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Vision of A Physician | CONSTIPATION, NOT A DISEASE

Dr. M. A. Usmani

 

In old books and in old therapies of the sub-continent, constipation has been branded as the mother of all diseases.This piece of insight had been proven to be quite superfluous and quaint. In my long practice of nearly 40 years, I’ve never treated constipation as an independent or a separate disease; and consider all laxative nostrums as positively injurious and devastating for health.

 

Constipation is either functional or pathological. Almost 90% of cases of constipation are functional; and 10% pathologic. Among these 10 cases, almost nine may be the cases for surgical intervention. I’m in this article dealing with the first class of cases, i.e. functional. In this category, I never consider constipation as a disease in its own right. Constipation, for me, is life-style;change the life-style, the constipation will automatically go.

 

When a patient comes to me for constipation, I ask him for other complaints. If he is reluctant to tell or say that he has no other complaint, I then ask him general questions as to how he lives and what he does in his life, his profession and his liabilities. His habits and living style are taken special notice of.

 

I’ve seen that 99% of cases are ‘cured’ without any medication whatsoever. In 1% of cases, in which I feel like giving some medicinal help are people who are really suffering from some sort of difficulty of bowels, functional or pathologic: either inertia or faulty peristalsis, or hemorrhoids, fissures or dryness and constriction.  Such anomalies are usually curable by homeopathy, and are dealt with accordingly.

 

If I find that the patient, who has come for the constipation, has many other things to tell, then I take the proper case, and the constipation becomes one symptom among so many. And the prescription that I decide for the whole case, I usually find, is seldom based on constipation. The indicated remedy, however, improves all aspects of the case, including constipation.

 

For constipation, in a well-taken case, I usually enquire about the foods and edibles that do not agree with the patient; either cause allergic reaction or induce diarrhea, or loosen the bowels and cause frequent defecations. This knowledge is the golden key to unlock the case of chronic constipation. This allergen, you may call it, is sure to help this case, alleviating age-old disability. The most often allergen that I find in such cases is, milk. That is, these cases find that milk does not agree with them, causing indigestion or diarrhea.  Now this piece of information is the secret of the solution. By giving ‘a hair of the dog that bites’, we instruct the patient to start taking milk daily, with breakfast or on retiring at night. He must start with half a cup of warm to hot milk, and judge the reaction. If no reaction, start increasing his dose by three to four spoons at a time; and when he starts having rather soft stools, he must keep the dose at that. And after few days the bowels may start getting very loose, start reducing the milk dose, by two to three spoons per day. In this way he will reach the optimum dose, where he will have daily one to two easy stools. This strategy will provide him ‘cure’ from his malady, with nutrition— a nutrition rich cure, you may call it; (for he has started taking milk which he had not tasted for many years).

 

As milk does not agree to a lot of people after infancy, especially during the advanced years, it is a great source for ‘curing’ constipation. Even for people who do not have indigestion from milk, it can still be a source for their salvation. In such cases a glass of warm milk, with a tablespoon of virginolive oil, will allay the difficulty magically. Olive oil itself is a mild laxative. But if this prescription of milk with olive oil does not help, a tablespoon of honey should also be added. Honey is also laxative.

 

Let’s come to other items of food that can be so employed. Vegetables and fruits are another source of help. Most vegetables, excepting potatoes, are laxative, more of less. The more leafy and soft pulpy they are, the more ‘laxatively’ they act. They should better be cooked or steamed; and served with olive oil, garlic and ginger seasoning. Leafy and pulpy vegetables should be selected for this purpose; such as spinach and lettuce, pumpkin, white gourd, sweet, bitter and round cucumbers, and many, many others, according to regions, habitat and countries. Most vegetables are flatulent in nature; lavish seasoning with ginger, garlic and asafetida, cumin and cinnamon should therefore be resorted to.

 

In addition to vegetables, a physician should also take full advantage of fruits, fresh and dried. As a rule, the more intensely sweet a fruit is, without the admixture of sour, the more laxative it is; and also the more pulpy, the more purgative it would be. So figs, fresh and dried, melon, water melon, ripe mangoes, ripe papaya, ripe, rather over-ripe, apricots (250 grams, at a time), raisins and so many others, can be relished and used as medicines.

 

One rule must be brought home, that is, warm things act as laxative, and cold as astringent. So much so that such an innocuous agent as water, in the state of warm or hot water, can act as an efficient aperient. Drinking two to three glasses of warm water, on rising in the morning, can help move bowels. Or a single glass of hotwater with a tablespoon of honey can equally suffice as well.

 

The vision of a physician should encircle the natural environ around him, and his knowledge should engulf and be enriched by the vision and knowledge of other systems of medicines and therapeutics.  What is wise and factual in one system is wisdom and knowledge for all.

 

So the motto for a seasoned physician is:

Where foods can solve the problem, medicine should not be used.

 

Usmani Resource Page

Copyright 2011/All rights reserved © Dr Usmani
Contact author for permission to use

Views: 1271

Comment by sajjadakram on December 20, 2010 at 7:30am

Dear Dr Usmani,

Thank you for this article based on your personal experience.It is worth reading.No doubt.

sajjad.

Comment by Dr Ravindra Saraswat on December 20, 2010 at 7:24pm

Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may have difficult and painful bowel movements.

Constipation causes large, hard stools to become lodged in the rectum. Watery stool can then leak out around the hardened stool. Constipation also causes the muscles of the rectum to stretch, which weakens the muscles so they can't hold stool in the rectum long enough for a person to reach a bathroom

Constipation is not a disease. It is a symptom. Constipation is usually caused by a disturbance of how the intestines works.

Constipation is the most common gastrointestinal complaint in the United States. Constipation affects almost everyone at one time or another. It causes about 2 million annual visits to the doctor.

What causes Constipation?

The hard and dry stools of constipation occur when the intestines absorbs too much water. (Waste moves through the intestines and the intestines absorb water as the waste moves through it). This happens because the intestines's muscle contractions are slow or sluggish, causing the stool to move through the intestines too slowly.

Some of the causes of constipation are:

  • Poor diet
  • Lack of exercise
  • Not enough fiber in diet
  • Not enough liquids
  • Medications
  • Irritable Bowel Syndrome
  • Changes in life or routine such as pregnancy, older age, and travel
  • Abuse of laxatives
  • Poor Bowel Habits
  • Ignoring the urge to have a bowel movement
  • Hormonal Changes
  • Specific diseases such as multiple sclerosis, Parkinson'ts disease, stroke and lupus
  • Fissures and Hemorroids
  • Problems with the intestines and rectum
  • Problems with intestinal function

In most cases, constipation is temporary and not serious.

Can constipation be prevented?

Maybe. To decrease your chances of developing constipation, do the following:

  1. Eat a well-balanced, high-fiber diet that includes beans, bran, whole grains, fresh fruits, and vegetables.
  2. Drink plenty of liquids.
  3. Exercise regularly.
  4. Drink aloe vera juice.

Complications of Constipation

Two of the most common complications of constipation are anal fissures and incontinence

Source: Mama's Health

Comment by Dr Ravindra Saraswat on December 20, 2010 at 7:36pm
Constipation - Homeopathy Treatment & Homeopathic Remedies

#Nux vomica [Nux.v]
Perhaps no remedy in the Materia Medica is oftener prescribed for anything than is Nux vomica for constipation. Nux vomica has peculiar and characteristic indications for constipation, and when prescribed upon these indications it will cure every time. Nothing is surer than this. But Nux vomica is often prescribed when these indications are not present, and often does much good; in this class of cases there will almost invariably be present one of the great clinical indications of the remedy, and that is, its value in antidoting purgative medicines. In many cases of inveterate constipation calling for this,that,and the other remedy, it will be noticed that expected results are not obtained and will not be obtained and will not be obtained until Nux vomica has been given to antidote the effects of drastic medicines. Then the case can be prescribed for, the indications followed, and success result. Another thing about Nux is the fact that while prescribed low, as in the tincture, it will frequently relieve constipation, but to cure it the drug must be given in a much higher potency. Hydrastis is another remedy that is sometimes useful after the abuse of purgatives, laxatives, cathartics and their like. In all these cases, however, the symptoms calling for the respective drug should be present. Hughes claims it to be superior to Nux as usually prescribed. He recommends a drop or two of the tincture in water once daily before breakfast. Hydrastis has a symptom, however, which is quite characteristic, that is a sinking, gone feeling at the epigastrium, which Nux vomica does not have to any extent. The constipation of Nux vomica is usually of the kind induced by lazy habits, inattention to Nature's calls in the first place, want of exercise, sedentary habits, and a sluggish condition of the whole system. It is due not only to inactivity of the whole system. It is due not only to inactivity of the intestines, but to an irregularity of the peristaltic actions, giving rise to the great characteristic, constant ineffectual urging to stool, and when the stool does occur it is incomplete and unsatisfactory, as if a part remained behind. Absence of desire for defecation contra-indicates Nux. Inflammatory symptoms or pain generally contra-indicates. Carbo vegetabilis has urging, but it is due to wind, while Opium and Bryonia have no urging at all. According to d'Espiney, the physical signs of this inharmonious intestinal action can be felt by palpating the abdominal walls. Anacardium resembles Nux vomica in many ways. It has a sensation of a plug in the rectum which cannot be expelled. There is a fitful intestinal activity, but withal a powerlessness of the rectum. Even soft stools are expelled with difficulty. Small quantities may be expelled with each attempt. The mental symptoms of Nux are important in treating constipation, for the effect that constipation has upon the minds of some people is well known. In cases indicating Nux vomica there will be a great crossness, irascibility and objection to all opposition. The Nux stool is also apt to be large, and haemorrhoids are a frequent accompaniment. We may sum up Nux vomica by calling again the attention to the mental characteristics, the sedentary temperament,the fitful intestinal action and its antidotal relation to purgative drugs. Dr. Cartier,of Paris, well says: "Nux vomica should never be given in constipation according to the law of similars in the low attenuations, or in the mother tincture. An opposite effect will be produced thereby, an augmentation of the spasmodic state of the intestines; the higher the dilution the better the chance success. Nor should it be too often repeated."

#Sulphur [Sulph]
Many of the older homoeopaths used to give Sulphur and Nux vomica in alteration for constipation. They complement each other, follow each other well, but better results will be obtained if each be given singly when indicated; for, surely, both cannot be indicated at once. With Sulphur there is an ineffectual urging to stool, with a sensation of heat and discomfort in the rectum , and there is a general uneasy feeling all through the intestinal tract, due to abdominal plethora or passive portal congestion. It is very useful remedy with which to commence the treatment of constipation, though, unless the symptoms call for it, it should not be given. A bad constitution and frequent ill health are good indications to start with, a tendency to piles is another. The stools are hard, dark, dry, and expelled with great straining, the first effort to stool being extremely painful. There is apt to be much twitching and burning of the anus, the evacuation are often unsatisfactory, and, as in Nux, there is often a sensation as if a part remained behind. Another characteristic symptom of Sulphur is constipation alternating with diarrhea. The general temperament of the drug has much to do with its choice; in fact, almost all of the indications for its use will be the general ones . The general venous system is usually at fault in true Sulphur cases, and anything that stimulates this system into action, such as exercise and cold, always benefits the Sulphur patient. Sulphur needs to be given high and n continued for any length of time .

#Opium [Op]
While the constipation of Nux is due to irregularity of intestinal action, that of Opium is due to absolute inaction of the intestines, a regular paralysis of the peristaltic movement. There is an absence of desire, absolutely no urging to stool whatever, and so the faeces become impacted in the bowels; and when passed at all come in little, hard, dry, black balls, here resembling the stool of Plumbum , but with Plumbum there is some activity. Another drug which has no urging to stool is Bryonia, but here the lack of urging is rather due to dryness of the mucous membrane than to intestinal inactivity; with Opium there is a want of sensibility throughout the intestinal tract, and consequently the constipation is not apt to inconvenience the patient, hence it is apt to go on getting worse until the attention is called to it by the flatus accumulating in the upper part of the intestines. Where the faeces require artificial means for their removal, this remedy should be thought of, though Selenium, Alumina, Plumbum or Bryonia may be used in this condition. Diminished secretions are also characteristic of Opium , so that dryness intestinal inactivity, is one of the causes of constipation of old people; the patient is drowsy and dizzy.

#Plumbum [Plumb]
As we have already seen, with Plumbum there is some intestinal action; in fact, at times there is considerable. Lead colic is one of the effects of the drug. So we have urging to stool, and accompanying this urging is a colic with a marked retraction of the abdominal walls. The stool is passed with the greatest difficulty and consists of little round balls, which are black, dry and hard, and there is accompanying, a marked spasm of the sphincter ani which is apt to be painful. The anus feels as if drawn upward. With this drug there is loss of muscular activity and diminished secretion of intestinal glands. Thus we see that the indications for Plumbum in constipation are concise and precise.

#Alumina [Alum]
Chief among remedies for constipation due to dryness of the intestinal tract stands Alumina. There is diminished peristaltic movement and complete inertia of the rectum, so that we have the symptom, soft stool expelled with difficulty, explained. There is little or no urging to stool. The stools may be hard and knotty like sheep dung, or may be soft. It is one of our most useful remedies in constipation of children where the rectum is dry, inflamed and bleeding about the orifice. Alumina differs from Bryonia chiefly in the state of rectal inactivity. A dry mouth and an irritated looking tongue may lead to the selection of Alumina. There is much straining with the remedy and the stool is passed in very small quantities , piecemeal, so to speak. If the characteristics of Alumina are prominent in a given case, they may be due to the use of aluminum ware in cooking. Even Spring water boiled in an aluminum pot will deposit a white sediment on cooling.

#Bryonia [Bry]
The large-hard-dry-stool-as-if-burnt of Bryonia is familiar to all of our Medical School. The constipation of the drug is due to dryness and there is no urging. Alumina is similar; its constipation is also due to dryness, but it has such complete inactivity of the rectum that even a soft stool is expelled with difficulty. With Bryonia the stools are passed with a great deal of difficulty, owing to an atony of the intestines similar to Veratrum album and Opium. Nux, as we have seen, produces and cures constipation due to fitful, irregular, peristaltic action. Bryonia cures constipation where not only the intestinal secretions are diminished, but the muscular action as well. Constipation in young children, according to Hughes, is frequently cured by Bryonia 30th. It is said to act better in rheumatic subjects and in summer. The mental condition of irritability and ill-humor will often be present as a concomitant of the Bryonia constipation. Older writers alternated Bryonia and Nux vomica with success in very obstinate cases.

#Natrum muriaticum [Nat-m]
All the muriates have crumbly stools, and so we find that the characteristic constipated stool of Natrum muriaticum is a hard and crumbly one; the rectum is dry, the stool is hard to expel and causes bleeding, smarting and soreness in the rectum. There is ineffectual urging to stool,with stitches in the rectum. It sometimes comes in the most obstinate cases, which are accompanied by hypochondriasis. Magnesia muriatica, another of the muriates, has characteristically a constipation in which the stools are passed with great difficulty, being composed of hard lumps like sheep dung, which are so dry that they crumble as they pass the anus. Ammonium muriaticum has this same symptom of dry and crumbly stools, they may also be coated externally with mucus. In constipation of young people who are subjected to acne and comedos, Natrum muriaticum should be thought of.

#Lycopodium [Lyc]
Like Nux, Lycopodium has a sensation after stool as if something remained behind. Constipation, due to constriction of the rectum, calls for this remedy, and here it reminds one of Silicea. The constipation , too, is apt to be associated with the stool. The stools are dry and hard, or the first part hard, the last soft. In the constipation of children and pregnant women it often finds a place, and it is here praised by Hartmann. A great deal of rumbling in the abdomen following the stool is an additional indication. Nux and Lycopodium may be easily distinguished , though each has ineffectual urging to stool. In Nux, as ,we have seen, this is due to irregular peristaltic action, while with Lycopodium it is due to a constriction of the rectum. The mental symptoms here, too, are of the utmost importance; the depression, the melancholy and the apprehension are characteristic.

#Graphites [Graph]
Graphites is one of our best remedies in constipation, if Homoeopathy can be said to have "best remedies". With this drug there is no urging. The patient sometimes goes days without a stool, and when it does come it is composed of little round balls, knotted together with shreds of mucus and accompanied with great pain when passing, owing to the fissure. These fissures, as well as the haemorrhoids which accompany them, burn, smart and itch intolerably. Excessive soreness of the anus in making the post defecation toilet is an indication for its use. Three or four remedies are usually to be thought of in this condition of fissure of the anus; they are: Silicea, Nitric acid, Paeonia and Ratanhia; these, with Graphites, will remove in most cases the underlying disease leading to the fissure. Aching of the anus after stool is also characteristic of Graphites, and sometimes we have with the drug ineffectual urging. The mucus-coated stool, the extreme soreness of the anus, the general Graphites temperament of sadness and obesity, will easily decide for the remedy. Graphites suits especially women who suffer from a neglect to attend promptly to nature's call.

#Platina [Plat]
With Platina, there is torpor of the whole intestinal tract, unsuccessful urging to stool and great dryness of the rectum. The stools seem to adhere to the rectum like glue or putty. There is great weakness in the abdomen and a sensation as if there were a load in the rectum which could not be expelled. It is considered a remedy for the constipation of emigrants and travelers, so it would seem to find an additional indication where the trouble was brought on by change in manner of living. It is also a remedy for the constipation due to lead poisoning. There is frequent urging, scanty, dry stool and great abdominal weakness. As under Ignatia, there are sharp stitches in the rectum.

#Silicea [Sil]
When constipation is due to inefficient expulsive force of the rectum and a spasmodic condition of the sphincter then Silicea is our remedy. With this condition we have a condition where the sphincter suddenly contracts and the partially expelled stool recedes. Causticum has constipation due to powerlessness of the rectum, so that the patient almost stands in order to enable him to get sufficient power to expel the stool, but the spasmodic condition of Silicea is absent. As with Graphites, Silicea has a great deal of soreness about the anus, also an oozing of moisture. There is urging to stool and a sensation as if faeces remained in the rectum.

#Veratrum album [Verat]
Though this remedy is ;one of our greatest diarrhea remedies, it has a marked effect in the treatment of constipation. The symptoms calling for its use are as follows: There is complete atony of the intestines, as under Bryonia and Opium. The faeces accumulate in large masses in into a sweat; but finally has to give it up, and the faeces have to be removed by artificial means. There are extreme cases where the patient is able to force a passage for himself; the stools are large, hard and black. As with the diarrhea there may be faintness after the stool. Dunham speaks of the constipation of Veratrum as one characterized by a disposition to stool in the upper part of the intestinal canal and an indisposition to stool in the lower part. Dr. Bryce claims that it will bring stool quickest of any medicine I ever tried." He used 3x. It comes in very well after Nux vomica, especially in constipation of children. Podophyllum 12th has proved of use in constipation of children. Of course, the above remedies will not cure every case of constipation, but they will, if studied closely, be found to correspond with the majority of cases. Phosphorus has a constipation of long slender stools voided with much straining.
Comment by Dr Rajneesh Kumar Sharma MD(Hom) on December 20, 2010 at 10:52pm

Very nice article. Thanks.

Comment by Dr Muhammed Rafeeque on December 21, 2010 at 5:43am

If you ask anybody, "do you have constipation?", the most probable answer could be "YES". This type of "constipation" is more among Asians due to the intake of excess of starchy food. Many of them feel that there should be 2 to 3 bowels daily! I have patients from one family with this habit. Now, even the small child of that family has developed the habit of frequent defecation before and after food. He is just following his parents.

Comment by Dr. Wequar Ali Khan on December 24, 2010 at 2:11am
Thank you Dr Usmani, for a well structured article on constipation. It gives us a newer perspective to tackle the "menace" of constipation.In my opinion the main cause is " lifestyle" as you have mentioned.
Comment by Dr. M. A. Usmani on December 24, 2010 at 2:43am

Thanks, Dr. Wequar, and payer: May God make happy for us, Pakistani, the coming New Year. Amen

 

Dr. Usmani

Comment by Dr. M. A. Usmani on December 24, 2010 at 2:47am
Thanks Dr. Sharma, and Happy New Year.
Comment by Dr. M. A. Usmani on December 24, 2010 at 2:48am
Happy New Year, Dr. Rafeeque.
Comment by dr. santosh z. maurya on December 28, 2010 at 7:44am

good article to learn sir,as we try to give lots of medicine to cure the constipation ,but simple answer we forget to give is "lifestyle".we good example of milk.thanks

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