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Ayurveda > Ayurveda Case Notes > Kruchra Mal Chikitsa By Dr. Satish Kulkarni Treatment for Constipation Patrick is facing a problem of chronic constipation. He suffered from a stroke which paralyzed the entire right side of his body and has been bed ridden since the past few years. Hence his rectum has to be cleaned on a daily basis and this is a difficult and painful job. He has been given liquid paraffin, purgative tablets and suppositories but they have provided only temporary or no relief. I suggested ayurvedic treatment since it provides better remedies for this problem. Ms. Jason seemed happy to learn this. She then requested a home visit. I made a visit and did a check-up for Mr. Jason. I noted that several things contribute to his constipation. His age, his lifestyle, his diet and the medicines that he has been taking for a long time, are all contributing to his constipation. Mr. Jason needs some physical activity. He spends most of his time sitting or sleeping in bed. He must overcome this tendency and start doing some exercises that he is able to do. If active exercises are not possible, he can opt for passive exercises with the help of family members. He needs these exercises to initiate a wave of digestion and pass stools as an end product of this. Drinking ample water and fruit juices will also help in solving this problem to a certain extent. But for this to help, he must drink two to three liters of liquid per day. In addition to this he needs an ample amount of fibrous food in his diet. He also needs plenty of green leafy vegetables and salads with cucumber, tomatoes, carrots, radish, cabbage, cauliflower and all kinds of seasonal fruits. All this roughage will help in forming soft stools and will naturally help in evacuating the bowel. As in all gut problems, fasting is an important initial remedy. One should fast at least once a month since this helps in giving periodical rest to the tract, thus helping to complete residual digestion and clean the gut. This also facilitates smooth passage of stools and gives a sense of complete evacuation. I advised keeping up with the habit of drinking warm milk before going to bed and suggested adding two teaspoonfuls of ghee (clear butter) to it. Among the medicines available for the treatment of constipation, triphalachurna {a powder consisting of haritaki (termilania chebula), bibhitak (terminalia bellerica) and amalaki (emblica officinalis)} or gandharvaharitaki{a powdered form of haritaki (termilania chebula) prepared in castor oil}are ideal. Ms. Jason agreed to give one teaspoonful of triphalachurna to Mr. Jason every day without fail. Constipation can be a result of one or more factors or even a combination of factors. It can be a simple complaint or it can be a result of serious diseases like colon cancer. One should follow the medical policy of ruling out the disease behind constipation first and then treating it. Some of the less serious causes of constipation are agnimandya (impaired digestive fire), accumulation of ama (toxic substances generated during metabolic activities), sedentary work, inadequate or excess sleep, increased work load or frequent change in daily activities like change in shifts of work, frequent travel, etc. Waiting for a couple of days before taking any medicines, fasting, eating a lot of fruits and using gentle herbal laxative medicines instead of aggressive bowel cleaners can be a good solution to this problem.
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