Constipation is caused by deficiency of qi, blood and body fluids as well as internal accumulation of dryness and heat after the recovery from a disease.
1. Syndrome differentiation and treatment
(1) Intestinal dryness due to deficiency of body fluids
Dry stool, difficult defecation, dry lips and mouth, dry throat, thirst, scanty urine, red tongue with a little fur and without fluid, thready and unsmooth pulse. In the case of concurrent residual dryness and heat, it manifests flushed face, dysphoria, abdominal distension or abdominalgia, dry mouth, foul breath, red tongue with yellowish fur and rapid pulse. It is advisable to nourish body fluids and moisten the intestine. The prescription used is Wuren Pill (Five-Kernel Pill) with additional Shengdihuang (Radix Rehmanniae), Xuanshen (Radix Scrophulariae) and Maimendong (Radix Ophiopogonis). In the case of concurrent enterogastric dryness and heat manifested by abdominal distension or abdominalgia, foul breath and yellowish fur, use the modified Maziren Pill (Hemp Seed Pill). More information, please continue to read Constipation in TCM.
(2) Deficiency of qi and blood
Constipation, lustreless complexion, light-headedness, palpitation, or no dry and hard stool, strain in defecation, sweating, short breath, mental fatigue, lassitude of limbs, pale lips and tongue, thin fur, thready and weak pulse. It is advisable to supplement qi, nourish blood, and moisten the intestine to promote defecation. The prescription used is Danggui Buxue Decoction (Chinese Angelica Decoction for Replenishing blood) with additional Shengheshouwu (unprepared Radix Polygoni Multiflori), Zhike (Fructus Aurantii) and Digupi (Cortex Lycii Radicis). In the case of marked qi deficiency, use Huangqi Decoction (Decoction of Radix Astragali seu Hedysari); in the case of marked blood deficiency, use Runchang Pill (Intestine-Moistening Pill). More information, please continue to read Causes of Constipation in TCM.
(3) Accumulation of cold due to yang deficiency
Possible dry stool, difficult defecation, slight abdominal cold and pain, cold hands and feet, or soreness and cold of waist and spine, pale complexion, clear and profuse urine, pale tongue with white fur, deep and slow pulse. It is advisable to relax the bowels with warm-and moist-natured drugs. The prescription used is the modified Jichuan Decoction, or Banliu Pill or Congrong Runchang Pill (Pill of Herba Cistanchis for Moistening the Bowels).
2. Rehabilitation methods
(1) Physical training
Physical training increases gastrointestinal peristalsis and promotes defecation. Walking with rapid steps and fitness running are more suitable. Do it in the morning every day, fifteen to twenty minutes each time. The distance is determined by personal conditions and the amount of exercise by the fact that mild short breath and sweating appear. After training, take a lukewarm bath or hot hip bath for five to ten minutes. Then, go to number two. Besides, practice the abdominal breathing for thirty to forty minutes each time. It has the actions of massaging the stomach and bowels, and promoting gastrointestinal peristalsis due to the obvious rhythmical upward and downward movements of the diaphragm. More information, please continue to read Symptoms of Constipation in TCM.
(2) Acumox and massage
Acumox:
Select the Back-shu point, Front Mu-point and Lower-He (sea) point of the large intestine meridian, specifically, Dachangshu (BL 25), Tianshu (ST 25) and Shangjuxu (ST 37) in acumox. In the case of intestinal dryness due to deficiency of body fluids, add Hegu (LI 4) and Quchi (LI 11), with the reducing method or the uniform reinforcing-reducing method; in the case of deficiency of qi and blood, add Pishu (BL 20) and Weishu (BL 21), with the reinforcing method; in the case of cold constipation due to yang deficiency, apply moxibustion on Shenque (CV 8) and Qihai (CV 6) additionally. As for the ear acupuncture therapy, select Zhichang (MA- H 2), Dachang (MA - SC 4) and Nao with the moderate or forceful stimulation and the twirling-rotating manipulation. Retain the needle for twenty to thirty minutes. More information, please continue to read TCM Diagnosis for Constipation.
Massage:
First, press and knead Zhongwan (CV12), Tianshu (ST 25) and Guanyuan (CV 4). Then, massage the abdomen clockwise, press and knead Pishu (BL 20), Weishu (BL 21), Shenshu (BL 23) and Zusanli (ST 36). After that, massage Chengshan (BL 57) and Fenglong (ST 40). Simultaneously, press and rub the waist until the part is completely warm for fifteen to twenty minutes each time respectively in the morning and evening.
Besides, self-massage of the abdomen may be applied as follows.
(1) Pressing with the palm
Assume the supine position and unfasten the trouser belt. Then, flex the knees. After rubbing the palms against each other to make them warm, place the left hand flat on the right side of the lower abdomen and the right hand on the back of the left hand. At this time, push the hands upward to the lower part of the right costal region. Next, proceed to pass the abdomen horizontally along the part above the navel to the left side of the lower abdomen. Knead and press this part deep and slowly. Finally, press the above regions in the opposite direction to the original site. This is one cycle. Repeat the cycle for ten to dozens of times, or press the regions for ten to fifteen minutes.
(2) Digital pressing
After finishing the above pressing with the palm, change the palm into one finger to press digitally and slowly alone the above-mentioned course. Press one point digitally for three to five times with a total duration of five to ten minutes. Massage the abdomen with the even force until mild abdominal soreness and distension or the sound of "cooing, cooing" appear. Practice it once or twice a day. After the massage, shift to the sitting position and pat the sacral part gently with the hand for one minute. More information, please continue to read Chinese medicine Treatment for Constipation.
(3) Pounding-tapping
Bend the upper body forward. Then, clench the fists. Next, pound and tap Zusanli (ST 36) with the fist bottoms until soreness and distension appear locally.
3. Diet therapy
In the case of intestinal dryness due to deficiency of body fluids, select Baiziren Gruel (Gruel of Semen Boitae); in the case of deficiency of qi and blood, select Heshouwu Gruel (Gruel of Radix Polygoli Multiflori); in the case of cold constipation due to yang deficiency, select Congrong Yangrou Gruel (Gruel of Herba Cistanchis and Caro Caprae seu Ovis). Eat more vegetables and fruits usually such as spinach, Chinese cabbage, celery, banana and peach to increase the stimulation of plant fiber on intestinal peristalsis; drink more boiled water usually, or light salty boiled water in the morning; abstain from irritating things like pungent food and alcohol, and do not overeat cold, cool and uncooked food, either. More information, please continue to read TCM Treatment Evaluation for Constipation.
4. External therapy
Put the honey suppository, or pig's bile enema, or glycerin suppository into the anus to relax the bowels.