Constipation- Does it really need laxatives?

Clinical experiences series:

Ayurvedic considerations in management of constipation. 

According to Ayurveda, the food you eat is transformed into three categories by digestion:

1. Sara/Nutrients: are necessary for healthy physiological processes including bodily movements, digestion, etc. These are nutrients the body utilities its metabolic functions. 
2. Kitta/Waste: These are the bye products of cellular metabolism. These are ultimately discharged feces, urine, perspiration, etc., 
3. Mana/Mind: In order to maintain a sound mind, pleasant chemicals like serotonin and dopamine need to be produced. When this path is affected, it may affect the thoughts and sleep.

Whenever we address a constipation problem, we need to understand whether the constipation is caused by a lack of adequate nutrients like dietary fibre, magnesium, etc., is it by stress, or by any other problem with the intestine's peristaltic movements and water reabsorption.

This article narrates a 35-year-old woman with heavy job pressure, has experienced constipation for the past five years along with an under active thyroid function.

Her existing diet and life style was as follows :

Waking up: 6:00 AM

Diet pattern

Drink 1.5 litter, warm water - This much water in empty stomach will reduce the digestive capacity, which may leads to bloated feeling, constipation, etc.

Breakfast time 8:00 AM,

Egg - (Chicken egg increase constipation)

Dosa- fermented pan cake – (Regular use of Dosa will increase acidity of stomach leads to allergies)

Snack – 11:00 AM

Boiled Egg – (Not good for constipation)

Lunchtime: 2:00 PM

White rice, chicken, Dal, Spinach, (White rice and chicken may increase constipation.)

Afternoon Snacks: 4:00 PM,

Fruits & water with honey – (Honey not good for constipation.)

Dinner time 8:00 PM

Grilled chicken with yogurt, salads, - (Yogurt and chicken increase constipation , salads may produce bloated feeling.)

Sleeping Time - 11:00 pm

In our observation, her current diet contains less fibre, so even if she ate salads for supper, they could not have been adequately digested because digestion is often slower at night.

In addition, she often consumes chicken, chicken eggs and yogurt since they have the grahi characteristic, which means they will restrain bowel movements. This lessens the peristaltic action, which causes constipation.

Guidelines

How much quantity you should eat?

Quantity of food: Generally, you need to fill half of the stomach’s capacity with solids; one-fourth with liquids and rest has to be kept empty for the free movements of body humors. You should not feel heavy after any food, especially after dinner.

How much to drink?

Your water intake should be decided by your urine color. Normal urine is light yellow in color, if it is too much clear, reduce the water intake and if it is on the darker side or there is a strong smell, increase the water intake.

How you need to eat food?

While you are eating, give your full concentration on eating. Do not watch mobile or do not talk with your friends. Pray before having meals.

Sample Diet for 21 days.

Empty stomach – Mix ½ teaspoon melted ghee with rice water

(To prepare rice water – Soake 1 teaspoon of white rice in 200 ml of water for overnight, Moring boil it for 10 minutes)

Breakfast - (Avoid chicken egg it will increase constipation)

Coffee with jaggrey ( which will help to reduce constipation. Avoid honey and white sugar)

If appetite is excellent,

• Prefer like gluten free bread toast / foxtail millet roti (thina)with butter (which will help to produce serotonin in intestine).

If appetite is normal,

·       Prefer some porridge with warm nut milk (rice, foxtail millet)

·       Any of your traditional breakfast can also include (reduce the intake of fermented food – 1or 2 days/ week, instead of take green gram chila with chopped leafy vegetables like coriander, fenugreek, etc.)

If appetite less.

Prefer pouched apple with cinnamon. Any seasonal fruits. (avoid mango and pomegranates both of them increase constipation).

Snack 11:30 – Try to include vitamin C fruits like berries, mint lime juice, orange, etc. which will helps you to increase your metabolism.

Avoid egg

Lunch -12:30 to 1:30pm

Try to include all six tastes for lunch like

Sweet- carbohydrate, (rice /than millet/noodles/pasta)

Sour -vitamin (vegetables – lime)

Salty - mineral, (salt)

Spicy - minerals, (spices, animal protein )

Bitter – protein and vegetable (dhal, vegetables)

Astringent – protein and vegetables (dhal, vegetables)

Vegetables 

• Green vegetables, like spinach 3-4 day/ week (cooked with ginger, small onion turmeric)
• Leafy vegetables that are rich in iron, magnesium, selenium, etc. it will help for constipation, your mental thoughts and increase immunity.

Fruit vegetables – gourds like snake gourd , ridge gourd, ash gourd , bitter gourd, tomato, okra , broccoli, etc. take 3-4 days steamed as it is rich in antioxidants. 

• Reduce – Cabbage, cauliflower, Brussel sprouts. Bottle gourd, pumpkin. (all of them are difficult to digested by your body).
• Roots & stems- Carrots – (Rich in antioxidants) always prefer in the steamed form for better absorption. 2-3 days/week
• Beet root –1-2 days per weeks. (good to reduce constipation)
• Potato or sweet potato – (Try to add little cumin to avoid gas formation.) 2-3 days/week.

Protein (Take one type of Protein at a time)

• Plant protein - Green gram/ tur dal/masoor dhal- (Soaked and discard the water in which it is soaked, add turmeric, cumin and ginger while cooking. Reduce the intake of soya, Rajma, chickpea,
• Milk Protein –
• Paneer – 1-2 days/ week
• Cheese- 1-2 days/ 14 days
• Reduce yogurt and butter milk (both may cause constipation)
• Animal protein – Mutton, white fish, Duck egg, quail egg,
• Reduce red fish, red meat, chicken, chicken egg

Take Carbohydrates such as brown rice, pasta, Roti, Noodles, spaghetti etc.

• Brown rice OR whole grain cereals 2-3 days/week.
• Foxtail millet (thina)- 1-2 day/ 10 days.

Seeds/ nuts

Ayurveda believes in having a small quantity of fat is essential for body functions especially the neurological functions. Take a maximum of 1 teaspoons of oil per day.

Take olive or coconut oil with your food.

Or ½ teaspoon of ghee or 1 teaspoon of butter with lunch.

Afternoon Snacks. 3:00 to 5:00 PM

If you are hungry, take any home-made snack like rice cake, gluten free snacks, steamed vegetables with nuts.

Fruits: seasonal locally available fruits are recommended.

Avoid coffee in the afternoon.

Dinner - 6:00 -7:00 PM

Avoid salads, cheese, brown lentil, chickpea, pumpkin and animal protein like chicken and red fish in the night time.

Normally digestive fire is weak after sun set, it’s better to have light and easily digesting dinner. If you ate more for dinner, try to avoid your breakfast or have lighter breakfast.

Try to take an early light dinner with mainly carbohydrate and vegetables, which helps repairing process of body and to get a good sleep. This will pacify your Vata. You can try any of the following combinations.

Kichadi with vegetable

Sweet potato with steamed vegetables

Soup with barley and vegetable 2-3 day/ week. ( which will help you to increase bulkiness in stool)

Green gram chilla with leafy vegetables.

If you having late night dinner -reduce the next day’s breakfast.

Bed Time

5 -8 soaked almond without skin (helps to induce good sleep)

On alternate days -

Take 16 to 21 soaked black raisin for 21 days. (act as magnesium supplement helps to reduce constipation)

Herbal water:

Make herbal water with ¼ teaspoon coriander seed, 2 harad (Terminalia chebula) and three cardamoms. Boil this in 2 litres of water and reduce it to 1 and ½ litter and drink this lukewarm during the day.

Medicine:

1. Tab. Gandharavahasthadi Kwatham/Kashayam  

Dosage: 1 tablet before dinner.( if you get tablet or kwatham)

2. Thriphaladi choornam   - Add 20 gm powder with 4 lite water and boil it of 20 minutes and then do stiz bath with this water ( once in a week)

Result after 21 days

She is having regular bowel movements and her constipation has decreased, advised to stop taking the Gandarwahasthadi tab and to keep up with her diet and Sitz Bath.

Prepared by 

Dr. Poornima Sreelal 

The authour can be contacted through info.ayurdiet.in@gmail.com or connect through whatsApp +91-9447762555.