Suggest treatment for severe constipation
I badly need help from your side. I do not know what is wrong with me since 4-5 months and am living a very tensed life. I am writing a very detailed note. Hope you won't mind reading. It is very important for me to come out of it. It all started 2 years ago in May 2014. I was about to go USA for my higher studies. I started having headaches and body pain and difficult to fall asleep,as I used to worry about how will I manage in USA,am not sure this was the only reason. Actually initially it was not that severe but I kept visiting doctors and I didn't knew what was it as I had never suffered from this type of feeling. I used to have severe headaches and it used to be very difficult to concentrate on anything.This feeling of what is wrong with me kept increasing and I started becoming more anxious about what is wrong with me. My doctor had given me anxiety medicines.When I used to take them I used to get a good night's sleep and feel a little better. My digestion had suffered because of this as I didn't used to have a bowel movement. I thought it was constipation.At that time I used to take Kayam churn sometimes like once a month ,not more than that,whenever I used to get constipated.But suddenly heavy doses of kayam churna also didnt gave me complete stool evacuation. I started reading a lot on internet about what is wrong with me. I didnt knew what was it. I read about depression on internet once and I started feeling that I am having depression and I am not sure but I used to have some panic attacks.It used to go on and off and I didnt share much with anything about this. Then I reached USA in August 2014. By that time I always used to think about having a bowel movement and having complete bowel movement.Then I tried every laxative in US. Went to doctors, they could not find anything. Told me to take Psyllium husk laxative. I don't remember for how long it worked.Then I bought other laxative,that worked for a while. I used to difficult falling asleep.Used to feel heaviness in my head. Then one day I read about salt water flush to remove constipation. By that time, my panic attacks that I had in XXXXXXX were not there. None of my friend could say what I am going through. I used to behave like a normal person. There were months I used to feel better. Better bowel movements.After trying salt water flush and it worked. Then for 2-3 months I tried Salt water flush. Not daily.Like do it for 2-3 days and then repeat it after a week or two. I had got very obsessive about having bowel movements. I do not know how I completed my 1 year of studies. It must be a miracle. But when I completed my one year,last 2 months were like normal,but I had some issues having a good sound sleep and not feeling refreshed,but I used to have a bowel movement.Then came my summer vacation last year. Then suddenly one day I stopped having bowel movement.Salt water flush was also not working.There were like 10-12 days I didnt have a proper bowel movement. After drinking 1 litre salt water, I used to pass liquid but I used to feel incomplete evacuation. All this used to make me anxious. I used to practice yoga in XXXXXXX Here also I wanted to practice yoga,but due to my constipation problem,I lost the interest in doing yoga too. I had done Shankhaprakshalan in XXXXXXX once. And I did shankprashalan here in US. I thought everything will be fine now. I was shocked to have a constipation still. I lost 10 kgs in one year. Then I planned to go to XXXXXXX I was in XXXXXXX for a month.I went to doctor here,they gave me laxatives. I used to feel happy,meeting my friends,relatives,eating nice fresh prepared food. And one ayurvedic doctor gave me Psyllivac poweder, each 5 gms contains Psyllium husk,senna,citric acid,baking soda,salt, and few other ingredients. I used to have a nice bowel movement with that. And I was very happy in that one month. Then I came to US. I brought few Psyllivac from XXXXXXX and took those for 2 months. I used to have some anxiety,getting difficult falling asleep,but not that much. But yes I can tell I was not mentally stable. I stooped taking any laxative. I use to headaches and very difficult concentrating. I used to take coffee in morning and it used to give me a second visit to toilet and give me a second bowel movement. Then I started taking Triphala. It worked very well.But then my bottle got over.After few days my problem again got started.Then In this April,I joined a course where I was required to study daily 12 hours. I thought I will be able to do it, and my obessiveness of thinking about having stool movement will get reduced and I would concentrate on my studies.But my problem got worse there, I again tried salt water flush,other laxatives. But nothing was working and I left that course midway due to this.But I stopped having any bowel movement. It started having Bloating, didn't used to evacuate anything.Started having abdominal pain. But when I have a complete bowel movement I used to feel good. I visited many doctors after that. First, one doctor examined me,took x-ray,blood test,checked me for H pylori infection for any ulcer or gastritis. Everything was normal.In my x-ray he told me that stool is stuck in my large intestine. He gave me again psyllium husk. I started taking very heavy doses of it, and used to pass very big stools due to heavy fibre consumption. But I was very frustrated with all this. I contacted an Ayurvedic doctor online. I explained him about my constipation,but didn't tell him everything from 2014. He shipped me aam pachan vati and yakrit rasanayam from his own medicine manufacturing company and told me that after three months I will be completely alright. After trying for 1-1.5 months.I could not see much difference. Like I used to have bowel movement,but incomplete bowel movement daily. My problem has worsened since april. Before after taking laxatives I used to have a feeling of complete evacuation.But now nothing worked. I contacted a gastroenterologist. He told me I am having IBS. HE prescribe me Linzess which is a prescription medicine for IBS. I used to take some laxative at night and used to pass some stool in morning. I needed to take linzess in morning empty stomach. After I took linzess i used to have complete bowel movement, or sometimes diarhea types liquid movement.But I read on internet IBS is not curable. And I saw it is curable in Ayurveda. I contacted another ayurvedic doctor.I told him my situation. He told me to take following medicine,I wanted to confirm am I taking right medicines. :
First 20 days:
Tab XXXXXXX Bati (Gandhak Bati) - Purchase 60 Tabs, 1-0-1 after food with hot water mixed with juice of half lemon
Tab Kravyad Ras - Purchase 40 tabs, 1-0-1 with Tab XXXXXXX Bati
Gandharvahastadi Kashayam - 2 bottles - 15ml with 30ml warm water + Tab Dhanwantara XXXXXXX 2 nos, powdered and added to Kashaya, half an hour before dinner or at 6pm (Purchase 60 tabs)
From 21st day:
Stop XXXXXXX Bati and Kravyad Ras
Continue Gandharvahastadi Kashayam till you finish 2 bottles
Tab Arogyavardhini (80 tabs) - 2 tabs with ginger juice (1/2 spoon) + 1 spoon honey after breakfast or lunch
Tab Chitrakadi Vati (80 tabs) - Have it as reserve
Tab Shanka Vati (80 tabs) - Have it as reserve, Take 1-1-1 after food with hot water if you have abdominal pain, dont make it a habit
Tab Kutajadi (Pavaman pharmacy) - Purchase 100 tabs - 1-1-0 after food with warm water
Cap Mebarid - Purchase 50 Caps - 0-1-1 at bed time (Phyto Pharma)
Its been 10 days I am taking these medicines. I some days have a complete bowel movement with these medicines and taking Psyllivac powder at night. Some days I have incomplete bowel movement.Generally I do not have much urge, to have bowel movement but when I take psyllivac 2 times a day, I pass stools at once completely. But sometimes with that too , I do not have a normal bowel movement. And whole day I feel that the waste is stuck in my abdomen.I know doctor my mental stability is at very low at this point of time. When I have a normal bowel movement,I do feel good. I do not have any headache. If one day I start having normal bowel movement without taking anything. I will feel very happy. My headaches and my sleep problem will all go away,am sure.Please doctor help me out. I do take ashwagandha sometimes with hot ghee. It gives me good sleep sometimes. But I do not feel that fresh like say I used to feel 2 years ago,when I was completely normal/ But it is still better. Due to think I have IBS.My last 3-4 months have been worst period of my life. Do you think you can prescribe me anything or shall I continue with the ayurvedic medicines I mentioned it to you. There are few ayurvedic doctors here too. They are little far from my place. But if you think having a personal meeting will help me better. I will go and have a personal consultation or you can prescribe me any other medicines. .Hope to get a response from your side that will eradicate all my problems. I have somehow completed my studies, but last 4 months have been worst and I just cannot concentrate on finding a job. I hope you can provide me a complete solution to my list of problems. I have been seeing many of your youtube videos and I thought you might be of help to me and help me getting normal.I am 26 years old.I know ayurvedic doctors ask for some questionnare,I am forwarding you a questionaare the previous doctor had given me.Hopefully that might be useful to you.These were the following questionnare asked by previous ayurvedic doctor.
Write about your health condition in detail.
Age - 25
Height - 5’11
Weight - 80 Kgs
Birth weight - 3 kgs
Frequent weight changes – Increase / Decrease (constant 80-82 kgs since 7-8 years
Body-frame – Thin / Moderate / Large / Obese / Over-weight (if the frame has been changed due to exercise, gym, dieting or medication please specify) moderate to large)
BMI – if known - 25
Place of birth - XXXXXXX XXXXXXX District,Maharastra
Living place - Same as place of birth
Qualification - Masters in Computer Science
Occupation - Completed Masters(looking for a job in US now)
Marital status - Single
Smoking - no
Alcohol - no
Tobacco - no
Coffee / tea / any other beverages like coke, pepsi etc - tea/coffee sometimes
Frequent junks / snacking - Not much
Do you have any of these diagnosed conditions?
Diabetes - no
High BP - no
Cholesterol - no
Thyroid problems - no
Epilepsy (fits) no
Jaundice - no
Anaemia - no
Respiratory (breathing) troubles like asthma, bronchitis etc - no
Heart problems if any - no
Neurological problems if any - no
Gynaecological problems if any (PCOS etc) - no
Write about your -
Less - feel less hungry since 1-2 years
Early satiety (feeling enough after eating less) - yes
Bad - yes
Bloating - yes
Flatulence - yes but not much
Heartburn - no
Belching (explain nature like sour, salty etc) - yes sometimes
Vomiting sensation - no
Frequent stomach upsets yes
Pain in upper abdomen (belly / tummy) - belly
Anything else - I have Ibs -c, and there is always stomach discomfort
Do your stools / faeces sink / float / scatter in water before flushing? Sometimes scatter,sink. And very less times float when I eat more fibre previous day
Any mucus, blood, undigested food in stools - I think mucus and some times undigested food
Any foul smell from stools - no
Excessive gases moving down - yes
Feeling of incomplete evacuation -yes
Frequency – Once daily / alternate days / more than 2 times in a day - once a day but not complete,feels something is still stuck
Recent change in consistency - yes,consistency keeps changing more frequently since 3-4 months
Constipation – Always / occasional / frequent - yes but not hard and dry stools,but not able to strain much,some discomfort in belly region
Loose motions – Occasional / frequent / Altered with constipation - no
Sounds from abdomen - no
Pain in lower abdomen (belly / tummy) - yes
Bladder (urine related) – Number of times in a day / change in colour and consistency / feeling of incomplete evacuation / more urination at night - 4-5 times a day( no problems here)
Thirst – Specify the number of times you need to take water (including at night) - I drink 3 litres approx a day
Sleep – Less / more / disturbed / lot of dreams / nightmares / always alert / snoring / anything else - little disturbed since few months
Stress – Home / office / both - yes little
Mind - Anxiety / fear / depression / lack of courage / unable to take decisions / concentration / forgetfulness / anger / suicidal tendency / egoism / hatred / anything else - not able to concentrate since few months because of this
Voice changes - no
Skin – Dry / oily / pale / yellowish / Skin diseases if any / Pimples / Reaction to cold and heat or anything else / Known allergens / anything else - don’t know about it
Hair – Hair fall (specify quantity), Nature of hair (thin, thick, few, moderate, dense, patches, bald, early greying, curly, any other colour, anything else) - some hairfall like 7-10 hairs.thick hairs
Nails – Discolouration, change in shape and size (without cutting or trimming), quickly grows / anything else - normal
Eye – Sight and vision problems (specify the type of spectacles / contacts you are using and duration of use) / Type of sight / operations if any / pale / yellowness / tearing / eye irritation / eye strain / secretions / pain / sensitivity to sunlight, cold or anything / anything else - dry eyes(sit in front of laptop most of the time)
Tongue – Coated / clean / frequent mouth ulcers (sore mouth, lips) / foul smell / tastelessness / awkward tastes / specific tastes notices (like you take sweet and feel bitter etc) - clean(use tongue cleaner daily)
Nose – Abnormal smell / not feeling smell / anything else - no problems here
Sex life – Lack of interest / too much interest / infertility / sterility / premature ejaculation / unusual sexual practices - I am single
Energy – Little down since few months
Immunity – good
Common childhood problems - no
Frequent health issues (like stomach upsets, acidity, gases, headache, cold etc) - stomach upsets
Major health issues like arthritis, low back pain, nerve problems, depression, sleeplessness etc - Have had anxiety issues 2 years back.
Family history of problems
Treatment and medicine history, surgery and operations you have undergone (attach recent reports) - none
Priority of complaints which you want to get rid of (most troublesome symptoms or disease for which you are seeking advice or consultation) - stomach upsets,pain in abdomen,feel of fullness,not able to flush out completely feeling.
Seasonal compatibility – You are fine in cold / hot / moderate climate! - Everything is fine to me
Loved foods / drinks – Specify veg / non-veg - Vegetarian(no alcohol),like to drink tea
Foods / drinks / anything which doesn’t suit you - Of late, not able to eat much foods which produce gas
Rank these in the increasing order (as per your likes): Sweet, Sour, Salt, Spicy and hot, Bitter foods - spicy,hot,sweet,salt,bitter,sour
Water intake - 3 litres a day
Exercise - not much
Your preference – Coffee or cold drink, Fan / AC or warm room - tea, Slightly cold room
Favourite colours – (top 3) - Blue,black,white
For women and girls:
Menstrual history – details about monthly periods
Age of onset
Age of stoppage
Number of days of bleeding
Nature and colour changes in flow
Any symptoms like abdominal pain, leg cramps, mood swings, white discharge etc, if yes specify
Abortions / miscarriages
Breast related problems
What medicines are you taking currently? Allopathic or Ayurveda
Please write elaborately. (ayurveda - ama pachak vati,yakrit rasanayam,triphala) Allopathy - Linzess for IBS - C
The shape,texture and consistency of bowel is always different, they are semi solid types, or even solid then loose types. Even though if I have complete evacuation too, I know there are no stools in the gut. My stomach is kind of bloated.And when I try to push my abdomen inside,I cannot do it much, and I cannot feel it much. And I am having heaache mostlyon forehead, and am not able to concentrate,difficult to remember things,always feel that something is happening in stomach,some force,not force to go to bathroom,it is something different,its like some churning,no proper sleep due to this,eyes too burning little.You can say am not much in senses due to headache. My mind and my gut are not in sync,I do not get much feeling to have a bowel movement to have a bowel movement.It is because of Psyllivac Powder that I take, I have a bowel movement.Also my sleep is disturbed,I do not get a good sleep,I do not feel refreshed when I wake up in morning.And also do not feel energetic. I hope am not in something serious illness.
let me understand the pathology then will decide
Thanks for contacting Ayurveda with your health concern and before opting for Ayurveda management do let me furnish details from my side in understanding of your case history and then let me know how the latter fits in your medical history for further line of treatment:
1. Since regular/chronic use of laxative is an important cause of constipation since with prolonged use the colon becomes dependent upon laxative for evacuation [similar seems to be the cause with you]
2. As you have suffered a lot [mentally], independently as well as due to constipation thus this resulting 'mood disorder' [depression] causes decrease in level of neurotransmitters like norepinephrine and serotonin resulting in decrease nerve excitation and thus slow transit of bowels and resulting constipation.
3. Are medical causes like: underactive thyroid [hypothyroidism],diabetes, hyperparathyroidism,autonomic neuropathy,multiple sclerosis,pelvic muscle problem or surgical issues excluded?
4. As it was said earlier by a Doctor that 'stool is stuck in large intestine' was it fecal impaction or constipation?
5. please revert back with your clarifications, in the mean time one can safely use the following:
. take purgation with olive oil [non dependence and free from side effects]
. take 10 cashewnuts + 5 raisins in morning [empty stomach] or boil them in water for 15 minutes,later filter the water and drink
. take 1 tablespoon of apple juice [concentrated] and mix in water and drink
6. Since IBS is a psychosomatic disease [manodaihik vikaar] thus can be considered as a possible culprit in you [if other conditions are excluded] and in Ayurveda I usually treat it on the line of "GRAHANI"
Dr. Munish Sood
direct online link: bit.ly/drmunishsood
2.You can exclude any other diseases. I was very healthy and fit and am know too healthy, I do some walk and play some sports too.
3. I do not know if it is ibs or not, allopathic doctor said it ibs,but I cannot trust them,he didn't even talk to me for more than 10 mins.Ayurvedic doc said it is a slight ibs and interference of doshas.
4. Can I ever recover 100% from this. I take ashwagandha sometimes,I also XXXXXXX XXXXXXX vati,which shall I take to have a good sleep.Is it possible to recover and have a good 8 hrs sound sleep again ? I have a lot of trust in Ayurveda and I ny self have practiced yoga 2 years continuously before and I know it's wonders. I want to do yoga k
now too,but till I don't get good bowel movement,it is very discomforting to do yoga. I haven't done yoga since 2 years.
5. Shall I continue taking medicines which ayurvedic doctor has prescribed? 20 daysGandhak Vati,kravyad Ras, dhanwantara ghulika then 21st day Mebarid,kutajadi, Arogyavardhini vati, chitrakadi as reserve. If I can recover,then how much time will it take to be like I used to be before,if I follow all your recommendations.
6. I do not know if it was constipation or faecal impaction. Doctor had said that 2 corners of large intestine, faeces is stuck, and given few medicines ,with that I got some relief, but my constipation was not gone. I hope I have elaborated little more and have covered questions you asked.
Also, am not able to concentrate at all to my studies. It is almost impossible to study,as things dont go into my brain easily and it is almost impossible to learn new things as I am not able to grasp it. I know it is all related to my gut-brain sync.
Thanks for reverting back.
Since [as you said] one can safely exclude the medical causes as aggravating factor for constipation thus we have to break this vicious cycle of [Stress-constipation-anxiety] which is hampering your daily routine and activities, as such one has to be gradual in her approach and management is three dimensional and once your body get accustomed to the dietary regime and lifestyle management you can adjust all three in one.
A. FOR VISHAD-AVSAAD [DEPRESSION]
i. If problem falling asleep at night:
. avoid caffeine found in coffee, tea, chocolate, cola, and some pain relievers
PS. [four to six hours before bedtime.]
ii. avoid stressful, stimulating activities like doing work, discussing emotional issues.
PS. Physically and psychologically stressful activities can cause the body to secrete the stress hormone cortisol, which is associated with increasing alertness.
iii. take dinner 2-3 hours before bedtime and avoid foods that cause indigestion. [spicy-heavy- junk food]
iv. practice relaxation techniques like yoga, meditation but also Pranayam [anulom vilom] which will strengthen the relaxation response of body as opposite to stress response during panic attacks, i.e. don’t try to flee away from the situation which will reinforce the perception that your panic attacks are unbearable [remember they are uncomfortable but not life threatening], allow the symptoms to pass and you will gain ability to cope with them
PS. Yoga poses [Dhanurasana, Matsyasana, Janu Shirsasana, Paschimottanasana, Hastapadasana], hot shower and massage are simple techniques to overcome tension from anxiety
v. Since the said problems can be grouped under GAD [generalized Anxiety disorder], Dietary Regime and Lifestyle management along with Medicine is in accordance with “manovaha srotas vyadhi”
. Avoid: alcohol, pepper, garam masala, mustard oil, pickles, rye, spicy food, anger, grief, fear, late night waking, garlic, ginger, onion
. Take: mint, coriander, tomato, and cumin, plenty of water, vitamins and mineral supplements, apple, banana, grapes, dates
vi. Lemon juice mixed with sugar in a glass of water helps release stress removing hormones from the body and bring mind at peace/rest.
vii. Apple, almond, banana, broccoli, cantaloupe, melon, carrot, cashew nut, corn, cauliflower, grapes, guava, lemon, XXXXXXX orange, pineapple, soybean, spinach have anti oxidant and detoxifying properties so take them in plenty.
viii. brahmi vati 2
sarphagandha ghan vati 2.... at bed time with milk
.ashwagandha arishta: 20 ml
sarasvta arishta: 20 ml [after meals with equal amount of water]
PS. Prescription drugs and procedures available for this problem are: sarpagandha, khus, jatamansi, bramhi, kevada, vacha, tagar, amla, XXXXXXX XXXXXXX ras, mahakalyanak ghrita, manasmitra vatkam, XXXXXXX vati, mann XXXXXXX vati, Ashwagandharishta, sarasvatarishta, stresscom, nasya karma
ix. Since drug therapy is generally only a palliative treatment, we have to look at cognitive and behavior strategies thus you should consult with your health care professional for CBT [cognitive behavioral therapy] to identify and counteract negative thoughts.
B. FOR VIBHANDHA [CONSTIPATION]
i. Take: old brown rice, green gram, papaya, radish, bottle gourd, plenty of fluids, walking, musk melon, dates, SUDATION/ENEMA [Panchkarma Chikitsa]
ii. Avoid: newly harvested rice, black gram,peas,potato,late night awakening.
- Capsule/Tablet Herbolax [Himalaya]: 2-3 before dinner with warm water.
PS. the dosage is best individualized
- Abhyarishta : 30 ml with equal amount of water [twice daily]
C. FOR GRAHANI [IRRITABLE BOWEL SYNDROME]
i. Take: old brown rice,green gram,pigeon pea, banana, butter milk, honey, soup, cumin, coriander,carrots,honey mixed water,barley.
ii. Avoid: peas,wheat,garlic,vinegar,milk, jaggery, sour/hot spicy things, late night awakening, drinking excess water, excess physical exertion, lady finger, potato, elephant yam, cucumber,black gram, dry fruits,cold (air/water/sweet).
iii. panchamrit parpati: 250 mg
fried hinga [asafoetida]: 125 mg
fried jeera [cumin seeds]: 250 mg.. and take with honey thrice daily.
- soak 5 gm amla in water, when become soft, crush them and add black salt [quantity sufficient], and make lozenges of 125 mg and suck twice daily.
iv. kutjarishta 20ml
jeerakdyarishta 20ml.. mix with equal amount of water and take twice daily after meals.
v. Chitrakadi vati/tablet amoebica: 2 tablets before meals.
vi. Bilagyl Avleha: 2 tsf with lukewarm water.
D. ENTERIC NERVOUS SYSTEM [ENS]
Since it has its own independent reflex activity and almost separated from autonomic nervous system thus it is possible that irritation of this sends signal to brain [CNS] that might cause mood disorders so we have to control the hypersensitivity of the gut by adopting the psychosomatic treatment.
PS. Read more about the ENS and let me know about further queries and clarifications [if any] and if Interested I can courier you the medicine
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