Constipation is alleviated and eventually cured by learning certain simple yogic practices and the joy of giving.
Constipation is a common complaint today which people everywhere, from all age groups suffer from at one time or another. Constipation should be taken as a warning sign, even though in itself it is a simple and easily curable condition. If you do not correct the condition when it arises, then you may be allowing the process which causes constipation to snowball into more serious diseases such as arthritis and perhaps even lethal diseases such as arteriosclerosis and colonic cancer. The amazing thing that most people will appreciate is that it can be so easily remedied by yoga.
Constipation means the infrequent or difficult passage of hard, dry faeces. It is not just the irregularity of the stools, but the hardness and dryness of the faeces that makes passage so difficult and produces dissatisfaction with the bowel activity. This can have unpleasant psychological effects. The major symptoms, apart from difficulty passing stool, are headache, malaise, gas, loss of appetite, possibly nausea, foul smelling breath, and a general feeling of heaviness and discomfort in the abdomen. A doctor will look for a furred tongue in addition to the above.
Constipation in perspective
- What is a normal stool? The average person passes 1 large, well formed stool per day. However, some people enjoy good health and pass only 2 or 3 stools per week. Thus, every individual must assess for himself what his 'normal' is, and not try to compare himself with others.
In Britain, fewer than 10% of the people have less than 1 motion per day and only 1% have a motion less frequently than 3 times a week. In Britain, these latter are classed as constipated. However, hard and difficult to pass stools indicate constipation no matter what the frequency of motion. On a typical low residue diet, people in western countries rarely have more than 3 motions per day, whereas the high residue diet of other countries makes 3 motions per day normal.
- Is irregular motion unhealthy? Many people believe that they must pass a good motion every day, regularly, like clockwork. Of course, this is a good habit to get into, but it is not essential to good health. Often times this belief can lead to neurosis and create more problems than it is worth, especially if we fail to live up to our expectations and beliefs. Some people actually suffer from imaginary constipation wherein the stools appear normal by ordinary standards but do not measure up to their expectations. These people attribute their neurotic symptoms such as exhaustion, lack of energy, back pain, memory loss, insomnia and loss of appetite, to impaired elimination. When one develops neurosis he can then progress to real, and not just imagined, constipation caused by straining, mental tension and disharmony in the whole body. Try to develop regularity, but do not worry if you do not stick to a rigid timetable of defecation. Much depends on regularity of diet, type of food consumed, season and psychological health. But, please remember...
- Constipation is not fatal in itself! To prove this, there was a case recorded by Geib and Jones where a man did not go to the toilet for one year from June 18, 1900 to June 21, 1901.*1 Before the faeces was removed, he belched a good deal and suffered some pain, had a distended abdomen, felt weak and lost some weight. However, after the removal of a mass of faeces weighing 100 pounds, he recovered rapidly. This case is obviously an extreme one, but it illustrates the fact that we will not die from constipation, although the clogging of our eliminative channels will ultimately lead to bad health, loss of energy and perhaps even "serious disease.
- Can constipation cause auto-intoxication? The answer is not a simple clear cut yes or no. There is no way for faeces, metabolized poisons or other toxins to be reabsorbed back into the body through the mucus membranes once they are expelled. Only water and salts are reabsorbed. However, we do feel unwell when we are constipated. This may be caused by a clogging of the eliminative system at a physical and pranic level, preventing toxins from coming out.
It is still uncertain why the symptoms of constipation occur. Auto-intoxication was a popular theory which, with little evidence to support it, was discarded by most scientists and doctors. Experiments point to the fact that the symptoms of constipation are mechanical in origin, that is, they are caused by the stretching of tissues. Samson Wright's Applied Physiology demonstrates this point adequately.*2 Healthy men who normally emptied their bowels only once or twice daily withheld defecation for 4 days during which time they developed all the symptoms of supposed auto-intoxication such as foul breath, a furred tongue, impaired appetite, flatulence, nausea, a lowered attention span, depression, restlessness, headache, insomnia, and irritability. An X-ray taken with a special contrast medium (a barium meal) showed all the food was in the colon while the small intestine was empty. When an enema was administered and the bowel evacuated, distress was alleviated. The subjects felt normal after 1 to 2 hours. If auto-intoxication had actually occurred, relief would have been much longer in coming. These results were duplicated by packing masses of cotton wool or by inflating a balloon inside the rectum.
Auto-intoxication seems to be an imaginary condition which is made worse by fear of its consequences. The consequence, in the form of tension, heaviness, loss of energy, laxative abuse, and subsequent deterioration of the zest for life are very real, however.
- Are laxatives a good means to overcome this problem? The answer to this is a definite No! Laxatives can only cause more harm than good in the long term. Many people use them habitually because they fear constipation. When they try to stop using them, however, they have more trouble defecating because the laxatives have (i) cleaned out the whole digestive tract so that there is nothing left to defecate, and (ii) weakened the muscles of the intestines. This can lead to further fear of constipation and thus to the use of laxatives again. This vicious circle can easily be broken, however, with the help of yoga.
Cause of constipation
Constipation is a signal that all is not well within. Something is beginning to malfunction and should be corrected before worse damage occurs. The mechanism of metabolism functions on an input output basis. That is, we put food into our bodies (whether in the form of solid, liquid or gas) and we expel wastes that are unwanted (such as faeces, urine and carbon dioxide). Thus the body is in balance. However, if our balance is upset for some reason or other, we can either find ourselves putting out too much or too little, and this will affect our input.
In constipation we are not eliminating wastes efficiently. The body systems are upset. When the faeces are hard and dry, it means that there may be imbalance in secretion of juices from the stomach, intestines, liver, pancreas or other glands, or perhaps the absorption of water and salts is excessive. The point to remember is that there is imbalance and this is what must be corrected.
There are two types of constipation:
- Colic constipation occurs when there is a delay in movement of faeces into the rectum but the act of defecation is normal. This may be caused by a diet containing very little roughage fibre or residue. Without the stimulus from roughage, the muscles become lazy and do not effectively push the faeces along. Other intestinal ailments, pain and the presence of fecaliths (masses of hard dry faeces which obstruct or slow down peristalsis) can cause constipation by curtailing normal muscular movements.
- Dyschezic constipation is a condition in which the faeces arrive normally at the pelvic colon, but their final evacuation is not adequately performed. If defecation is neglected, the wall relaxes and the desire passes away. In time, excessive distension occurs and the ability of the walls to contract, even with effort, becomes impaired. Small amounts of faeces arc passed but the majority remains and distension continues.
One of the most important factors involved here is the habitual tendency to ignore the natural urge to go to the toilet which interferes with the nervous system and its defecation reflex. An obstruction in the region of the rectum, taking the form of a polyp (a small outgrowth of mucosa), a foreign body (any object placed inside), or a tumour can interfere with defecation. Some amazing foreign body obstructions, for example, a 40 watt electric light bulb and a tool case complete with tools, have been removed from the rectum and sigmoid colon.*3 However, this must be the least common cause of constipation.
Other factors involved in the dyschezic type are:
- a) Mental tension: If we are tense or if we strain when going to the toilet, our sympathetic nervous system is activated. This results in the opposite effect to that desired; the sphincters of the intestines close and the bowel wall expands to hold more faeces. In order to defecate properly, we should stimulate our parasympathetic nervous system by relaxing our minds and bodies. This contracts the bowel walls and pushes the faeces forward. There is no need to exert effort when you go to the toilet or to fear constipation. Fear only makes the condition worse. Defecation is automatic, like breathing. All we have to do is relax and be aware of the process. Trying too hard only causes further problems such as hernia, piles, prolapse and ulceration. In the elderly, straining may cause fainting or even death from a fatal cardiovascular accident.
- b) Lack of energy: When we have mental problems, such as depression, anxiety and other neuroses, we have to expend energy to maintain these states of mind, as they are unnatural and forced. They deplete our energy level and the physical body finds itself without sufficient energy to function efficiently. Thus the glands do not secrete or when they do, they secrete asynchronously so that their work is ineffective. At the same time, the muscles do not have sufficient force to propel the intestinal contents.
Another factor that reduces energy and makes it difficult to defecate is bad toilet training and the anxiety of trying to defecate without success. Bad training is probably at the root of all our problems and is the reason why we have to relearn to perform these simple body functions properly at later stages in our lives. It is for this reason that yoga is so valuable, re-educating us to live correctly and with a healthy frame of mind.
- c) Diet: Fats slow down the propulsion of faeces, and therefore should be reduced or eliminated from the diet. Meat and other low fibre foods such as refined flour, carbohydrate and fatty foods do not travel quickly through the intestine and as a result lead to constipation. This low fibre diet has also been linked up with haemorrhoids (caused by straining at stool), and colonic (large intestinal) cancer. This is opposed to the high fibre content diet which consists of grains (whole and unrefined), fruits, vegetables, and pulse. This helps to relieve both constipation and haemorrhoids. A copious supply of water should be maintained so as to keep the body well hydrated and to allow plenty of water to remain inside the intestines as lubrication for the faeces.
Psychology of constipation
Constipation can only occur in the body if there is constipation in the mind. Generally, people who are constipated do not like to give out. They are tight and hold their feelings in. Constipation is associated with mooladhara chakra which governs the possessions, security and self preservation aspects of the personality. The tendency towards tightness and holding in is therefore concerned with insecurity which leads to the hoarding of material possessions or perhaps to a deeper disharmony in the relationship between the individual and his environment.
Perhaps there is also a deep seated, subconscious fear of letting go and enjoying oneself. This may be further compounded by excessive toilet training coupled with the fear of being constipated. Not only are some people unable to defecate easily and naturally, but they fear that if they miss going to the toilet for even one day serious complications will result.
Fortunately yogic sadhana makes it very easy to overcome such problems. The appropriate practices relax tension associated with the mooladhara chakra and this automatically relieves the situation.
Suggestions for removing constipation
- Visit your doctor for a thorough medical examination to ensure that there is no serious underlying cause for your constipation. When you know that there is nothing seriously wrong, you will feel more relaxed.
- Do not listen to many expert opinions. One is usually more than enough. Some people may make you worry unnecessarily, causing more constipation in the process.
- Exercise regularly. This is one of the best preventions for constipation. Inactivity depletes the body of energy, allowing it to degenerate. City life with all the modern conveniences at hand can induce laziness and the build up of toxins within the body. Yoga exercises help to relax and empty out the bowels. For city dwellers and sedentary workers with reduced access to physical work, asana and pranayama are the ideal replacement.
- Regulate the volume of stool and the frequency of defecation by adding cereal bran (chilka) and plenty of fruit and vegetable to the diet. These foods contain cellulose, hemicellulose and lignin which add bulk and thereby stimulate intestinal movement. Furthermore, cellulose and hemicellulose are partly digested by bacteria in the colon with the formation of fatty acids. These act as natural laxatives.
- Drink plenty of liquids. Upon arising drink 2 glasses of warm water with lemon, if you are not practicing laghoo shankhaprakshalana.
- Reduce your dependence on commercial laxatives as much as possible. If you are on purgatives and don't want to give them up straight away, we suggest that you change to colloxil, a type of detergent based laxative. But give this up also after a month of gradual withdrawal.
- Try to establish a regular bowel habit at a suitable time during the day, especially in the morning before breakfast as this is the time when you are most likely to be relaxed - mentally, emotionally and physically. Do not worry if you do not achieve this immediately and do not strain.
- Remove chronic tension which plays a vital role in constipation. One of the basic aims of yoga is to bring mental and emotional peace into one's life. As such, all yogic practices have an indirect contribution to make in removing constipation. Most commercial cures aim at removing the symptoms, namely the physical constipation. Yoga, on the other hand, aims at the root cause, mental and emotional constipation. If this more subtle form of constipation is removed, then the physical by product will also disappear.
The yogic method par excellence for removing constipation is laghoo shankhaprakshalana. In this technique, saline water and certain asanas are used to clean the whole gastrointestinal tract. This is one of the most direct, dynamic and effective methods to remove constipation. It is simple to perform and takes only half an hour in the morning. Laghoo shankhaprakshalana can lead up to or follow on from a full course of shankhaprakshalana, but this requires expert guidance for its successful practice.
To overcome problems associated with mooladhara chakra practice pawanmuktasana part II, moola bandha and ashwini mudra. These are of particular benefit in relaxing the deeper tensions related to this area of the personality.
The following practices generally help to alleviate constipation and its underlying causes. Select those that suit you best.
- Hatha yoga: Agnisara and nauli kriyas, moola shodhana, basti.
- Asanas: Suryanamaskara, sarvangasana, paschimottanasana, bhujangasana, shalabhasana, dhanurasana, ardha matsyendrasana.
- Pranayama: Nadi shodhana, bhastrika, ujjayi.
*1. Journal of the American Medical Association, 38:1304-5, 1902.
*2. Samson Wright's Applied Physiology 11th ed., p. 370, Oxford Uni. Press, London, 1965.
*3. H.W. Davenport, Physiology of the Digestive System p. 217 Year Book Medical Pub. Inc., Chicago, 1968.