Qabz (Constipation)

Introduction

Constipation (qabz) also known by variety of names such as Husr, Ehtebaas-al- batan, Eátaqaal-al- batan, Ehtabas-al- tabiya, Eátaqaal-al- tabiya  and Imsaak-ul- batan.

It is a condition in which an individual experiences infrequent or uncomfortable bowel movements or it is a condition of delayed defecation, where the quantity of stool reduces and becomes hard to pass.

According to some authors it is a condition in which an individual experiences difficulty in emptying the bowels, usually associated with hardened faeces. It is more common among children, aged ones and pregnant women. Women suffers more than men. In elderly population, about 70% people are affecting or complaining about constipation. It is the most common gastrointestinal complaint all over the world resulting in over two million reported cases annually.

Constipation (qabz) may be occasional or habitual. Generally, a person is considered to be constipated when bowel movements result in the passage of small amounts of hard and dry stool. Every individual has different bowel patterns.

In new-born babies and infants, main cause of constipation is “Bottle Feeding” as it is not digested easily and even properly in comparison to mother’s milk. Breastfed babies have a hormone called “Motiline” that helps in bowel movement. Bryan cereal should be preferred with babies to relive from constipation.

The major cause of the constipation is due to low fibre diet, dehydration or dieting. Some of the symptoms associated with constipation are bloating, sluggishness and being uncomfortable. In general constipation is not a serious problem. Understanding the right cause will help in preventing constipation.

Causes of Constipation (Qabz)

According to Unani Medicine, constipation (qabz) is caused by intake of less quantity of food, consumption of constipative and flatulent diets, decreased repulsive force or increased retensive force of intestine, weakened intestinal sensation and muscles, excessive absorption of chyme by the liver, decreased flow of secretions towards intestine and weakened heat of stomach and intestine (Zo’f-e- hararat-e- meda wa ama’a).

As per classics of Unani medicine, Constipation (qabz) is a boon of faulty lifestyle and wrong dietary pattern. Causes like untimely, unbalanced food habits, irregular sleeping habits, and low physical exercise are few of them. It is also mentioned that constipation is the mother of all diseases. It causes gastritis, piles, duodenal ulcer and severe abdominal pain.

Signs and Symptoms of Constipation (Qabz)

Some commonly seen signs and symptoms in constipation patient include darkness of tongue, food digestion takes long time, stools become yellowish in colour, difficulty in passing stool, fetid/ bad breath, bowel movement problem, abdominal bloating, cramps and uneasiness, excessive gas, loss of appetite, feeling of inactiveness, rectal bleeding in case of acute constipation, nausea, vomiting, weight loss, headache and dizziness, and hard, dry and small faecal formation. Etc.

Common Causes of Constipation (Qabz)

• Insufficient dietary fibre intake or not having enough roughage in diet
• Diet deficient in leafy, green vegetables and salads
• Low fluid/ water intake and dehydration
• Decreased physical activity/ Lack of exercise
• Heavy intake of dairy products, meats, refined sugar and eggs
• Excessive use of strong tea,  coffee and alcoholic beverages
• Slimming and dieting pattern
• Haemorrhoids, Intestinal obstruction, Irritable bowel syndrome (IBS)
• Stroke, anxiety and stress
• Weak bowel muscles and Colonic inertia
• Certain medications like usage of Diuretics, antidepressants, anticonvulsant, antihistamines, Excessive intake of calcium, Iron tablets and overuse of laxative and suppositories (use to soften stool) etc.
• Long bed rest
• Over eating and insufficient chewing
• Other colon and rectum problems
• Frequent travelling
• Hormonal imbalance during pregnancy and menstrual periods
• Ignoring the urge to have a bowel movement

Risk factors of constipation (Qabz)

• Old aged person
• Sedentary and deskbound work habits
• Bed-ridden
• insufficient liquids/ water intake
• Certain medications
• Insufficient intake of dietary fibre

Complications of Constipation (Qabz)

• Haemorrhoids (piles)
• Faecal impaction in large intestine and rectum
• Faecal incontinence
• Rectal prolapse (coming out of rectal tissue from anus)
• Anal fissure
• Rectal bleeding
• Hernia

Management of Constipation (qabz)

Principles of Treatment (Usool-e- Elaaj)

As per Unani philosophy the basic principles which are followed for the management of constipation (qabz) are:

1. Removal of underlying cause/ Treatment of the cause
2. Improvement of digestion and correction of hepatic insufficiency
3. Laxation of bowels (Talayin-e- Taba’)
4. Removal of constipation (Rafa-e- qabz)
5. Toning up of intestine (Taqwiyat-e- Ama’a)

Some Common Unani Prescriptions

• Take 6- 12 gm of Aspghol husk (Plantago ovata, Forsk.) along with milk or lukewarm water and take daily at bed time to get relief from constipation.
• Take 6-10 ml of Roghan-e- Badam (Almond oil) with lukewarm milk at bed time is useful for constipation.
• Take 6-10 ml of Roghan-e- Bed-e- Anjeer (Castor oil) with lukewarm milk at bed time is useful for constipation.
• Oral administration of safoof banafsha (powder) (Viola odorata Linn.) mixed with equal quantity of sugar at bed time with lukewarm water.
• Oral administration of crushed Anjir (Ficus carica Linn.) 10 parts, Maghz-e- Qurtum (seed kernel of Carthamus tinctorius Linn.) 1 part in dose of 21 gm.
• Local application of pessary made up of soap, especially in children.
• Grind 25 gms. Halailah siyah (Terminalia chebula- Black variety) and 25 gm of Almond (Prunus amygdalus) separately and add honey. The mixture may be taken twice a day. It is useful Unani remedy for constipation and piles.
• Take equal quantity of sana (Cassia senna), sonth (Zingiber officinale), sonf (Funiculum vulgare) and sendha namak. Grind it properly, use at bed time to cure constipation. The mixture is verf effective Unani treatment for constipation.
• 10 gm of Itrifal Zamani should be taken with lukewarm water before going to bed.
• Take 2 table spoon full of Itrifal Mulayyan to treat constipation that is recommended with warm water at bed time. It is a valuable Unani medicine for old age.
• Take about 30 ml of Sharbat-e- Arzani mix it with half cup water. It is a good mixture for constipation.
• Gulqand and Majoon Anjeer are also very beneficial in constipation patients.

Homemade remedies for constipations (Qabz)

These Homemade remedies can cure constipation naturally. One can find natural constipation relief by using these remedies/ through the items that is present in kitchen or at home. Few constipation homemade remedies are mentioned to tackle constipation naturally.

• Take Luke warm milk before going to bed.
• Take ripped Bel fruit, as it is excellent for avoiding constipation.
• Eat Guava in sufficient quantity as it provides roughage and gives relief from constipation.
• Mix 6-10 ml of castor oil in Luke warm milk, it will help in treating chronic constipation.
• Drinking 3-4 glasses of water early morning in empty stomach helps in bowel movement and passage of normal stool.
• Add more fibrous fruits and leafy green vegetables in your diet.
• Taking 2tsp of molasses is good to treat constipation.
• Sleep at least 6-8 hours.
• Consume properly cooked vegetables to avoid constipation.
• Eat your foods whenever you are feeling hungry only.
• Use spices like zeera siyah/ cumin (Cuminum cyminum Linn.), haldi/ turmeric (Curcuma longa) and dhania/ coriander (Coriandrum sativum Linn.), all helps to digest your food.
• Avoid excessive non-vegetarian, deep fried, junk food etc.
• Cabbage juice (Brassica oleracea Linn.) is very beneficial in treating constipation.
• Heat some dry grapes (Vitis vinifera Linn.) in milk, drink it after straining. It is a potent remedy for constipation.
• Take Spiegel seeds/ kalaunji or shooneez (Nigella sativa Linn.) mix it with luke warm milk. Add some sugar. It is very good for constipation.
• Common Pear (Pyrus communis Linn.) is helpful in chronic constipation.
• More fibrous nature of orange easily digests the food and helps in bowel movement.
• Fruits like papaya (Carica papaya Linn.) and figs (Ficus carica Linn.) act like as cleanser for the bowel.
• Fennel seeds (Foeniculum vulgare Mill.) are beneficial in the treatment of constipation.

Some commonly used Unani Compound Formulations

Roghan-e- Bed-e- Anjir, Sharbat-e- Deenar, Sharbat-e- Banafsha, Sharbat-e- Mulayyin, Itrifal Mulayyin, Habb-e- Ghareeqoon, Habb-e- Muqil, Habb-e- Mulayyin, Sharbat-e- Anjir, Majoon-e- Anjir, Qurs-e- Mulayyin.

Regimenal Therapy (Ilaj Bil Tadbeer)

Hammam (Medicated Bath) at empty stomach.

Dietary Recommendations

Diets should be mostly of fresh vegetables. Ma’ul Jubn, Dry fruits like fig, Almond apricot and dates, Maweez Munaqqa (Vitis vinifera Linn.) are recommend to the constipation patients. Food should be properly chewed. Wholesome diet, fruits, boiled vegetables and soup is a good remedy for constipation as well as for good health because of enriched nutrition. Fresh Vegetables like radish, turnip, peas, carrot, tomato, bitter gourd, beetroot, sprouts, coriander, cabbage, mints are useful to relieve from constipation. Eat fresh fruits like avocado, guava, mango, orange, jamun, papaya, grapes, etc. Increases the quantity of salads in your diet. Increase the intake of watermelon, mangoes, cucumber after taking foods. Drink more quantity of water. Eat whole grain cereals, bran, honey and lentils. Milk products like butter, ghee and cream.

Dietary Restrictions

Avoid Aghziya Munaffikha (Flatulent diets), Aghziya qaabiza (Constipative diets), Aghzia Ghaleeza (Viscous diets). Apart from that fast foods, alcohol, coffee and strong tea should be avoided. Restrict your non-vegetarian diet, fried foods, oily and junk foods. Bread, cakes, pasta, maida, pizzas, burgers, cookies too responsible for constipation and comes under as unhealthy diet. Cheese, Yoghurt also cause constipation- avoid them. Avoid spices, fats, excessive salt.  Avoid white flour, biscuits, preserves, white sugar, boiled egg etc.

Prevention/ Precaution (Tahaffuz)

Regimens causing constipation must be avoided. Life style modifications and modification in dietary intake play important role to overcome the disease. Some precautionary measures for avoiding constipation include increased body movement and exercise, walking or light exercise in open air in the morning is beneficial. Increase of fluid intake, and dietary changes including increased fibre and fruit and salads. Apple-pear juice is also highly recommended; and stewed fruits like prunes, figs, or dates are highly beneficial.

References

http://welfarehab.org/dieses/Constipation%20Cure%20and%20Treatment%20through%20Diet.pdf

http://www.unaniherbal.org/herbal-medicine-acute-habitual-constipation.html

http://healthyunani.blogspot.in/

http://desimedicine.blogspot.in/2012/04/constipation.html

http://www.ashshifa.com/kasiniforvariousdiseases.htm

http://www.medindia.net/homeremedies/constipation.asp

Note:

• Along with medicine the patients have to follow strict regimen as per the concept of Unani system. The patients are therefore, strongly advised to avoid self-medication.
• They are advised to visit the nearest authorized Unani treatment centre for advice and treatment.