Constipation
Overview
Constipation is infrequent, difficult, or incomplete passage of dry hard stools. In Chinese medicine it results from internal binding of dryness-heat, qi stagnation, qi deficiency with weak conveyance, blood deficiency leaving the intestine unmoistened, or yang deficiency with congealing yin-cold. It is divided into excess constipation (heat, qi) and deficiency constipation (qi, blood, yang).
Pattern differentiation (clinical patterns)
Heat Constipation
Dry hard stools with abdominal bloating and pain, flushed face, body heat, dry mouth and bad breath, vexation, scanty dark urine, red tongue with dry yellow coating, slippery rapid pulse.
Drain heat and guide out stagnation; moisten the intestine to promote bowel movement.
Qi Deficiency Constipation
Urge to defecate but straining causes fatigue, sweating, and shortness of breath, with exhaustion afterward; stools are not necessarily hard; pale face and tired limbs, pale tender tongue with thin coating, weak pulse.
Boost qi and fortify the spleen; moisten the intestine to promote movement (and nourish blood).
Connections
Daily care & prevention
Increase fiber (vegetables, whole grains, legumes, dragon fruit, prunes) and fluids; a glass of warm water on waking can help. Toilet at a regular time, do not suppress the urge, avoid prolonged squatting and excessive straining, exercise regularly, and massage the abdomen. Massage Tianshu (ST25), Zhigou (TE6), Zusanli (ST36), and Shangjuxu (ST37). Older or frail people should not rely long-term on stimulant laxatives.
When to seek medical care
Seek prompt evaluation for a recent marked change in bowel habits, blood or black stools, unexplained weight loss or anemia, persistent abdominal pain, vomiting, or inability to pass gas or stool, to rule out colorectal cancer or obstruction.