Ayurvedic Concept Of Constipation
The glory of Ayurveda lies in its evaluation of a theory of maintenance of health and genesis of disease. The Ayurvedic theory of tridosha stands for all times and circumstances and it justifies the ancient needs and caring for the future. These three doshas (vata, pitta and kapha) maintain the integrity of the human body. The equilibrium of these three basic substances is responsible for maintaining good health. Similarly disequilibrium of these doshas may cause disintegration of the body with diseases or may lead to death. There are three main malas according to Ayurveda, Purish(stool), Sweda(sweat) and Mutra(urine). Purish is produced after the digestion of food material in the large intestine. The undigested food residue which is expelled out of pakvashaya with the help of apan vayu is called purish.
Definition of Mala (body waste) according to Ayurveda:
After digestion, food is divided in to two parts, sara and kitta. Sara bhag is known as Aahar rasa, while kitta bhag is known as mala. Sweda, mutra, purisha etc. are nourished by this second part of digestion i.e. kitta bhag. Charka in Sharirasthana has given clarification of mala i.e. Body constituents (dhatu) are of two types, mala and Prasad, Mala part is that which is harmful to the body and it is produced in hollow space in the body and is evacuated through the external opening i.e. ‘khamala’ (wax formation in ear, slimy sticky discharge from eyes, discharge from nose etc.) vitiated dosha and anything which are harmful to the body are called as mala.
Samyak Malapravrutti (Normal bowel activity):
After division of Sara and kitta, again kitta is divided into two parts, the liquid part is known as Muttra (urine), while the solid part is known as Shakrut or Purisha (stool). The quantity of purisha is said to have owned seven Anjaali. Even though purish is panchabhautik in nature, vayu and Agni are more dominant. The rasa of purisha is katu. The normal color of purisha is yellow and having a typical smell i.e. purisha gandha.
Three main parts of Purish (stool) according to Ayurveda:
1. Annasya anusha: After digestion some part of food (digested or not digested) is present in stool.
2. Dhatuna anusha: The process of digestion is continuously going in the body, from which formation of dhatus takes place. During this, waste products are formed which get mix with purisha in intestine.
3. Malinvata aunsha: during digestion gases are formed and these gases come out with purisha.
Types of Koshta (bowel) according to Ayurveda:
- Krura Koshta: krura koshtha having dominance of vata, in which the virechan (purgation) should be given with tikshna dravyas in large quantity.
- Mrudu koshtha: It has dominance of pitta; in which virechan should be given with mrudu dravyas in less quantity.
- Madyam koshtha: It is of samadoshaja, in which virechan should be given in madhyam matra.
In mrudu koshtha the symptoms of samyak sneha are seen within 3 days, in sadharan koshtha after 5 days and in krura koshtha after 7 days.
Purishvaha Strotas (stool excretory system) according to Ayurveda:
Roots of the purishvaha strotas are pakvashaya and, sthulaguda.
Dushti hetu (disturbing causes) of purishvaha strotas: Suppression of the urge of defecation, consumption of excessive food, indigestion of good, eating in quick succession, hampered digestive power and starvation are the etiological factors to vitiate the purishvaha strotas.
Dushti Lakshane (abnormal symptoms) of purishvaha strotas: When purishavaha strotas is vitiated the purisha is evacuated with difficulty or with efforts. In that case the quantity is less and its movement is painful and with particular sound. The stool defecated liquid or loose, hard, granular and in excessive quantity.
Purishdhara kala (system of separation of waste products of body):
This is in the anthakoshtha, between, last parts of laghwantra (small intestine) and starting part of bruhadantra (large intestine) which also known as unduka. Here the separation of rasa, mutra and purisha takes place. This fuction of separation is due to vata and Agni. Separation of mala is more in pakvashaya. Here liquid waste material is separated and it sends towards basti and solid part of the waste remains there.
Process of normal evacuation of Purish (stool) according to Ayurveda:
The Guda (anus) is divided into two parts – uttarguda and adharguda. In uttarguda purisha mala is stored while by adharguda this stored purishmala is evacuated. The guda is in apan region. While in uttarguda, purishmala is stored, at the same time adharguda remains empty. When food comes from digestion, the process starts under the control of pranvayu. Pran helps saman and apan vayu for forward movements of intestine. Because of this movement, mala comes into unduka and then it enters into the uttarguda, which gets enlarged and produce an urge for evacuation of purishamala. This urge helps to increase the function of apana and movements of guda. The contraction of abdominal muscles and vitapa muscles helps to increases the pressure on the guda, due to which the adharguda opens through which the purish mala is evacuated. By stopping a breath for some period by udana, helps to put more pressure on guda. All these interconnected functions help to normal evacuation of purishamala. The guda (anus) is made up of three folds i.e. Pravahini, Visarjani and Sanvarni. The last Part, sanvarni is under control of prana. So it is possible to control the urge for some time. If this happens recurreritly its affects the sensations of urge leading to malavstambha. This clearly indicates that, three is relation between body and mind.
Functions of Purish (stool) according to Ayurveda:
Purishamala should remain in pakvashaya or purishdharakala for some time to maintain proper functions of dhatus. If this purishamala is evacuated in large quantity then it affects all dhatus. The function of purishamala is to support or to stabilize the body. Purisha formation takes place in pakvashaya. In third stage of digestion katu rasa is formed, which helps to support vata. This vata controls the movements of intestine. The movement of large intestine is comparatively less than that of duodenum and small intestines. If the movements of intestines get disturbed, it affects digestion process, due to which, undigested food materials evacuated through guda. To stop this process of indigestion, movements should be balanced by purisha with the help of vata and Agni.
If purishmala is evacuated in less quantity then it causes accumulation of Purishamala and if it is evacuated in large quantity then it causes decrease in Purishmala. The decrease or increase of purishamala is harm full to body, so purishakshaya should be controlled.
Increased stool symptoms according to Ayurveda: If purisha increases, it causes flatulence, heaviness and pain in abdomen.
Decreased stool symptoms according to Ayurveda: If purisha is decreased it causes, flatulence, twisting like pain in abdomen. Gases distention causes pain in chest, sternum and heart.
Malavshtambha (constipation) according to Ayurveda:
In Ayurvedic literature Avastambha means Dharan. This avastambha is Marathi version meaning avarodha. Malavstambha means there is change in natural evacuation of stool i.e. irregular evacuation of hard stool.
Causes of constipation according to Ayurveda:
Vishamashan (irregular diet), adhyashan (frequent eating), langhan (starving), guru (hard), ruksha (dry), vistambhi, picchil, fermented food, Night works, sleeping in day time, ati-vyayam (over exercise), ati-maithuan (excess of sex), vega-vidharan (avoiding natural urges), mansik chinta (over thinking), vyagrata (anxiety), agnimandya (less appetite), atisheet padartha sevan (cold food) etc.
Symptoms of constipation according to Ayurveda:
Heaviness in lower abdomen, irregular bowel habits, loss of appetite, bad smell or Gases etc. Pravahan, Shushka and grathit mala (hard stool), adhmaan (flatulence), atop (sounds in bowel), udar-shool (abdominal pain), shirshool (head ache) and Unustahi (nervousness), aniyamita and sakashtha malapravruti, ajirna (indigestion), hrullasa (nausea), udar-daha (hyperacidity), amlodgar (reflux), urodaha, anidra (insomnia), swapnadhikya, alasya (laziness), mana-aswasthya (bad feeling).
Types of constipation according to Ayurveda:
l. Vata pradhan malavstambha: – Stool is shushkha, grathil, shul, flatulence and Pravahan.
2. Vatakapha pradhan malavstambha: – Stool is picchil, sheethil, Pravahan, and adhodar-guruta. Mukha-dourgandha, mukha-prasek and kshudha – alpata.
Etiology of constipation according to Ayurveda:
When the stools become hardened, dense, knotted, dry and waffed on by Vata, the Channel become closed up causing a rectal edema aggravated by this reason only; Vayu moves upwards and stay blocked in the pelvic region, back and cardiac or chest region. It also gathers up at the head and causes many types of distortions – deafness, darkness and so on. In addition, this vata also disturbs pitta and kapha from their own natural sites and as it is running out (hither and thither), the seven dhatus like ras and others become vitiated.
Treatment of constipation according to Ayurveda:
When a person develops tenable malavstmbha, he should give up eating Dry fruits and he should never be purgated. Unctuous and charming foods are varied types of meats accompanied with Kulattha rasa should be given enema with decoctions as well as medicated oils. For a person who counteracts, no distortions (due to hardened stools) will arise. Do not give hard purgatives and just treat this patient with anuloman (mild purgative).
Pathya (do’s) for constipation according to Ayurveda:
Diet – Milk, raw food, green vegetables, mainly vegetable food which is easy to digest. Take small quantity of water in regular intervals during the meal.
Exercise – Walking, Yogasana.