latter tend to congest the liver and delay the digestive process.” Also, avoid cold and processed foods, meat products, and vegetables like potatoes, ladyfingers, brinjal, radish, cauliflower, and pulses like kidney beans and black grams. These are gas-forming. In all cases of constipation, laxatives play a major role. Take one to two teaspoons of ghee in hot milk at bedtime. This is a gentle but effective remedy for constipation. However, if you’re prone to colds, avoid using this remedy on a regular basis. Most digestive problems can also be corrected by the use of triphala powder, a mild laxative. Take about one-and-a half teaspoon of this powder with warm water at bedtime. If constipation is severe, have two teaspoons of castor oil with a warm cup of milk. (This treatment is advisable only if you’re home the next morning.) A word of caution: In case you are pregnant, avoid this treatment as castor oil can cause premature contractions. For bowel retraining, try the magic potion: water. Dr Sudha Asokan, director and chief physician of the Ayurveda Kendra, says, “Water is the best medicine as it cleanses and detoxifies the body. Drink at least one to two litres of water per day, in addition to other liquids like fresh juices and buttermilk.” To regularise bowel movements, drink 2-3 glasses of warm water in the morning on an empty stomach. Exercise is another mandatory solution to reluctant bowel movements. One of the most common causes of constipation is the sedentary urban lifestyle, involving long hours of sitting hunched in a chair. Regular exercise slashes escalating stress levels, and regulates easy bowel movements. A stroll, a quick jog, or biking can actually strengthen your abdominal muscles. Your body will also automatically demand food. Dr N.K. Sharma also advocates acupressure. Putting pressure on the specific points related with the intestines can bring instant relief to a constipated person. “The curve of the foot, the points between your fingers, your heel, and the centre of your palm are the sensitive points for the intestine.” The right posture while evacuating is the squatting posture (as required in the Indian style-toilet)-with a narrow angle between the thighs and hips. In case your feet are hanging above the floor (in the Western style-toilet), place a stool underneath to increase the angle between the thighs and the hips. A warm water enema treatment, strictly on doctor’s recommendation, lubricates the rectum, smoothening the passage of the stool. Some time-tested nature cure remedies can also do wonders like the hip-bath. Splash cold water in the region, reaching from the anus to the lower abdomen. This stimulates the bowel movements, and reduces the heat in the area owing to excessive straining or hard stools. You could also place a cold strip of cloth on the abdomen for 20 minutes. Try the mudpack: Prepare a thick dough-like mudpack (finely kneaded). Apply a one-inch thick strip of this pack in the area below your navel. This soaks the heat and activates the abdomen. An abdominal massage, by a nature cure practitioner, stimulates the bowel movements, tones the abdominal muscles and evacuates the stools. “There can be innumerable causes of constipation,” says Delhi-based homoeopathy specialist, Dr Amarjit Singh. “Faulty food habits, stress, anxiety, sedentary habits, addiction and irritable bowel syndrome, and a voluntary control of the natural urge are some of the major stimulators,” he continues. Serious causes include cancer of colon, stricture, fissures and piles. Diabetic patients also complain of intermittent constipation and diarrhoea. While all the above treatments can bring a definitive relief from constipation, a salubrious lifestyle and healthy eating habits will certainly decrease the chances of constipation in future. Says Anita Anand, “Constipation stems from the human tendency to control, to hold on. However, what we fail to understand is that the more we tend to control, the more constrained we are. Curing constipation thus implies letting go and accepting all that’s uncontrollable.”
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