Constipation occurs when bowel movements become difficult or less frequent. The normal length of time between bowel movements ranges widely from person to person. Some people have bowel movements three times a day; others, only one or two times a week. Going longer than three days without a bowel movement is too long. After three days, the stool or feces become harder and more difficult to pass.
You are considered constipated if you have two or more of the following for at least 3 months:
- Straining during a bowel movement more than 25% of the time
- Hard stools more than 25% of the time
- Incomplete evacuation more than 25% of the time
- Two or fewer bowel movements in a week
Traditional Chinese Medicine
Constipation Caused by Excess Patterns of Disharmony
A number of patterns of disharmony, both excess and deficiency, can cause constipation. The excess patterns are excess heat and qi stagnation. When exterior heat penetrates into the interior, it can affect the large intestine, with symptoms of high fever, thirst, and sweating. The pulse is full and rapid, and the tongue is red with a yellow coat. In this case, herbs are selected that have a cooling, purgative effect such as rhubarb root (da huang). A simple but effective formula for this condition is Xiao Cheng Qi Tang (“Less Drastic Purgative Decoction”). The patent formula, Peach Kernel Pills, is an effective remedy for less severe cases of constipation due to excess heat.
Constipation due to stagnant qi typically gets worse when the person is under stress. In this case, herbs are given that relax stuck qi and restore intestinal function. A good combination of patent medicines to take for this pattern is Xiao Yao Wan and Mu Xiang Shun Qi Wan.
Constipation Caused by Deficiency Patterns of Disharmony
A deficiency of qi, blood, yin, or yang can also cause constipation. When qi is deficient, the person does not have the energy to move the bowels and often feels exhausted after trying. A person with this condition has a pale face and tongue and may break into a sweat while defecating. A good patent remedy for this condition is Shen Qi Da Bu Wan, which contains qi tonics such as Astragalus (huang qi) and Codonopsis (dang shen). Cannabis seeds (huo ma ren) are a good addition, since they are a nourishing, lubricating laxative. They are now available in health food stores in the form of hemp seed oil.
If yang is also deficient, the person feels cold and may have low back pain. In this case, the formula should also contain Cistanches (rou cong rong); the patient should eat walnuts (hu tao ren), a lubricating yang tonic.
If yin deficiency is the underlying cause, the person has small, hard, dry stools, thirst, night sweats, and a red tongue with little or no coating. The patent medicine Rehmannia Teapills with the addition of some hemp seed oil is appropriate in this pattern.