We don’t really talk about our bowel movements on a daily basis. But in Chinese medicine and in macrobiotics, what our body discharges is an important factor in diagnosing the condition and function of the digestive organs and other internal organs. 

Emotional constipation

According to the five-element model in Chinese medicine (Wood, Fire, Earth, Metal and Water), the digestive system generally represents the Earth element. But in fact, all five elements participate and are manifested in the digestive process. The functions of the terminal organ in the digestive tract, the large intestine, represent the elements of metal and wood. Metal is responsible for the final absorption of fluids and minerals from the large intestine to the blood stream, thus causing the stools to cohere and solidify. The element of wood is responsible for creating the peristaltic movement along the intestine and for pushing the stools out.

From a psychological and emotional viewpoint, the metal element relates to sorrow, grief, sadness, mourning and woefulness. When a person experiences extreme grief or for a prolong period of time, the activity of the large intestine is affected and constipation may develop, for example.

Highly specific details

The texture, color and shape of the stools depend not only on the activity of the large intestine and actually begin to take shape in our food choices, in how the food is prepared and in the digestion phases; chewing the food and letting it blend with the saliva, our stomach, pancreas, gall bladder and small intestine movements.

There are different approaches to defining what proper stools are. From the Chinese medicineviewpoint, 1-3 effortless bowel movements every day, producing neither too soft nor too hard stools, light brown in color and shaped like an oblong buoy, are considered regular bowel movements. According to the Chinese clock, bowel activity peaks between 5am and 7am, which is therefore the classic time to defecate. 

Despite this definition, stable and regular bowel movements, for example every other day is not considered constipation and does not require treatment. There is a much wider range among suckling babies, and up to ten days without a bowel movement is not considered constipation, as long as there are no signs of distress or pain.

Under the magnifying glass

Looking at the stools can provide hints about intestinal strength and about how suitable the food is for the individual’s nutritional needs. For example, very soft, shapeless, fairly light color stools indicate low intestinal strength or that the food was too cold for the individual (salad, fruit, cheese). On the other hand, very hard, small and concentrated shapes, dark or black in color hints towards dryness and/or intestinal heat or that the food eaten was too hot and dry for the individual (crackers, buckwheat, grilled meat).

Diagnosing children

This diagnosis can be particularly effective as a way for parents to follow up on their children’s intestinal strength and general vitality. For example, when the child has soft stools or light colored, odorless diarrhea, the diagnosis can determine that the popsicle/ watermelon/ yogurt eaten earlier did not get digested and that the food eaten was too cold and too moist at that time. In this case, parents should make a change in the child’s diet to avoid cold and moist food, while adding hot cooked food instead, until the feces return to normal. If despite the cold and moist food the stools look normal, it can be assumed that the intestinal strength is good and no harm was caused by the food that was eaten.

Careful, constipation

Constipation is a common phenomenon which happens for many reasons. In a state of constipation, undigested food remnants and waste linger in the digestive system for a longer time than usual. Meanwhile, the gut flora work to decompose them, which is when toxic gas and decomposition products are created. If the constipation persists, fluids are reabsorbed and the stools dry up and thereby promote to the risk of fecal stones, hemorrhoids, intestinal inflammation, fissures and even several types of cancer, beyond the uncomfortable feeling that accompanies anyone who suffers from constipation.

Blocked sewage

The function of the intestine can be compared to the home sewage system. Blockage in the drainage system can occur for the following reasons:

  1. Constipation induced by cold– inhibited bowel movements due to a cold digestive system which contracts the circular muscles and paralyzes the peristaltic movement is usually accompanied by a strong stomachache. This constipation is a result of eating cold food and is also typical in old age. Treatment should heat the stomach with well cooked hot food and warming spices (ginger, galangal, cardamom, bay leafs, black pepper, mustard, fenugreek, cinnamon). Warm stomach compresses and moxa should be used for alleviation.
  2. Constipation from lack in Qi– the intestine lacks the power to push the stools out and the bowel movement involves effort. The stools are usually soft, resembling pencils, with a feeling of fatigue after defecation. Sometimes this condition is accompanied by hemorrhoids and is typical after a severe and prolonged disease, in adults and women after giving birth. Treatment should include foods that reinforce Qi and “push” the stools, such as onion, leak, fennel, pumpkin, beets.
  3. Dry bowels– the large intestine is responsible for solidifying the stools and is therefore vulnerable in dry conditions. Intestinal dryness is commonly concomitant with cold or hot intestines or anemia of all types. This type of constipation is characterized by dry, solid stools which are hard to excrete. Treatment includes moistening the intestine with glutinous substances such as kuzu, tapioca, Agar-Agar, strengthening the blood with foods that are rich in iron for anemia, and balancing the intestinal temperature to hot or cold according to the condition accompanying the dryness.
  4. Constipation due to impeded Qi flow in the intestine– this condition is characterized by alternating diarrhea and constipation as well as a stomachache. Treatment should include green foods that promote moisture and movement, such as lettuce, coriander, green peas, fennel, leak, sprouted wheat and green lentils. Combining physical activity in the treatment is extremely important.

Constipation from the macrobiotics viewpoint

Macrobiotics distinguishes between Yin constipation and Yang constipation.

Yin constipation:flaccidity and low muscle tone in the large intestine caused from insufficient intake of fiber-rich foods such as whole grains, legumes, vegetables with their skins and seaweed, combined with excessive consumption of white flour, sugar and sweet snacks, fruit, juices and very oily food. In this state, the large intestine lacks the strength to contract and create peristaltic movement (bowel movement). The stools can be soft.

Yin constipation: In this condition the bowels are blocked and stiff following overconsumption of rich animal source foods (beef, mutton, eggs, tuna, salmon) baked food (breads, stiff pastries, crackers) and excessive salt. The stools become small, hard and concentrated, with a very strong smell.

Diarrhea in Western medicine

The term diarrhea is defined as bowel movement with a diluted watery texture. Diarrhea can be acute or chronic.

Different types of diarrhea:

  1. Osmotic diarrhea: means something in the intestine draws fluids from the body into the intestinal cavity. A common example is diarrhea as a result of eating sugar substitutes like sorbitol, which isn’t digested by the body and causes fluids to be discharged into the intestine causing diarrhea.
  2. Secretory diarrhea: this happens when the body discharges fluids into the intestine following a viral infection (bacteria or virus) or specific medication.
  3. Bloody diarrhea: appears during inflammatory intestinal disease like ulcerative colitis or Crohn’s disease and in various intestinal infections.

Acute diarrhea with either osmotic or viral etiology(from contaminated food or direct infection), which usually passes after three days and doesn’t require medical treatment. In a state of severe acute diarrhea, seek medical attention to prevent dehydration.

Types of chronic diarrhea:

  1. Enzyme deficiency, such as in cases of lactose intolerance
  2. Gut flora is affected due to intake of antibiotics
  3. Stress and tension such as in sensitive Irritable Bowel Syndrome
  4. Hyperthyroidism

Diarrhea in Chinese medicine

Metaphorically speaking, in Chinese tradition, the proper digestive process depends on the “internal cooking” ability of the digestive organs. The stomach resembles a large pot on the stove. Food and liquid enter the stomach and go through a “cooking” process until they reach soup texture. The fire under the pot is provided by the Qi of the Spleen. Chronic conditions of soft stools or diarrhea are indicative of weakness of the digestive fire and digestive organs that are responsible for breaking down the food, absorbing it in the blood stream and secreting it out of the body.

  1. Diarrhea from internal cold– the digestive fire is weak and cannot decompose the food. This diarrhea includes leftover foods in the stools, a cold sensation in the stomach, a strong and contracting stomachache. Treatment should include hot cooked food, using warming ingredients such as toasted grains, toast, root vegetables, warming and contracting spices such as nutmeg, rice porridge (congee) with scallion and chives, ginger tea. Use moxa to warm the stomach and keep the stomach area covered up and warm.
  2. Diarrhea from lack in spleen and stomach Qi– the digestive strength is weak and the food “slides” out before it is “cooked” and absorbed. This diarrhea does not have a strong odor, it’s fairly light in color and defecation tends to be followed by fatigue. Treatment should include white/whole grain rice, gourd vegetables, chicken soup, eaten in small amounts at shorter intervals and at regular times.
  3. Diarrhea from excessive dampness in the intestines: excessive dampness occurs following a weakened digestive fire, combined with consumption of foods with a moistening effect such as banana, peanuts, oil, dairy products, sugar and more. Dampness is naturally heavy and drips down to the intestine, where it disturbs the digestive process and the absorption of food, causing soft/creamy stools, sometimes with mucus. Cold moisture in the intestine is a possible result of the two conditions mentioned above (cold and weakened Qi). Treatment will include drying foods that promote movement and dissipate the accumulated mucus such as millet, buckwheat, basmati rice, grits, pumpkin, adzuki beans, dry ginger, turmeric, brewed pomegranate peel. Prolonged dampness in the bowels can warm up and turn into phlegm, which makes the diarrhea darker, needing to defecate more often, with a burning sensation in the anus and strong smelling stools.To treat this condition we’ll prefer drying and cooling foods that promote movement such as celery stalks, kohlrabi, cooked lettuce, pumpkin, radish, small radish, turnip, cabbage, coriander, mung beans, brewed geranium.
  4. Diarrhea from stagnated food and heat in the intestines: this condition is caused by eating large amounts of food, swallowing without chewing, eating while working and overeating heavy, dense and oily foods, such as meat, salmon, tuna, eggs, mayonnaise, tahini, cheese and a variety of pastries. This condition is typically manifested by bloating and gas after a meal, belching, heartburn is possible, running to the toilet soon after eating, and producing painful smelly diarrhea. Treatment should first correct the eating habits and the diet should include rice sprouts, sprouted legumes, cruciferous vegetables and drinking small amounts of small-radish juice.

Diarrhea from the macrobiotics viewpoint

Macrobiotics also distinguishes between Yin diarrhea and Yang diarrhea.

Yin diarrhea: light color, runny, fairly odorless, moderate frequency, caused by eating foods with an extreme Yin effect: fruits, fruit juices, summer vegetables, nightshades vegetables, beverages and cold drinks. Eating sugar and ice cream can cause strong acute diarrhea, accompanied by measurable fever and a high defecation frequency.

Yang diarrhea: dark and heavy diarrhea, fairly dense, quite pungent and at a high frequency. Caused by overeating animal source foods, particularly red meat, chicken, eggs and seafood, and following complex and extremely diverse meals. 

Diarrhea in babies

Diarrhea is common in babies and children. Babies can be given the following for acute diarrhea with anunderlying virus:

  1. Cooked rice water: cook a small amount of white rice in a lot of water (3 tablespoons rice in 1 liter [34 oz] of water), bring to a boil, reduce the heat and cook for another 5-10 minutes. Strain the rice and discard, let the cooking water cool to lukewarm temperature and serve. 
  2. Carrot soup: this soup helps alleviate intestinal mucus. Cook 2 kg (4.5 lb) carrots in 3 liters (102 oz) of water for half an hour, strain and keep the cooking water, let cool and serve.
  3. For older children, prepare drinks with an astringent effect that contracts and dries the digestive mucus and stops the diarrhea.Sumac drink (boiled 1 teaspoon in a cup of water for 3 minutes and let the child drink once a day) or a brew made fromlemon scented geranium.

KUZU – the magical food for treating the large intestine and bowel movements

Kuzu – white starchy grains produced from the Ge Gen root.Available in most natural health food stores. In Chinese culture, kuzu is used like cornflour, for thickening and condensation of food, glazing vegetables dishes, thickening compotes and therapeutic drinks. In Chinese herbal medicine, kuzu is considered a cooling substance, sweet and slightly pungent, strengthening the stomach and intestines. Kuzu is used for treating acute diarrhea with underlying infection, chronic diarrhea with underlying weakened Qi and constipation with underlying fever, dryness and anemia.

Kuzu and prune drink for constipation

A natural drink for treating constipation with dry hard stools.This drink is made from kuzu and dry prunes. The high sugar content makes it ideal for treating constipation in children. Simple and effective in most cases.


3-4 fresh organic plums or prunes

1/2 to 1 Kuzu granules

2 cups water


Cut 3-4 fresh plums or prunes into pieces and place in a pot. Add 2 cups of water and bring to a boil. Cook for 5 minutes. Dissolve 1/2 to 1 teaspoon of kuzu in a 1/4 cup of COLD water, add to the boiling compote and cook for 1 more minute, turn off the heat.

Kuzu cream drink for treating diarrhea in babies

Chronic diarrhea or soft stools are common in babies. When the baby is pale, with dark color in the lower eyelids and the digestive system is weak due to a “cold” diet (a diet rich in fresh, raw, cold food, fruits, vegetables and dairy products).


1 teaspoon kuzu granules

2 drops tamari soy sauce


In a dry pan, toast the kuzu over medium heat until it turns slightly brown. Let the kuzu cool down. Dissolve the kuzu in a cup of cold water and mix well. Cook the kuzu water in a pot over medium heat. Bring to a boil, lower the heat and continue to cook for another 2-3 minutes while stirring. Add 2 drops of tamari soy sauce and turn the heat off immediately.

For diarrhea with underlying infection (viral stomach infection), it is recommended to add 1/4 teaspoon of umeboshi spread after the heat is turned off, and then stir well.

Note: Surprisingly, babies and children love the salty flavor of this drink, as opposed to their parent’s expectations.

Nutritional importance in treating the large intestine and bowel movements

The quality and regularity of our excrements are the basis for our good health, quality of life and longevity. It’s almost obvious that proper nutrition is crucial in its effect on normal bowel movements and therefore every person suffering from related issues would be wise to get consultation and recommendations for a customized diet that will help to rebalance their digestive system and prevent future complications.


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