Traditional medicine suggests that one bowel movement in the early morning followed by a possible second bowel movement later in the day is optimal. Your stool should be more or less the shape and texture of a ripe banana, easy to pass, formed, and somewhat bulky.Normally, the bowels should open every day, first thing in the morning and the stools should be light-brown in color, roughly cylindrical in shape and a few inches long. The stool should float (if it sinks this indicates poor digestion).

Passing roughly one to two bowel movements each day is considered normal, but this can fluctuate from person to person. Constipation occurs when the stools are passed infrequently (less than every day, sometimes as little as once per week), or with great difficulty and even pain in some cases. Most commonly, constipation is a result of dryness in the body and the colon. The stools that are eventually passed are dry, rough, hard and dark in color, resembling goat pellets. This type of constipation is often accompanied by uncomfortable gas and bloating.

Constipation can also occur due to congestion and stagnation, reducing mobility in the colon. In this case; defecation may occur every day or less often, defecation may take a long time waiting over the toilet, involving some strain, and the stools are not necessarily hard, but could be rather soft and shapeless.

Constipation is a cause for accumulation of toxins in the colon, which is evidenced by a thick coating at the root of the tongue. A normal and healthy colon function is indicated by a very thin white coating. 

What counts as constipation?

  1. Bowel movement which do not occur daily
  2. Quantity is very small
  3. Dry stools
  4. Difficult defecation
  5. Abnormal shape of stools

The importance of healthy elimination cannot be under stressed.  Poor bowel health results in fermentation of fecal matter, which irritates and ultimately degrades the lining of the intestines. Fermentation also creates toxins that are absorbed into the blood. Daily evacuation of stool prevents a cascade of potential health problems.

Main causes of constipation


  1. Eating food that is difficult to digest.
  2. Excessive consumption of cold foods – cold is obstructing and it may affect the large intestine by blocking its excretion of stools.
  3. Excessive consumption of dry foods or hot foods that dry up the fluids of the stomach and the intestines and may cause constipation by drying up the stools so that they cannot be moved properly.
  4. Lack of fiber in food
  5. Coffee or black tea first thing in the morning promote elimination but in the long run will promote constipation, as they are diuretic and therefor dry the colon

Emotional stress:

Emotional stress such as anger, resentment, frustration or melancholy over a long period of time may cause stagnation of the intestines resulting in constipation, abdominal distension and pain. Excessive mental work and too much thinking and worrying, slow down the transportation of food in the intestines, leading to constipation.

Besides mental factors as insomnia, nervousness, stress, worry, grief and fear that could cause constipation, any excess stimulation of the nervous system, such as excess screen time, may contribute to the development of constipation.

Life style:

  1. Exercise stimulates the peristalsis of the large intestine and contributes to a healthy daily defecation. Constipation is a common condition in western industrialized society, since lack of exercise is a common phenomenon.
  2. Sleeping late in the morning.
  3. Holding back the urge to go.
  4. Modern life style of up quickly and rushing off to work tends to block the natural urge towards elimination.
  5. Sex in the morning will weaken the energy needed for elimination.
  6. Medical factors such as being bedridden or taking too many medications, particularly diuretics.

Overwork and childbirth

Excessive prolonged physical work and childbirth deplete the body’s energy levels resulting in the failure of the intestines to move the stools. Overwork in the sense of working long hours without adequate rest for many years bring upon the same results.

Febrile disease:

High fever during a febrile disease tends to dry up the stools, causing constipation with abdominal pain and pronounced dryness.

Diagnosing the causes and type of constipation

Stool shape:

Stools which are round and small like pebbles indicate heat if they are very dry or cold and dryness (Vishama Agni/Liver dry Stagnation).

Long and thin stools like pencils indicate low energy levels of the intestines and a state of relative exhaustion (Manda Agni/Spleen Qi Deficiency), usually accompanied by cold.

Moisture of stools:

Dry stools indicate fire or heat and dryness (Yin Deficiency). With fire there is intense thirst with desire to drink large amounts of cold water. With heat and dryness there is only dryness of the mouth with desire to sip water.

Loose stools which are hesitant and difficult to come out indicate weakness of the intestines (Manda Agni/Spleen Qi Deficiency) or cold and dryness (Vishama Agni/Liver dry Stagnation).

Watery, explosive stools indicate either damp heat (in which case the stools are yellow and frothy) or damp cold.


Constipation with abdominal pain usually points to cold and dryness (Vishama Agni/Liver dry Stagnation).

Effort of defecation:

Difficult defecation with much effort and a feeling of exhaustion after bowel movement indicates cold (Deficiency of Qi or Yang). Cramps after defecation indicate cold or stagnation of Qi.


Pale stools indicate dampness, usually damp heat in the Gall-Bladder

Dark stools indicate heat.

Green stools in children indicate heat.

The hazards of purgatives and colonics:

Toxins in the colon and constipation should not normally be treated with purgatives and colonics. These can weaken the tone of the colon and bread dependency. Symptoms of excess use of colonics and purgatives include lack of appetite, excessive weight loss, insomnia, temporary diarrhea and continued constipation, palpitations, anxiety and feeling faint.

General treatment

First step for treating constipation would be to balance and improve digestion. Spices are used for tonifying the digestive fire, fiber for improving colon mobility and laxatives to heal and smooth out the colon lining. For chronic constipation diet should be addressed first, with adequate intake of either oily and/or bulk foods. These include dairy, nuts, whole grains, bran, fruits and vegetables. Many fruit juices are appropriate – prune,grape, cherry, but not so much apple or cranberry, which can cause constipation. More oils and fats may be needed in the diet; sesame oil is excellent as is olive oil.

To relieve dry type constipation, sip hot water throughout the day. This will rehydrate the digestive tract, stimulate digestion and peristaltic contractions. A mug of warm milk with ghee in the evening is also effective to moisten a dry digestive tract, encouraging a bowel movement. Heavy and unctuous, some psyllium husk in a cup of warm milk acts as a demulcent that coats the digestive tract, adds bulk and assists in passing a stool when constipated.

Congested and stagnant type constipation can benefit from adding more fiber to the diet and utilizing the cleansing and scraping properties of Triphala.

In terms of lifestyle, it is beneficial to arise at dawn to empty the bowels. Often a glass of hot water or herbal tea will help stimulate peristalsis. Yoga postures or a mild massage of the lower abdomen are helpful.

Squatting, rather than sitting on the toilet, is a more natural position for elimination and helps relieve blockages or spasms in the intestines that may inhibit normal evacuation. If squatting is not possible, another way to do so when sitting on the toilet is to bend forward, bringing the chest towards the knees, and elevating the knees towards the chest using a stool.

A good breakfast, either oily and laxative such as oatmeal with milk and ghee, or bulky such as a green salad and whole grain, may bring about a normal evacuation if it has not occurred by that point.

Summary – types of constipation

Constipation is more often a condition of excess dryness of the colon, particularly as a long standing condition or in the elderly. Secondary conditions of constipation may result due to excess heat (heat which dry out the stool) or excess cold and damp mucus congestion clogging the colon.

Heat + dryness:

  1. Fire (acute heat in febrile disease/Tikshna Agni/Stomach Fire)
  2. Chronic interior heat (Yin deficiency/excess Vata-Pitta)

Cold + Dryness:

  1. Blood deficiency/Liver dry Stagnation/Vishama Agni

Cold + Dampness:

  1. Exterior Cold invasion
  2. Yang deficiency/Manda Agni

Cold + Dryness + dampness:

  1. Spleen Qi deficiency/Manda-Vishama Agni


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