I see so many cases of constipation in my busy Ayurvedic practice, and just like everything else I treat, the underlying causes need to be addressed — we don’t just want to take laxatives since they can be habit forming and sometimes, especially if they have been used for too long, they can even damage the nerves in the gut, making it literally impossible to move your bowels.
And, as I always say, the underlying causes of any disease in any given person are usually more than one, and they are usually different in each patient. This is definitely true with constipation.
The ancient doctors said before any prescription is written for herbs, you must first see what the patient is doing wrong and tell them to stop doing those things. Otherwise the herbs might not be so effective. So, let’s see what some of the more common causes might be, and then we can discuss how we might treat those underlying causes.
One of the most common causes of constipation is if the Apana, the subdosha (or subsection) of Vata which resides in the intestinal region moves upwards. Apana Vata is a downward flow which moves the bowel movement down, as well as the menstrual flow and even babies during delivery. So if Apana moves up it can make it difficult to move your bowels. In the case of the menstrual flow it can cause painful periods and even endometriosis as the blood mistakenly moves upwards, into the fallopian tubes and out into the abdominal cavity. And if your Apana is moving upwards at the time of labor, it could prolong the labor time, making it difficult for the baby to move downwards through the birth canal.
Apana moves upwards if you have too many thoughts in the mind, if you hyper-analyze things, talk on the phone too long, or talk too much in general. Prana Vata is the movement of thoughts through the mind, so if the thoughts become too much, the Prana Vata sucks up the Apana to give it more energy. Apana can also move up if you rush through the day, multitask and push yourself without periods of proper rest and early bedtime. And in general the Vata can go out of balance if the diet is too light and dry, especially if you eat lots of raw foods and salads, as well as other cold foods, since Vata is cold, dry and light; therefore a cold, dry and light diet can aggravate Vata.
To balance Vata, you need the opposite: warm cooked foods and an unctuous diet, which includes ghee, olive oil, avocados, nuts and seeds. Which is why boiled milk is perhaps the most Vata-pacifying food of all, as long as you can digest it properly. This is also why you feel every cell in your body unwinding and relaxing as you sip on the boiled milk — this is what it feels like when the Vata settles down. In fact a common treatment for constipation in Ayurveda is 1 cup of boiled milk with 1 tsp of ghee stirred into it to help lubricate the bowel more.
Another reason for constipation, which is also related to Apana moving up is that the gall bladder might not release bile as the stomach contents squirt into the duodenum, which is the beginning of the small intestines. The bile flow gives you the urge to move your bowels. There are many reasons why the bile might not squirt out of the gall bladder. Let’s look at some of those reasons, because this is a huge underlying cause of constipation. If you just take a laxative to move your bowels it might work, but what you might really need are herbs and/or foods to promote bile flow. Luckily nature gave us so many of these herbs and foods which I use all day every day in my practice.
So here’s the reason the bile may not flow: One reason is that your bile may become thick like a sludge — this happens if you eat or drink cold foods and beverages. Think of it this way: all the fats in your diet, plus the fat-soluble vitamins A, D, E and K, the fat-soluble toxins and even hormones like estrogen which is made from cholesterol, all have to go to the gall bladder to be processed. So any cold foods and beverages you ingest can solidify the fats being held in the gall bladder, causing them to congeal resulting in bile sludge, where the bile, instead of being like a thin flowing liquid becomes thick like a sludge or a toothpaste. Then it can no longer flow easily out of the gall bladder, creating constipation.
Also, the sphincter in the gall bladder, known as the Sphincter of Oddi, must relax and open to allow the bile to flow through. In order for the sphincter to relax you have to be relaxed yourself. But again, if your Vata is high and you are feeling anxious or nervous, the sphincter might not be able to open and allow the bile to flow through, also resulting in constipation.
Also, the sphincter opens up under the presence of magnesium, which relaxes the muscles of the sphincter. If magnesium is low, which is a very common deficiency in the majority of the population, then the Sphincter of Oddi might not be able to open up to allow the bile to flow through, again, resulting in constipation.
You might also get constipated if you don’t drink enough water. If you aren’t taking in enough water your colon will pull water from the stool to keep you hydrated, which will dry out the stool resulting in constipation. Extra water in the stool makes it softer and helps it to pass more smoothly. I’ve had many people tell me their bowels move much better once they increase their water intake.
And you might also get constipated if you eat too many dry foods, such as chips, rice cakes, pretzels, or starches such as rice, oatmeal and other grains. Pastas and breads are especially constipating as the white flour they contain can slow up the bowel movement. All grains are somewhat binding, so if you are constipated try eating less grains and more fresh fruits and cooked vegetables. The fiber in these types of foods can help to soften up the bowel movement so it can flow better and be less hard.
Ayurveda does not recommend a low fat diet, but instead a diet which contains fats that will not clog the arteries or any other channel. A diet rich in beneficial fats is important for numerous reasons, one of which is that it will keep the bowel lubricated which prevents constipation. Always remember that the seat of Vata, that element of dryness which can literally dry us out, is located in the intestinal region. As we age, we must combat this tendency to dry up by keeping an unctuous diet, which is somewhat confusing to some people since we’ve been told our whole lives that we need to follow a low fat diet. This incorrect information has led many people to develop all kinds of health problems, one of which is constipation as our bowel movements dry up as we go deeper into the Vata stage of life which occurs after age 50 and beyond.
Nature has given us many herbs and foods to help facilitate bile flow and bowel movements. It’s best to work with your Ayurvedic practitioner to learn how to use all these herbal treatments since you don’t want to aggravate the other doshas, such as Pitta or Kapha, for example, as you take herbs or change your diet.
But once you learn how to tailor a protocol for your own personal imbalances, you will be amazed how you healthy you feel as you keep your whole body balanced.
One final note here: constipation can come from other reasons which are more serious than those mentioned here, which is why I hesitate to mention all the herbal treatments and foods we use for constipation. If you have irritable bowel syndrome or inflammatory bowel disease, gastroparesis, or other more complicated digestive diseases, very careful and specific measures need to be taken than is required in just treating constipation in general.
So you must proceed with caution since some of the herbal formulas such as Triphala can also scrape their way through the bowel, removing old fecal material and toxins stuck in the walls of the bowel, but this scraping action might be too irritating for those patients with intractable inflammatory bowel disease for example, or those recovering from food poisoning, parasites or other intestinal bugs.
I hope you can see that constipation can be treated successfully if you first identify all the underlying causes and then work with your Ayurvedic practitioner to come up with a treatment plan which will work for your own unique individual imbalances and not create harm as you address these issues.
Thank you,