Disease Introduction, Causes and Symptoms
A person suffering from this disease does not go for defecation for 2 to 3 days. When he goes for defecation, the stool (faeces) comes out in less quantity, hard/hard and dry. This means that the patient does not have a clear bowel movement (diarrhea) and the patient feels that his stomach has not been cleaned. This is a very common physical disorder due to which the patient remains mentally worried and his nature becomes irritable. Usually a normal person excretes 200 to 250 grams of stool from the body in a day, but this quantity depends a lot on his food and drink. Similarly, usually a person goes for defecation 1 or 2 times every day. Many people go to the toilet 3-4 times a day and many people do not go to the toilet for several days. In case of constipation, the patient sits for several hours to defecate but a very small amount of hard stool comes out. This makes the patient even more frustrated and he also develops symptoms like laziness, lethargy, headache, lack of interest in doing any work, mental stress and irritable nature.
The main causes (etiology) of this disease are written below-
• Mainly this disease is caused due to reduced movement of intestines (Peristalsis). Decreased efficiency of the liver is also one of its main causes. Besides, oily, fine, fine flour of electric grinder, pulses without peel, polished rice, chapattis made of bran-free flour, green vegetables prepared after removing the peel, excessive use of fiber-less food, habit of drinking less water, inactive lifestyle without effort, habit of consuming tobacco, tea or bidi-cigarette for defecation, habit of defecating by taking purgatives/compounds repeatedly, forcibly stopping the urge to defecate, anxiety, fear, anger and mental disorders, long-term diseases, excessive exertion and inadequate diet, eating foods made of refined flour in excess, change in diet, eating food with less fiber and drinking less water, pregnancy, drinking heavy water, change in water, intestines becoming weak in old age, diabetes, porphyria and mental stress, many medicines such as Codeine, opiates, antacids, anesthesia, ganglion blocking drugs, in case of severe pain during defecation, as in anal fissure, piles, proctitis, the patient does not go for defecation due to fear of pain. In case of stomach related diseases (vomiting, carcinoma, opacolon, pyloric outlet obstruction), after major operations (since the patient remains in bed for many days and the stool becomes dry due to not taking anything by mouth), due to mental disorders (due to changes in the anatomical nervous system), excessive consumption of opium, night vigil, deficiency of vitamin B, continuous sitting, clerical life and in people doing mental work, this (constipation) is a common disease.
Special-
Causes of defecation process and stool blockage in detail-
• The food taken through mouth in food comes out of stomach in about three hours and reaches the lower end of ileum in 2 or 21⁄2 hours and remains there for some time. Thereafter, on taking any food or drink, a 'motivational movement' arises in this lower part of the small intestine (which is called Gastro Caecal Reflex as it arises due to the movement of stomach). On its occurrence, the door between small intestine and large intestine (lleocaecal Value) which remains closed all the time opens and this food collected in the lower part of small intestine slides further into the Ceacum. Thus, the collected 1-11⁄2 litres of food fluid (which contains 90% water and very small quantities of sugars, fats, proteins and salts) passes from the small intestine to the large intestine.
On reaching the large intestine, the movement of this food fluid stops. It remains there at one place for hours. In the ascending large intestine and the half lying large intestine, the water of this food fluid and the soluble parts of the food dissolve. Only the stool of the food fluid remains in the Pelvic Colon. About 3-4 times a day and night, 'peristalsis' occurs in the large intestine which lasts for only a few seconds. In this, the stool of the ascending intestine moves in a group to the lying intestine and the stool of the lying intestine moves in a group to the descending intestine, i.e. mass peristalsis occurs in the large intestine. In this way, the food eaten reaches the lower end of the pelvic colon after about 16 hours and after reaching there stays there for 5-6 hours i.e. the food and liquid taken in the early morning and at 12 noon reaches the pelvic colon by 4 am the next day after a period of 16 hours. When a person wakes up at 5 or 6 am and drinks normal or heated water or drinks hot tea etc. or just resolves to defecate, then a motivating movement starts occurring in the pelvic colon through the movement of the stomach or due to mental inspiration, due to which the stool present there starts sliding forward and entering the rectum.
At that time, if the person is relaxed i.e. he is not occupied with any work or worry i.e. if the sympathetic nerves are not stimulated, then the sensation of defecation in the rectum or the need/desire to defecate starts. Since it is related to the movement of the stomach, it is called Gastrocalic Reflex. Thus, when a sensation is felt in the sensory vessels of the rectum due to the entry of stool, then its perception reaches the defecation center present in 2-4 Sacral Segments of the Spinal Cord, from where an efferent impulse comes through the Sacral Para Sympathetics, due to which a motivating movement is generated not only in the rectum but also in the muscles of the entire lower part of the colon (intestine) while lying down. Due to the stimulation of this group of nerves, the inner door of the anus (Anal Sphincter) opens at this time and due to contraction in the entire lower part of the large intestine, the entire stool of the Pescending Colon and Pelvic Colon comes out of the body with a force. Along with this, the food fluid of the ascending intestine slips into the lying large intestine and the food fluid of the lying intestine slips into the pelvic colon. Thus, defecation is a reflex act.
This reflex also depends on thoughts or conditions. This reflex is generated by the time of defecation or by thinking about it or by drinking some beverage like tea etc. At the time of defecation, the person also exerts pressure of the muscles of the wall of his colon and the diaphragm, i.e. these voluntary muscles also help the involuntary muscles of the colon at that time. Thus the rectum, which was empty before the act of defecation, becomes empty even after it. If this act of defecation or reflex does not happen regularly once in 24 or 48 hours, then it is known by the names of constipation, malpractice, constipation etc.
• When a person ignores the sensation or urge or reflex (mentioned above) in the rectum due to laziness or some work or shame or lack of space for defecation, then the urge to defecate subsides automatically. Thereafter, this Gastro Colic Reflex is generated again after a meal or after a light meal like tea etc. and the person defecates or the next day in the morning at the fixed time, the urge to defecate arises and the stool present in the rectum comes out and the rectum becomes clean again. But if this urge or reflex to defecate is ignored while giving priority to other activities, i.e., even if the stool is present in the rectum, one does not go to defecate, then gradually the sensation or feeling of discomfort arising from the entry of stool in the rectum becomes increasingly mild, i.e., the nervous stimulation arising in the nerves of the rectum due to the entry of stool becomes mild and suppressed. (Colic Reflex decreases.) The stool gets collected in the rectum and becomes dry and due to the rectum becoming loose, it becomes difficult to throw it out or it is appropriate to call it a disease of defecation with difficulty. This is caused due to the nervous weakness of the rectum. It is clear that children and young people should be taught by the family members that they should never ignore the reflex of defecation.
• Colonic Constipation or Constipation caused by weakness in the movement of large intestine. The peristalsis of food in the intestinal wall is produced by the nerves of Auerbach's Plexus covered in the wall. Sympathetic and Parasympa- thetic nerves regulate this movement. This peristaltic movement increases due to the disturbing substance present in the food. That is why even if the diet is very bland like branless fine flour, refined flour or machine/mill cleaned rice, milk, curd etc. is consumed, then also the symptoms of 'Intestinal Stasis' remain due to slowing of peristaltic movement. The bran of flour contains vitamin B-1 which is a strength enhancer for the nerves of the body. If there is a deficiency of this vitamin, then the peristaltic power of the intestine also becomes slow, which leads to constipation. We get it in the amount of one milligram daily from food. Hence polished grains also become the cause of constipation. Vegetables, vegetables, fruits etc. have high amount of cellulose, hence constipation occurs even if they are not consumed at all.
The bile secreted by the liver is also a stimulant of peristalsis in the intestine. Hence constipation occurs in yakdog also. People who are sedentary, do not exercise, walk etc., like other flesh of their body, the flesh of the large intestine also becomes weak, due to which the person suffers from constipation. It is natural for the large intestine to become weak (intestine becomes atony) when there is an increase in fat in the body or in jaundice or after any acute fever or in tuberculosis or in diabetes and also due to old age, due to which the person suffers from constipation. (This is called Atonic or Colonic Constipation.)
• Spastic Constipation caused due to spasm in the large intestine. If there is excess production of Organic Acids and gas in the intestine due to indigestion, especially carbohydrate indigestion, then the pressure of gas on the intestinal wall and the adverse effect of acids cause constipation in the intestine and its food motility or stool motility becomes slow. Similarly in people of 'Vata' nature/temperament who are not happy but remain poisonous, agitated and worried, (like in people of Neurasthenia, Hysteria etc. nature) due to disturbance of Sympathetic nervous system there is also constipation in intestine and the movement of large intestine (Peristalis) caused by Parasym pathetic nervous system becomes slow. Irritation (inflammation) in gall bladder, rectum-anus-uterus also causes constipation in large intestine and leads to Spastic Constipation. Intestine gets constipation due to excessive use of laxatives and tobacco or due to mental reasons also. When piles get swollen and when there is inflammation in prostate gland also there is constipation in large intestine and leads to constipation.
If the patient has cancer in his intestine, then there is a repeated urge to defecate but the defecation is incomplete. If it is accompanied by constipation and the age is old, then the effect of myelitis should be known in the defecation centre present in the spinal cord. Drinking water from rocky rocks or stony plains (which contain limestone) causes calcium carbonate to reach the intestines in large quantities, which also causes constipation due to its absorbency. Similarly, the water of some places is heavy and causes constipation. Even after exercise, due to excessive sweating or drinking less water, the stool dries up and constipation occurs. In cities, where the life of the people is anxious and artificiality has entered the food in large quantities, this (constipation) disease is seen more today than in rural areas. The symptoms of this disease (constipation) are written below- The symptoms of constipation in a patient mainly depend on the following things-
(A) Expansion of rectum and colon due to stool retention-
Many changes occur in the patient-
• Loss of appetite.
• Body slumped/laziness.
• Dizziness.
• Head heaviness.
• Nausea.
• Acidic belching.
• Wind/gas coming out of anus.
• Stomach heaviness.
• Mental tension.
• Tongue cracked or white.
• Lack of concentration in any work.
All the above symptoms occur due to expansion of rectum and colon. If the patient defecates naturally or after applying a spaytoscope, these symptoms go away/end.
(B) Excessive use of medicines for bowel movement or bowel movement-
Consumption of laxatives leads to loss of water, sodium and potassium and muscles become weak. Deficiency of other electrolytes is caused. Use of excessive enema causes damage to the intestines and the body.
(C) Colonic neurosis
This mostly occurs in children after constipation. Being too strict with children makes them anxious and fearful. Many times if the child does not defecate in the morning, then a medicine for clearing the bowel (laxative/laxative) is given to them, which makes the child habituated to that medicine.
Other major symptoms
• Defecation/diarrhea is not clear. Stool (faeces) is released without appetite and in less quantity.
• Loss of appetite.
• Heaviness in the stomach and mild pain.
• Heaviness in the body and head of the patient.
• Sometimes, there is a feeling of foul smell from the mouth.
• Tongue being covered with mucus.
• Formation of gas in the stomach.
• Increase in blood pressure due to adverse effects on the blood.
• Bad taste in the mouth.
• Symptoms like lethargy, sluggishness, insomnia and fever are found.
• Long-term constipation causes the origin of diseases like piles, sciatica pain etc.
• Some patients are unable to defecate without consuming tea or cigarette.
• Even when the patient goes to defecate (even after sitting for a long time to defecate), there is no tendency to defecate.
Complications of Constipation
• Anal Fissure
• Piles
• Retention of Urine
• Stool sticks to the large intestine and anus (Impaction of Stool)
• Ulcer in the large intestine (Colonic Ulcer)
• Catarrhal Colon
• Lack of control over bowel movement (Incontinence of Bowel)
• Inflammation of the large intestine due to lack of oxygen (Ischaemic Colitis)
• Prolapse of the rectum
• The colon may harden and become pipe-like.
• Piles, fistula, inguinal hernia, isocardial infarctions can often occur due to constant straining while defecating.
• A patient suffering from constipation does not have natural energy. Investigations and Diagnosis
• Ask the patient thoroughly about his diet, lifestyle, eating habits and daily routine.
• Get detailed information about any disease, operation, medicines etc.
After that
• Proctoscopy. Sigmoidoscopy.
• Barium enema.
• On examining (P/R) by inserting a finger in the anus of the patient, hard stool is found collected.
Special-
The main/root cause of constipation (disease) should be found out. All the above mentioned investigations reveal about piles, fissure and malignancy.
Treatment
Medicines should be used for the treatment of this disease only for some time. One should not depend on medicines only because after some time the same medicine becomes ineffective. Among the medicines, those which lubricate the intestines are especially useful for constipation/constriction, that is, such lubrication which causes the intestines to become soft and smooth.
Saponification is especially beneficial for lubrication. For example, taking 4-6 drams of Paraffin Liquid before going to bed or for some time after meals on both days lubricates the colon and rectum and relieves constipation. Similarly, taking 2-6 drams of olive oil or the same amount of almond oil after breakfast in the morning and before going to bed at night also lubricates the intestines and relieves constipation.
• Tablet Lexorin (Manufacturer- Himalaya Drugs). Give 1-2 tablets to the patient at bedtime.
• Tablet Regulex (Mild and Forte) (Manufacturer- Charak Pharmaceuticals). Give 1-2 tablets at night before going to bed. Its strong tablets are also available. One tablet is sufficient.
• Virechanee Tablet (Manufacturer- Vaidyanath). Give one tablet at bedtime.
• Julabin Tablet (Manufacturer Dabur). Give 2 tablets to the patient at bedtime.
•Herbolex Tablet (Manufacturer Himalaya Drugs). Give 1-3 tablets to the patient at bedtime.
•Laxative Tablet (Manufacturer- Zandu Pharma). Give 1-4 tablets to the patient at bedtime.
•Abhayasan Tablet (Manufacturer- Same as before). Give 2 tablets at bedtime with lukewarm water.
•Livomin Syrup (Manufacturer- Charak Pharma). Give 1/3-1/2 teaspoon 3-4 times a day.
•Livonin Drops (Manufacturer- Same as before). Give 4-5 drops to infants 3-4 times a day with milk or fruit juice.
• Pedilex Forte Drink (Manufacturer- Same as before). Give 1-2 spoons to children and 1⁄2 to 1 spoon to infants and 2-3 spoons to adult patients with lukewarm water.
• Livarol Syrup (Manufacturer- Vaidyanath). Give half to one spoon. Give half the quantity to children.
• Koshtha Vriddhi Vati (Rajvaidya Sheetal Prasad). Give 2 tablets at night before sleeping. Can be given in new and old constipation (all).
• ABC Granules (Manufacturer-Ajmera). Give 1-2 spoons at night before sleeping.
•Agastiprash (Manufacturer-Aapyudhi). Give 2-4 spoons with milk at night before sleeping. Beneficial in chronic constipation.
•Anulom Churna (Manufacturer Sagar). Give 1 spoon of powder with lukewarm water. Beneficial in constipation and piles.
•Anulom Tablet (Manufacturer-same as before). Give 1-2 tablets at night before sleeping.
•Anulom DS Tablet (Manufacturer-same as before). Give 1-2 tablets to the patient at night before sleeping.
•Ayulex Tablet (Manufacturer-Ajmera). Quantity and method of intake same as before.
•Bowelcare Capsule (Manufacturer Organic India). Give 1-2 capsules twice a day. • Constina Churna (Manufacturer-Ajmera). Give 1-2 teaspoons twice a day.
• Constivin Capsule (Manufacturer-Aryuvin Pharma). Give 1 capsule to children and 2 capsules to adults at bedtime with a glass of warm water.
• Ezigo Tablet (Manufacturer-Abhinav). Give 1-2 tablets at bedtime with a glass of warm water.
• Egilex Capsule (Manufacturer-Ayushya). Give 1-1 capsule 3 times a day. • Fibrolex Powder (Manufacturer-Vitahealth). Give 1 teaspoon (5 grams) at bedtime with warm water.
• Freelex Granules (Manufacturer-Prakriti). Give 1-2 tablets at night with warm water.
• Golex Powder (Manufacturer-Franco India). Give 2 teaspoons at bedtime.
• Herbolex Capsule (Manufacturer-Himalaya). Give 2-3 capsules with warm water before dinner. Caution- Do not use in pregnant women.
• Isabgol Plus (Manufacturer-Multani). Give 6-7 grams 1 to 3 times with water.
• Constipation Capsule (Manufacturer-Chirayu). Take 1 capsule with water at night before sleeping.
• Constipation Har Granules (Manufacturer- Vaidyanath). Use 1-2 spoons as per requirement.
• Kayam Churna (Manufacturer- Seth Brothers). Give 1 spoon with warm water at night before sleeping. • Lexi Gold Capsule (Manufacturer- Agrigold). Take 1-2 capsules with warm water at night before sleeping.
• Lexinol Capsule (Manufacturer- Kapal). Give 1-2 capsules at night before sleeping. • Lexoherb (Salt and Sugar Free) (Manufacturer Amrita). Give one spoon at night before sleeping. Beneficial in constipation, piles, fissure, gas problem and acidity. • Lexostar Tablet (Manufacturer- Herbotech). Give 1-2 tablets with warm water at night before sleeping.
Other useful medicines
Lexone Capsule (Manufacturer-Snehnatura), Lex Sena Tablet (Manufacturer-Bacfo), Lexone Compound Tablet (Manufacturer Akshay), Lion Churna (Manufacturer-Nar-Narayana), Mega Lex Powder (Manufacturer-Megha), Gyro Lex Life (Manufacturer-SDL), Mal Shuddhi Vati (Manufacturer-Nar-Narayana), Nityam Churna (Manufacturer Zandu), Filex- Ifermix (Manufacturer-Phyto Pharma), Picrolex Capsule (Manufacturer Himalaya), Picrolex Syrup (Manufacturer-As before), Laxative Tablet (Manufacturer-Dhanvantari), Laxative Syrup (Manufacturer-As before), Spolex Powder (Manufacturer J&J), Sukhada Churna (Manufacturer-Chirayu), Trikgol Powder (Manufacturer Dabur), Udar Shuddha Drink (Manufacturer-Santhigiri), Virechana Vati (Manufacturer-Shri Shri Ayurveda) etc. are also very beneficial medicines for constipation. Dosage and method of intake etc. should be checked in the leaflet/literature provided by the drug manufacturer along with the medicine.
Scriptural Ayurvedic medicines
• Give one tablet each of Sukh Virechani Vati, Kshemasi Vati, Narachras, Vishva Tapharan Ras, Trivridaadi Gutika etc. to the patient with cold water as per requirement.
• Give Bindu Ghrita for intense purgation. Quantity 1 drop of ghee is sufficient. As many drops of this ghee are given to the patient, as many diarrhea will occur.
• Ichchha Bhedi Ras-Only one tablet of this is sufficient. If the tablet is taken with cold water and diarrhea is excessive, then drink hot water and if the tablet is taken with hot water, then drink cold water if diarrhea is excessive. This tablet can also be taken with milk. It is a strong laxative.
• Use of Panchsakar Churna, Rukmish Ras Triphala Churna, Abhyarishta, etc. is also beneficial.
• Soak Haritaki-Choti Harad in cow urine for 7 days (one week) and keep changing the cow urine daily, then dry it in the shade and mix rock salt and black salt and make powder and keep it safe. By using this, every type of constipation, indigestion (whether it is caused by poor digestion or due to Vata-Kamdrishti or liver disorder) is beneficial like Amrit.
Simple home Ayurvedic remedy for constipation
• Constipation disease is cured by regularly consuming Vidhara powder in the amount of 5-5 grams for 2-3 months.
• Tying Aak leaves on the stomach removes constipation.
• Boiling walnut peels and drinking it causes diarrhea.
• Consuming dried neem fruits with warm water at night clears the bowels in the morning.
• Consuming 30 grams of castor oil with sugar candy in warm milk cures constipation.
• Consuming 6 grams of Triphala powder mixed with honey and drinking warm milk on top cures constipation.
• Boil 15-20 raisins in 250 ml of milk and add the same amount of water. When the water evaporates and only milk is left, eating the raisins and drinking the same milk cures constipation.
• Drinking 100 ml tomato juice daily is beneficial.
• Drinking the juice of 2 large yellow oranges before breakfast is also beneficial.
• According to the Ayurvedic system of treatment, Vayu shamak i.e. lubrication is done for constipation. If one tola of ghee is taken with a little milk in the morning and evening or at the beginning and at the end of the meal or with 2-4 pieces of roti continuously for a few days or 30 grams to 60 grams of raisins are consumed with milk every day in the morning, then constipation gets cured.
• This disease also gets cured by reducing the grains in the diet and increasing the quantity of vegetables and fruits.
• Consuming 6-6 masha almond oil twice a day (morning and night) continuously for a few days also lubricates the intestine and removes stool blockage.
• Mixing 1.5 tola of good soap in 2.5 tola of castor oil and inserting a small quantity of it in the anus helps in passing stool.
• Keeping a wet bandage on the pelvis for 30 minutes twice a day (morning and evening) also increases the stool motility.
• For mild purgation, take Gulkand made from rose flowers and sugar twice a day or take 2-3 pieces of plum shaped pills made by mixing Gulkand and chutney of seedless raisins and powder of fine leaves of senna at night before sleeping, helps in passing stool in the morning.
• Consuming 1 to 1.5 grams of Mulhathi or Rose flowers 16 parts, Senna leaves 16 parts, sulphur and fennel 8 parts each, and sugar 5 parts at night clears the stool in the morning.
• Taking Triphala powder or Revand sugar, small cardamom 1-1 Triphala mixture, Rose flowers 2-2 tola, 4 tola Senna powder 3-4 masha at bedtime causes mild purgation.
• Consuming 2-3 Ratti tablets of equal parts of Usara Reband and pure Alua relieves constipation.
• For constipation in infants, dissolve 6 mashas of Gulkand in one ounce of water, filter it and consume 1 spoon of it at an interval of 2-2 hours, clears the stool.
• Giving ground harad or mixing Haritaki powder 3 masha, 6 masha raisins in 2 ounces of water and 2 ounces of milk and then filtering it and consuming it in the quantity of 1 spoon each also clears the stool.
• Make children lick 1 spoon of fig or banyan syrup.
• After breastfeeding, give orange juice to infants or give them water repeatedly.
• Rubbing castor oil on the stomach of children cures constipation.
• Take 100 grams of fennel, 50 grams of senna leaves and 200 grams of sugar candy and grind all three to make a powder. Consume 6 grams with warm water at night before sleeping. There will be free diarrhea in the morning.
• Taking 2 spoons of Isabgol in 1 cup of milk at bedtime helps in clearing diarrhea in the morning.
• Mixing 1-2 spoons of pure Desi Shri in a big glass of hot milk and consuming it at bedtime helps in clearing diarrhea in the morning.
● Correct and safe treatment of constipation is to improve diet and lifestyle. If you want to get rid of constipation permanently, then eat chapati made of refined flour, pulses with peel and mild spices, green vegetables in sufficient quantity. Reduce the amount of food intake. Do not eat without feeling hungry or when you are less hungry. Eat less and chew it well. Drink 4-5 lemons, honey syrup once a week and eat half the stomach in the evening/night. Never stop the urge to urinate or defecate. Your stomach will never get upset.
Diet/Supportive Treatment
• Waking up in the morning, drinking cold water and taking morning walk and bathing is beneficial.
• In constipation, consume ripe guava, boiled carrot, papaya, low-fat food (like cow's milk, cheese, chapatti made of bran flour, seasonal fruits, green vegetables (Bathua, spinach etc.) instead of pulses, mango, grapes, raisins, munakka, dates, orange, pear and lemon juice.
• Stale food, gas-increasing food, oily and fried food should not be taken.
• Only easily digestible, light (quickly digested), simple and nutritious food should be taken.
• Strong medicines should be used only occasionally when there is a great need. Use of enema is also not beneficial.
• Lubricants are of special importance in the treatment of constipation.
• In the recent disease of constipation, the disease is cured only by following the rules of diet, lifestyle and health, but in chronic disease, along with following proper diet, drug therapy is also required.
• 8-10 glasses of fluids required daily.
• It is very important to go to the toilet regularly twice a day (morning and evening).
• Shirshasana and Sarvangasana are especially useful.
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