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General characteristics

General characteristics

Constipation can be defined as having difficulty emptying the bowels. This can present as having to strain or by an infrequent desire to go, for example going a day or more without experiencing the need to poo. Some also complain of feeling that they have not fully completed the bowel movement, that there is more to come. Often it can be a complicated picture with bouts of both constipation and diarrhoea. Haemmorrhoids are a common feature in constipation due to the increased pressure in the blood vessels caused by straining. Other problems such as anal fissures can be both a cause and result of constipation.

It is important to figure out why the constipation is occurring as it has many causes. A diet lacking in fibre, stress and nervous tension, over or under active bowel nerves, habitually putting off going when the signal arises, not chewing food properly, eating too quickly and while on the go or travelling, lack of exercise, pregnancy, adhesions (maybe from earlier abdominal surgery), side effects of prescribed or over the counter medicines, reduced bile secretions from the gallbladder, intestinal obstruction due to worms, inflammation or strictures or other underlying health problems.

Constipation can present once in a while during times of stress or poor diet etc. or can be long term over months or years. Short term constipation can usually be remedied by diet changes and the use of laxative herbs. Chronic or long term constipation needs deeper thought and effort to remedy and laxatives of any kind, herbal or otherwise should not be relied upon as a regular fix. Long term laxative use can exhaust the nerves of the bowels, damage the kidneys and cause depletion of the body as a whole. It is far better to make all the dietary changes you can, take the gentler more regulatory bowel and digestive herbs and seek expert confirmation as to the cause should the constipation still stubbornly remain.

If chronic, long term constipation is ignored it may lead to many other symptoms in the body. Waste products from digestion and general body metabolism remain in the bowel and are reabsorbed back into the bloodstream, predisposing the body to general poor health and altering the delicate balance of bacteria within the bowel itself.

Diet and lifestyle

Diet and lifestyle

The major enemy of the constipated bowel is starchy food devoid of fibre. This means white flour products such as bread, cakes, biscuits, pastries, pies, pasties and the like and even white rice and potatoes. They all act as a kind of squishy, slow moving glue in the bowels. White flour and rice have no outer husk and are therefore sadly lacking in fibre so if you suffer from long term constipation look closely at what you are eating. Switch to a more fibrous, rougher bread and flour (if it contains seeds all the better) and substantially reduce  the amount of white flour products you eat, balancing it out with plenty of fruit, veg and other fibre containing foods.

Since a lack of fibre or roughage is implicated in the cause of constipation, it goes without saying that daily doses of plant based fibre are crucial in both its prevention and cure. [Take a quick look at 'Fibre' in the Natural Healing section of this website]. Fibre is the fibrous part of a plant that is essentially indigestible. It  passes through the intestines fairly intact (though broken down into smaller pieces) and gives the bowel muscles a bulk form to work on and push through to the end. Without it, the bowel muscles lose their tone and can become weakened. This can, over time lead to a weakening of the bowel and result in the formation of pockets in the bowel wall (diverticulosis) which can become clogged with old faecal matter. Fortunately, the plant kingdom is full of foods containing beneficial fibre.

*whole grains (those with their outer husks still intact) such as wheat, oats, barley, amaranth, millet, quinoa, rice. A daily bowl of shop bought, or even better, homemade muesli or porridge is a good way to start the day. The grains give steady energy and plenty of fibre to ensure good digestive health.

*Fresh fruit and vegetables all contain fibre. Those which take a bit of extra chewing such as apples, pears, carrots, celery etc are especially good. Include as many as possible in their raw state in salads and include the skins where appropriate. Juices of fresh fruits such as orange, prune, pineapple are excellent but try to avoid shop bought ones and make your own if possible. My eldest son as a baby was constipated for several days and freshly squeezed orange juice worked like rocket fuel! Soaking prunes or figs in water overnight and drinking the resulting juice and of course the soft fruit should be part of weekly life if you are prone to regular constipation.

*Seeds and nuts. If you 'sprout' them by soaking in water until a little tail appears then they include even more goodness. Good choices include aniseed, flax or linseeds, fennel seed, caraway, cumin, coriander and fenugreek seeds.

* cold pressed oils such as olive, hempseed and flax will help to lubricate the bowels and make the stools softer and easier to pass. Use them uncooked as dressings or take a daily dose as directed on the bottle for the more therapeutic oils. A tablespoon of olive oil first thing on an empty stomach also helps stimulate digestive juices.

Water is obviously required to soften the faeces and smooth the way for easier passage. Herbal teas and fruit juices contain water but be aware that tea, coffee and alcohol act as a diuretic and will increase the amount of water you pass as urine.

Exercise of all kinds benefits the bowels and any movement that involves the stomach moving (swimming, cycling, walking, horseriding, yoga, dancing etc) will encourage the natural peristaltic movement of the bowel muscles. Sitting or inactivity for long periods will require balancing out with bouts of exercise throughout the day.

Try and eat in a relaxed way in pleasant surroundings if possible and chew every mouthful well. Saliva is crucial in the digestive process as a whole.

Do not ignore the urge to go. Get into the habit of going when you need to, ignoring the urge will result in a back up of faeces which can cause the bowel walls to bulge with waste that would normally have been expelled. Observation of many animals shows that bowel movements often happen not long after eating, clearing the waste from the last meal in preparation for the next.

Useful herbs

Useful herbs

The inclusion of more plant based fibre is the finest remedy for most causes of constipation but this may need to be introduced gradually and slowly increased over time for those who have suffered longterm. If constipation still holds on after diet improvements then herbs would be the second course of action.

The safer herbs that can be used to alleviate constipation can be put into the following categories:

* Aperient laxatives. These gentle acting laxative herbs stimulate the natural movement (peristalsis) of the intestines. Herbs include dandelion, liqourice, figs, elderberries and many of the fresh and dried fruits.

* Bulking agents. These add bulk to the stools and (like fibre) give the intestines something to work on. Herbs such as psyllium seeds, slippery elm powder, fenugreek seeds and linseeds also contain slimy substances, called mucilages which lubricate and soothe the passage of the faeces. These are very useful when bowel movements produce small, soft worm like stools.

* Cathartics. These are the stronger laxatives like senna and cascara, rhubarb and aloes which stimulate strong peristalsis and add water from the body to the stool. They often cause pain due to the increased forced activity of the bowel so need to be taken with calming herbs such as dill seed, fennel seed, ginger or chamomile. Some can be draining to the body over time and if used habitually can lead to the bowel becoming lazy and laxative dependant. The cathartics are useful when constipation is particularly stubborn and has been present for moths or years but it is advised to start gently and include some bulking agents and soothing and slimy herbs such as marshmallow root or irish moss to ease the passages of stools.

* Anti-spasmodics. These are used when the natural rhythm of the intestines is interrupted by the muscles going into spasm which usually produces cramping pain (eg. colic in babies). Herbs like wild yam, peppermint, chamomile and ginger can help.

* Digestive tonics/Bitters. These are herbs which act on the other organs of digestion like the stomach, small intestine, liver and pancreas. These are perhaps the most useful and beneficial agents as they work to improve the secretions of the digestive organs and therefore improve constipation. This is a large category containing herbs like dandelion root, gentian, yellow dock, centaury, barberry, fringe tree, figwort, blue flag and burdock root.

For occasional bouts of stubborn constipation you can soak 5 senna pods overnight in a cup of warm water and drink the resulting fluid first thing on an empty stomach. Alternatively try cascara bark with some fennel seed, ginger and chamomile to ease any spasm that may accompany.

If constipation is becoming more frequent then it may also call for longer term use of digestive tonics and mild laxatives to improve digestive function before things get more chronic. A general mix could contain yellow dock, dandelion root, barberry, chamomile, boneset and liqourice.

If constipation is more long term then you may need to use the bulk laxatives to retrain the bowel muscles. Include psyllium husks or soaked linseeds daily and drink plenty of water to enable their ease of passage. The digestive tonics will be invaluable as will the use of occasional stronger cathartic herbs to really get things moving.

When constipation is due to nervous tension and 'holding in' emotionally as is common in children and the more sensitive adults then the stronger laxatives would be unwise. Instead opt for a milder mix containing herbs such as dandelion root, liqourice and plenty of relaxing nervine gut herbs like chamomile, wild yam and crampbark. The nervous system as a whole will need to be helped with herbs to relax and tone the nervous system, such as skullcap, passionflower, vervain, oats and vervain, perhaps even valerian and black cohosh root for more severe body tension.

Damiana can also be useful as a stimulating tonic to the nerves with a bitter slightly laxative effect.

A cup or two of chickweed tea can prove useful.

A generous pinch of chilli/cayenne powder to herbal teas can help also.

If the stools are coming out very hard and dry you could try violet leaf tea, 2-3 cups daily to add moisture and help lubricate the stools.

Natural healing

Natural healing

In many traditions a healthy, properly working gut is considered the very foundation of good all round health. Even in Britain a generation or so back, people would take their syrup of figs, castor oil and the like to ensure regular bowel movements. The following activities will do much to gently encourage the natural rhythm of the bowel.
Lie down, get comfy and gently massage the tummy in a steady circular clockwise motion.
Place alternate hot and cold packs or flannels over the tummy or shower the area with hot then cold water each day at the end of a shower.
Take time each day to practise deep belly breathing. Lie comfortably and breathe in deeply, making sure the belly area fills up with each in breath. Then exhale deeply watching the tummy go all the way down again. Repeat several times then relax.

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