Constipation
Constipation means infrequent, hard or difficult-to-pass stools, or a feeling of incomplete emptying. Common causes include low fibre and fluid intake, irregular routine, inactivity, some medicines and stress. In Ayurveda it is Vibandha (Sanskrit for constipation), mainly due to aggravated Vata, the energy linked with movement and dryness, which dries and slows the bowel. Ayurvedic care suits people with ongoing constipation who have had medical causes checked and want to improve diet, fluids and routine alongside medical care.
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- Fewer than three bowel movements a week, or hard, lumpy stools
- Straining or a sense of incomplete emptying
- Bloating and abdominal discomfort
Assessment & Treatment
- Consultation on bowel habit, diet, fluids, activity, medicines and stress.
- Warm, moist, fibre-rich meals at regular times, adequate water, and a regular toilet routine.
- Herbal support where suitable, for example Triphala (a traditional blend of three dried fruits). Herbs are not suitable for everyone. Tell the clinic if you are pregnant or breastfeeding, have liver disease, inflammatory bowel disease or a bowel blockage, or take other medicines, as herbs can interact with them.
- For long-standing Vata-type constipation, a doctor may suggest Basti, a medicated enema, or abdominal Abhyanga, a warm oil massage. Research on either for constipation is limited, so both are offered only after assessment. Tell the clinic first about bowel surgery, bowel inflammation, bleeding piles or pregnancy.
Precautions & When to See a Doctor
See a doctor for blood in the stool, black stools, unexplained weight loss, a recent change in bowel habit (especially after age 50), severe abdominal pain or vomiting, or if you cannot pass wind. Also see a doctor if constipation has not improved after about three weeks of self-care, if you have a family history of bowel cancer, or if you feel unusually tired or breathless. Long-term use of strong laxatives should be avoided without medical advice. If you take prescribed medicines, do not stop or change them without talking to your doctor, even if they may be causing constipation. Ayurvedic care here complements medical care; it does not replace it.
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What the Evidence Shows
- A systematic review and meta-analysis of randomised trials in adults found that fibre supplements improve constipation. Psyllium above 10 g a day for at least four weeks appeared most helpful, but the authors urged caution because results varied considerably between studies [1].
- In a 1998 randomised trial, psyllium softened stools better than the stool softener docusate [2]. In an exploratory trial in US patients, kiwifruit, psyllium and prunes each improved constipation symptoms, but psyllium caused the most side effects and kiwifruit the fewest [3].
- An open-label study reported improved straining and other symptoms of functional constipation with a specific herbal formula, but its authors said larger comparative studies are needed [4]. A 2021 review of Triphala Rasayana, a broader rejuvenation formula, suggests possible digestive benefit but does not focus on constipation [5]. A 2017 review of Triphala itself says more research is needed [6].
Psyllium (isabgol) is part of traditional Indian practice and is a fibre supplement. A 2021 systematic review rated polyethylene glycol and senna first-line laxatives with good evidence, and fibre supplements with moderate evidence [7]. Evidence for Ayurvedic herbs and procedures in constipation is limited, so talk with your doctor about which option suits you.
Prepared by the AyurSoul Healthcare team from the published research listed below. Medical review by Dr. Hemlata Soni, BAMS is in progress. This page is for education and does not replace individual medical advice. Medical disclaimer.
Frequently Asked Questions
Is Triphala safe to take every day?
Research has not yet confirmed that taking Triphala every day for a long time is safe, so ask your doctor before daily use, especially if you are pregnant or breastfeeding, have liver disease or take other medicines.
How much water should I drink?
Usually enough to keep your urine pale yellow, adjusted for heat and activity. The doctor will advise if you have heart or kidney conditions.
Can Basti help constipation?
Some practitioners use Basti for long-standing Vata-type constipation, but there is little published research on it for this condition. It is offered only after assessment, and the doctor will check it is suitable for you, for example during pregnancy.
Clinical Research
7 studies: 1 systematic review / meta-analysis, 1 systematic review, 2 randomised trials, 1 clinical study, 2 review articles.
Show the 7 studies
Numbers in the text refer to this list. Each study is labelled by type: systematic reviews and randomised trials are stronger evidence than pilot studies or single case reports.
- van der Schoot A, Drysdale C, Whelan K, et al.. The Effect of Fiber Supplementation on Chronic Constipation in Adults: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. The American journal of clinical nutrition, 2022. Systematic review / meta-analysis PubMed
- McRorie JW, Daggy BP, Morel JG, et al.. Psyllium is superior to docusate sodium for treatment of chronic constipation. Alimentary pharmacology & therapeutics, 1998. Randomised controlled trial PubMed
- Chey SW, Chey WD, Jackson K, et al.. Exploratory Comparative Effectiveness Trial of Green Kiwifruit, Psyllium, or Prunes in US Patients With Chronic Constipation. The American journal of gastroenterology, 2021. Randomised controlled trial PubMed
- Munshi R, Bhalerao S, Rathi P, et al.. An open-label, prospective clinical study to evaluate the efficacy and safety of TLPL/AY/01/2008 in the management of functional constipation. Journal of Ayurveda and integrative medicine, 2011. Clinical study PubMed
- Ahmed S, Ding X, Sharma A. Exploring scientific validation of Triphala Rasayana in ayurveda as a source of rejuvenation for contemporary healthcare: An update. Journal of ethnopharmacology, 2021. Review article PubMed
- Peterson CT, Denniston K, Chopra D. Therapeutic Uses of Triphala in Ayurvedic Medicine. Journal of alternative and complementary medicine (New York, N.Y.), 2017. Review article PubMed
- Rao SSC, Brenner DM. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. The American journal of gastroenterology, 2021. Systematic review PubMed