Constipation

Constipation is mainly caused by the disturbed transmitting function of the large intestine and also related to the function of the spleen , stomach and kidney . In view of the difference in etiology and pathogenesis , this illness can be divided into two types ; deficiency and excess .

Etiology and Pathogenesis

After food is digested by the spleen and stomach , its refined nutrients are assimilated , and the wastes are egested through the transmission of the large intestine . If the stomach and intestines are diseased , various kinds of constipation occur in the following conditions : internal accumulation of dryness and heat , stagnation of qi , deficiency of qi with inability of transmission , blood deficiency with dryness of the intestines , and agglomeration of cold .

Constitutional yang preponderance , or indulgence in alcohol and spicy greasy food may lead to accumulation of heat in the stomach and intestines . Or after some febrile diseases , the remnant heat and insufficiency of body fluids give rise to dryness and heat in the intestines , and in addition , there may be disturbance of fluid distribution to the lower jiao . Constipation is present in any of the above cases .

Emotional factors , such as anxiety and depression , or lack of movement can cause stagnation ofqi , impairing the transmitting function of the large intestine . As a result , the wastes are retained inside and unable to move downward , and hence constipation .

The coexistent deficiency of qi and blood can result from internal injury by overstrain or improper food intake , or happen after an illness or delivery or in the aged people . Qi deficiency results in weakness of the large intestine in transmission , while blood deficiency gives rise to shortage of body fluid , then the large intestine can no longer be moistened . Apparently both qi and blood deficiency can cause difficult evacuation of the feces , and hence constipation .

Constitutional debility or senile decay results in retention of the endogenous cold in the stomach and intestines . Consequently the yang qi is obstructed and the body fluid fail in distribution . Difficulty of the large intestine in transmission leads to constipation .

Differentiation

Excess condition

Main manifestations : Infrequent and difficult defecation from every three to five days , or even longer . In case of accumulation of heat , there are fever , dire thirst , foul breath , rolling and forceful pulse , yellow , dry tongue coating ; in case of stagnation of qi , there are fullness and distending pain in the abdomen and hypochondriac regions , frequent belching , loss of appetite , thin sticky tongue coating and string - taut pulse .

Analysis : The large intestine is concerned with transmission . When there is accumulation of heat in the stomach and intestines , which consumes the body fluid or stagnation of qi , disturbing the normal function of the large intestine , constipation may result . Fever and dire thirst indicate internal preponderance of pathogenic heat . When the heat in the stomach and intestines causes evaporation , there is foul breath . The yellow and dry tongue coating reveals the damage of the body fluid by the heat , while the rolling and forceful pulse is a sign of excess in the interior . Emotional disturbance leads to stagnation of qi in the liver and spleen , thus resulting in frequent belching , and fullness and distending pain in the abdomen or hypochondrium . Since the spleen fails in transportation and transformation , there is loss of appetite . Thin , sticky tongue coating and string - taut pulse are the signs of disharmony between the liver and spleen .

Deficiency condition :

Main manifestations : In cases of deficiency of qi and blood , pale and lusterless complexion , lips and nails , dizziness and palpitation , lassitude , shortness of breath , pale tongue with thin coating , thready and weak pulse ; in cases of agglomeration of cold , pain and cold sensation in the abdomen , preference for warmth and aversion to cold , pale tongue with white and moist coating , deep slow pulse .

Analysis : Constipation can be caused either by qi deficiency , resulting in failure of the large intestine in transmission , or by blood deficiency with shortage of body fluid unable to moisten the large intestine . Endogenous cold stays in the stomach and intestines , leading to agglomeration of yin qi , failure of yang qi in transportation , and weakened transmission of the large intestine , and hence difficulty of defecation . Deficiency of qi and blood fails to ascend to nourish the upper portion , so there are pale and lusterless complexion and lips , lassitude and shortness of breath . In case of blood deficiency , the heart is poorly nourished , hence palpitation . When the head and eyes fail to be nourished , dizziness results . Since the nail is the external manifestation of the liver , there will be lusterless nails when the liver blood is insufficient . When cold is agglomerated , the circulation of qi is impeded , this accounts for the cold pain in the abdomen . Cold is of yin nature , and disorders caused by cold can be relieved by warmth , so there is preference for warmth and aversion to cold . Pale tongue with thin coating , thready weak pulse are the signs of insufficiency of qi and blood , while pale tongue with white , moist coating shows the internal cold due to yang deficiency .

Treatment

Method : The Back - ( Shu ) and Front - ( Mu ) points of the Large Intestine Meridian are mainly selected . For the excess condition the reducing method is applied to eliminate the heat , moisten the intestine , and remove the stagnation of qi , while for deficiency condition , the reinforcing method is used to reinforce qi and nourish blood , and moisten the intestines for defecation . Constipation due to cold can be relieved by moxibustion to warm the fu organ for defecation .

Prescription : Dachangshu ( B 25 ) , Tianshu ( S 25 ) , Zhigou ( SJ 6 ) , Zhaohai ( K 6 ) .

Accumulation of heat : Quchi ( Li11 ) , Hegu ( Li4 ) .

Stagnation of qi : Zhongwan ( Ren 12 ) , Taichong ( Liv 3 ) .

Deficiency of qi and blood : Pishu ( B 20 ) , Weishu ( B 21 ) , Zusanii ( S 36 ) .

Agglomeration of cold : Moxibustion to Shenque ( Ren 8 ) and Qihai ( Ren 6 ) . Explanation : The causes of constipation are different , but they are common in impairing the transmitting function of the large intestine . Therefore , Dachangshu ( B 25 ) and the Front - ( Mu ) point of the large intestine are applied to promote the flow of qi in the large intestine , the transmission can be regained when the qi of the fu organ flows smoothly . Zhigou ( SJ6 ) can promote the flow of qi in the three jiao . When the qi in the three jiao is in normal circulation , the qi of the fu organ will circulate freely . Zhigou ( SJ6 ) combined with Zhaohai ( K 6 ) is a principal point in treating constipation . Quchi ( Li11 ) and Hegu ( Li4 ) can reduce the heat from the large intestine . Zhongwan ( Ren 12 ) , the Influential Point of the fu organs , is selected to lower the qi of the fu organ . The reducing method applied to Taichong ( Liv 3 ) is to soothe the liver qi . Reinforcing to Pishu ( B 20 ) , Weishu ( B 21 ) and Zusanii ( S 36 ) is able to reinforce qi in the spleen and stomach . Once the spleen and stomach qi is vigorous , qi and blood can be produced as a natural consequence , so this is the approach of treating the root cause of constipation in deficiency conditions . Moxibustion to Shenque ( Ren 8 ) and Qihai ( Ren 6 ) is offered to reduce cold and loosen the bowels .