Symptoms
The most common symptoms of constipation are infrequency, irregularity or difficulty of elimination due to hard faecal matter. Among the other symptoms are a coated tongue, foul breath, loss of appetite, headache, dizziness, dark circles under the eyes, depression, nausea, pimples on the face, ulcer in the mouth, constant fullness in the abdomen, diarrhoea alternating with constipation, varicose veins, pain in the lumber region, acidity, heart burn, and insomnia.

Causes
The most important causes for chronic constipation are wrong diet and a faulty style of living. All foods in their natural state contain a good percentage of ‘ropughage’ which is most essential in preserving natural balance of foods and also in helping peristalsis - the natural rhythmic action by means of which the food is passed down the alimentary canal. Much of the food we eat today is very deficient in natural bulk or roughage and this results in chronic constipation.
Intake of refined and rich food lacking in vitamins and minerals, insufficient intake of water, consumption of meat in large quantities, excessive use of strong tea and coffee, insufficient chewing, overeating and wrong combination of foods, irregular habits of eating and drinking may all contribute to poor bowel function. Other causes include faulty and irregular habit of defeacation, frequent use of purgatives, weakness of abdominal muscles due to sedentary habits, lack of physical activity and emotional stress and strain.
Diseases such as tumours or growths, a sluggish liver, colitis, spastic condition of the intestine, hyperacidity, diseases of the rectum and colon, bad teeth, uterine diseases, diabetes, use of certain drugs for treating other ailments, abnormal condition of the lower spine and enlargement of the prostate glands can also cause chronic constipation.

Treatment
The most important factor in curing constipation is a natural and simple diet. This should consist of unrefined food such as whole grain celerals, bran, honey, molasses, and lentills; green and leafy vegetables, especially spinach, french beans, tomatoes, lettuce, onion, cabbage, cauliflower, brussels, sprouts, celery, turnip, pumpkin, peas, beets, asparagus, carrot; fresh fruits, especially pears, grapes, figs, papayas, mangoes, grapefruit, gooseberries, guava and oranges ; dry fruits such as figs, raisins, apricots and dates ; milk products in the form of butter, ghee and cream.
The diet alone is not enough. Food should be properly chewed-each morsel for at least 15 times. Hurried meals and meals at odd times should be avoided. Sugar and sugary foods should be strictly avoided because sugar steals B vitamins from the body, without which the intestines cannot function normally. Foods which constipate are all products made of white flour, rice, bread, pulses, cakes, pastries, biscuits, cheese, fleshy foods, preserves, white sugar and hard-boiled eggs.
Regular drinking of water is beneficial not only for constipation but also for cleaning the system, diluting the blood and washing out poisons. Normally six to eight glasses of water should be taken daily as it is essential for digesting and dissolving food nutrients so that they can be absorbed and utilised by the body. Water should, however, not be taken with meals as it dilutes the gastric juices essential for proper digestion. Water should be taken either half an hour before or an hour after meals.
Generally all fruits, except banana and jack fruit, are beneficial in the treatment of constipation. Certain fruits are however, more effective. Bael fruit is regarded as best of all laxatives. It cleans and tones up the intestines. Its regular use for two or three months throws out even the old accumulated faecal matter. Though generally used to check diarrhoea, bael contains both laxative and constipative properties. It hardens the stools when they are loose and serves as a laxative when the bowels are constipated. It should be preferably used in its original form and before dinner. About 60 grams of the fruit will suffice for an adult.
Pears are regarded the next best fruit beneficial in the treatment of constipation. Patients suffering from chronic constipation should better adopt an exclusive diet of this fruit or its juice for few days, but in ordinary cases a medium-sized pear taken after dinner or with breakfast will have the desired effect. The same is true of guava which, when eaten with seeds, gives roughage to the diet and helps in the normal evacuation of the bowels.
Grapes have also proved highly beneficial in overcoming constipation. The combination of the properties of the cellulose, sugar and organic acid in grapes make them a laxative food. Their field of action is not limited to clearing the bowels only. They also tone up the stomach and intestines and relieve the most chronic constipation. One should take atleast 350 grams of grapes daily to achieve the desired results. When fresh grapes are not available, raisins soaked in water can be used. Raisins should be soaked in a tumblerful of drinking water for 24 to 48 hours. This would swell them to the original size of the grapes. The raisins should be eaten early in the morning. The water in which raisins are soaked should be drunk along with the soaked raisins.
Drinking hot water with sour lime juice and half a teaspoon of salt is also an effective remedy for constipation. Drinking water which has been kept overnight in a copper vessel, the first thing in the morning will bring good results. Linseed is extremely useful in difficult cases of constipation. A teaspoon of linseed swallowed with water before each meal provides both bulk and lubrication.
In all ordinary cases of constipation, an exclusive fruit diet for about seven days would be the best way to begin the treatment. For long-standing and stubborn cases, it should be advisable to have a short fast for four or five days. This will drive out the packed contents of the bowels, eliminate toxins and purify the blood stream. Weak patients may take orange juice during the period of fasting. After the all-fruit diet or the short fast, as the case may be, the patient should gradually embark upon a balanced diet comprising adequate raw foods, ripe fruits and whole grain cereals. It some cases, further short periods on fruits or short fasts may be necessary at intervals of two months or so,depending on the progress being made. The bowels should be cleansed daily through a warm water enema for a few days at the commencement of the treatment.
A cold friction bath taken daily in the morning can help cure constipation. An alternate hot and cold hit bath taken before retiring to bed is also beneficial. Abdominal exercise and manual or mechanical vibratory massage have a refreshing and stimulating effect in many cases.
Toning up the muscles also helps in the treatment of constipation. Fresh air, outdoor games, walking, swimming, gardening and exercise play an important role in strengthening and activating the muscles, thereby preventing constipation .
Certain yogic asanas also help to bring relief from constipation as they strengthen the abdominal and pelvic muscles and stimulate the peristalic action of the bowels. These asanas are :bhujansana, shalabhasana, yogamudra, dhanurasana, halasana, paschimotanasana. Pranayamas such as anuloma-viloma and bhastrika and jalaneti kriys are also helpful.

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