Constipation is not a standalone disease, but rather a group of symptoms. It refers to hard, dry stools and difficulty passing them. Abnormal gastrointestinal motility causes feces to remain in the intestines for too long, leading to excessive water absorption and resulting in hard, dry stools that are difficult to pass.
I. Causes of Constipation
1. Gastrointestinal Dryness and Heat: In individuals with a yang-excess constitution, a preference for alcohol and fried foods, or residual heat following a febrile illness, dryness and heat accumulate in the intestines, leading to depletion of body fluids.
2. Stagnation of Qi: Worry and overthinking, combined with prolonged sitting and lack of physical activity, cause qi to become stagnant and the flow of qi in the viscera to be obstructed.
3. Deficiency of Both Qi and Blood: Exhaustion, post-illness, postpartum, or advanced age and frailty; qi deficiency impairs propulsion, while blood deficiency leads to insufficient body fluids, causing the intestines to lose their natural lubrication.
4. Stagnation of Yin-Cold: Advanced age and frailty, insufficiency of yang qi, and the internal generation of yin-cold, resulting in weakened intestinal propulsion.
II. Treatment of Constipation
1. Avoid blindly and indiscriminately using laxatives without first determining the underlying cause.
2. Constipation in children: Often caused by dietary factors; reduce high-protein foods and increase fruits and vegetables, such as bananas and pears; do not administer laxatives lightly.
3. Constipation resulting from postpartum or elderly physical weakness should be treated with Traditional Chinese Medicine.
4. Patients with hemorrhoids or anal fissures may withhold bowel movements due to fear of pain, which exacerbates constipation; the underlying condition must be treated, and a regular bowel movement routine should be established.
Traditional Chinese Medicine Differential Diagnosis and Treatment
1. Heat Accumulation: Accumulated heat in the stomach and intestines, dry and hard stools, bad breath and mouth sores, body heat and flushed face, scanty and reddish urine, abdominal distension and pain, and a yellow, dry tongue coating. Treatment principle: Clear heat and moisten the intestines. Use Ma Ren Tang; if body fluids are depleted, add Sheng Di, Xuan Shen, and Shi Hu.
2. Qi Stagnation: Hard, dry stools; inability to pass stool despite the urge; abdominal distension and pain; belching; and fullness in the chest and flanks. Treatment involves regulating qi and resolving stagnation using modified Liu Mo Decoction.
3. Qi Deficiency: Pale complexion; fatigue and timidity; difficulty defecating; sweating and shortness of breath during defecation; and fatigue after defecation. Treatment involves tonifying qi and moistening the intestines using modified Huang Qi Decoction.
4. Blood Deficiency: Severe constipation with difficulty passing stools; lackluster complexion; palpitations and dizziness; pale tongue. Nourish blood and moisten dryness: Runchang Wan or Wuren Wan.
5. Yin Cold Stagnation (Yang Deficiency): Difficult and painful defecation; cold pain in the abdomen; preference for warmth and aversion to cold; cold extremities; clear and copious urine; pale tongue with white coating; deep and slow pulse. Warm yang and promote bowel movements: Jichuan Decoction with added cinnamon bark.
Ear Acupoint Application: Large Intestine, Triple Energizer, Spleen, Abdomen, Subcortical, combined with Lung and Constipation points.
Elderly individuals may use raw Polygonum multiflorum decocted in water to moisten the intestines. For habitual constipation, regulate emotions, exercise, drink a glass of warm water before bed, and use the restroom at regular times to establish a bowel movement reflex.