December is Constipation Awareness Month

Open up your GUT feelings!

December is Constipation Awareness Month. So, we’re taking this opportunity to raise awareness about this perennial trouble that is a hidden despair for millions of people. Lack of awareness of constipation as a treatable medical condition often prevents those affected from seeking care. We raise awareness to open up the conversation and encourage those experiencing symptoms to talk to their doctor.

The constipation dilemma is of consequence & it appears differently to different people. The myths need to be busted for the common man to make their mind to see a doctor. “Constipation isn’t serious” is something the masses believe mindlessly. Well, in fact, there are myriad of disorders that can cause constipation which needs intense medical attention. Yet another myth is that “there are only over-the-counter medicines for constipation”, but the actual fact is that these medicines can be used only occasionally, but the dosage may still not be right for you, it can end up causing dehydration and electrolyte imbalance that can put oneself in deep trouble. To avoid this, one has to consult a doctor and get a prescription which is meticulously customised for you.

What is constipation?

To seek medical care, one must know what exactly do you mean by constipation. Constipation refers to persistent, infrequent, difficult or incomplete evacuation of bowel. Some says I do pass bowel daily, just that I have to strain a bit unlike before. Having a normal frequency of bowel movement yet having to strain excessively with prolonged defecation time to evacuate hard stools also comes under constipation.

What causes constipation?

Well, there are some very obvious causes and of course some which you might be oblivious of which can lead to constipation.

➢ Delaying or ignoring the call or the natural urge habitually has to be one of the most important causative factors. Over the time, ignoring of natural
urge leads to inhibition of the Vagus nerve-initiated reflex. So, make sure you pay heed to the calls every time.
➢ A diet that is low in Fibre (which forms the bulk of stool) is another important causative factor. Consume lots of vegetables and fruits that contain fibre. Having said that, fibre intake may exacerbate problems in the setting of dehydration or impaired motility of intestines.
➢ Reduced fluid intake can also lead to constipation forming hard stools for which you need to correct your fluid intake quantity.
➢ Disordered or delayed colonic transit due to an underlying disease that inturn can lead to overabsorption and form hard stools which amplifies the existing pathology.
➢ Laxative abuse or over use of laxatives can diminish your natural urges. For this, one has to stop over-the-counter medication and seek advice from a physician.
➢ Lack of exercise or long periods of inactivity due to illness or following surgery may cause constipation. Minimum of 150 min/week of exercise can help in resolving this if not bedridden for illness.
➢ Hypothyroidism, or an underactive thyroid gland, slows the body’s metabolic processes—even the gut.
➢ A tumour or stricture in the lumen of intestine can cause constipation
➢ Neurological disorder like Parkinson’s Disease patients can suffer from paralytic ileus wherein severe form of constipation is a feature. Disorders like Irritable Bowel Syndrome-C, Diabetes, and pregnancy related constipation are also few of the main culprits.
➢ Lot of medications can cause constipation. Painkillers, specifically narcotics, can cause constipation. Some of the receptors for the narcotic class of drugs are in the digestive tract, so it tends to bring everything to a halt. So, if you are under any painkiller and experiencing constipation, inform your doctor about it. Medication for hypertension (CCB), diuretics and anti-allergic can also lead to constipation.
➢ The disease depression and the medication-Anti-depressants; both are notorious to cause constipation.
➢ Those who are taking Calcium and Iron supplements may often complain of constipation.

What are its assessments?

  1. Previous bowel habits, including the frequency, consistency and volume
  2. Abdominal and rectal examination
  3. Blood investigation for underlying disorders
  4. Radiographic assessment/ Colonoscopy

How do we treat Constipation?

❖ Pathologies related to excretion are often the result of broader imbalances with Agni (the metabolic fire). So internal medicines are prescribed to correct the metabolism.
❖ Treating the underlying multifarious disorders that is causing the constipation.
❖ IP based treatment incorporating Shamana aushadi/ internal medication and shodhana procedures like virechana, basti etc in case of severe constipation
❖ Correcting the diet with a proper diet chart on what-to-take and what-not-to. Rectifying the fluid intake.
❖ Yogasanas, to name a few, like pavanamukthasana, paschimottasana & bhujangasana to improve the motility of intestines.

You might have felt “butterflies in your stomach” when nervous, which means you are getting signals from your second brain, the Enteric Nervous System (which when inhibited leads to constipation). Hidden in the walls of the intestine, this little brain in your gut is currently revolutionizing medicine’s understanding of the links between digestion, mood, health, immunity and even the way you think. ENS might not help you in calculating your check book or compose a poetry like your big brain in skull, But it definitely is having a big say with regards to your health. So, pay attention to issues like constipation & open up your Gut feeling which your little brain is trying to communicate! We, the Doctors of Kayachikitsa department are always at the service of little as well as big brain.

Author : Dr. Ambili Aravind MD (Ayu) Assistant Professor, Dept  of Kaya Chikitsa