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Tired of not pooping?  Being constipated is frustrating.  It’s uncomfortable, there’s often bloating involved, and then there’s the crankiness.  But so many have learned to live with these symptoms.  I often overhear conversations where constipation and diarrhea are confusing and tiring, but it seems they’re the new normal

Gut issues seem to be the Cinderella of the medical world – the neglected younger sister.

The brain is fascinating and we love to study the neurology and neurochemistry of it.  We all know to protect it: wear your helmet when you ride a bike.  But the gut?  Unless something really major is happening, the gut often doesn’t get much thought.

What is going on down there?  Why does stress so often lead to constipation – or its companion, the Big D?  We’ll talk about the latter in a future article, but for now, let’s talk about what stops us up and causes constipation.

Our digestive system is controlled by our enteric nervous system.  It’s got its own nervous system which functions separately from the brain and spinal cord.  It’s so powerful that it’s often called “The Second Brain.”  It has five times as many neurons as in the spinal cord, and about 2/3 as many neurons as are in a cat.

It connects to the autonomic nervous system (Fig 1):Autonomic nervous system main figure Blessing

But it has its own nervous system entirely (Fig 2):Enteric Nervous System

Our body is constantly running all of these systems (Fig 1) all of the time.

When a little extra stress hits us, it takes the juice out of our gut to send it to the other “fight or flight” systems of the body.

This is why our bellies react – maybe they shut down and we lose appetite, or sometimes they get too much stimulation and we get lose bowels.

Detoxes are commonly recommended by natural health providers for everything from indigestion to chronic disease, including the C-word.  Why?  Because everything starts in the gut, and if toxins aren’t getting cleared out, they build up and in concentrated form seep back into the digestive system.  So even though a little constipation might not seem like a big thing, it is.  It is absolutely important to get and keep the bowels moving well and regularly.

There are several different causes for constipation.  Possibilities include:

THE LIVER.  The liver creates bile and sends it to the gallbladder for storage and condensing, bile is primarily responsible for the breakdown and metabolism of fat in the body.  It is also a way to excrete excess cholesterol and the waste products from breaking down red blood cells, called bilirubin.  If the bile that is created is too thick, or too weak, or if the gallbladder has been removed, this process will be interrupted.  Chinese medicine differentiations may include: Liver Qi Stagnation, Liver Fire.  Symptoms will be: constipated bowel movements (BM) will  be hard at first, shift to soft, or like pebbles.  There will be gas and bloating, irritability, stress, and depression.  Tongue: normal, Pulse: wiry.

THE LARGE INTESTINE.  Funny that wasn’t first, but so many times the root of constipation is from liver problems.  Accumulation of  heat or damp heat in the large intestine.  Symptoms are: constipation with the Four Bigs: Big Fever, Big Thirst, Big Pulse, Red Face.  Constipation with abdominal distension and pain.  Possible delirium, solid mass.  Restless.  Tongue: red with yellow coating, Pulse: Rapid, full.

QI DEFICIENCY.  This happens if there simply isn’t enough energy to push the bowels.  Most commonly happens in mature population, or post surgery.  Symptoms: constipation with fatigue, shortness of breath.  Sweating during BM. BM itself likely not hard, just difficult to pass.  Face may be pale, appetite low, soft voice. Tongue: pale, Pulse: Thin, deep.

KIDNEY YANG DEFICIENCY: More extreme than just qi deficiency.  Symptoms: constipation with qi deficiency symptoms AND cold hands and feet, cold sensation in the abdomen and possibly the back.  May have edema of the legs.  Frequent clear urination, impotence and decreased libido, pale face, desire for warmth.  Tongue: pale and swollen with moist white coat, Pulse: Deep, weak, and slow.

Many years ago when I had a serious illness I was trying to better understand because no Western doc could help me, I found and read “The Web That Has No Weaver.”  It was an excellent introduction to Chinese medicine, and inspired me to further explore Chinese medicine.

So now that you likely have a better understanding of what the cause of your constipation is, and what symptoms to start observing in your body, let’s give you a few things to try outside of clinic.  If those aren’t enough, be sure to schedule an appointment: either in-person or via phone.

In order of priority:

Lifestyle for constipation:

Exercise is the number one activity that moves the bowels.

So much so that if you haven’t been exercising and you go for a run – plan to run by a bathroom, or in a loop around your house.  Better to do 2 or 3 laps and have access to a bathroom than 1 big loop and not have one when you need it!

Pressure points for constipation:

The general rule with pressure points is: if it hurts, try rubbing it!  Some places to try are:

LI4: You know, that one between your thumb and forefinger that’s good for headaches.  It’s on the large intestine channel, and can also help with constipation.  Try it!

RN6: This is located 3 finger widths (yes, that’s right, bodies are measured by your own ratios in Chinese medicine.  Three of your own finger’s width) below your belly button.

RN12: Follow your sternum down towards your belly button till you run out of bone.  For you anatomy geeks, this will be just south of the zyphoid process.  Gently rub here, preferably on an empty stomach.

ST36: The very famous, very powerful, very effective point.  It is the command point of the abdomen, and holds five different classifications. If this point were in the military, it would be a 5 Star General!  Find it by putting your thumb in the lower outer border of your knee, that bit that feels like a little indention.  Where your pinky lands, on the outside of the shinbone, is where ST36 is.


*Note: the practitioner is showing this with the forefinger in the knee indention.  When locating on yourself, it is more accurate to use your thumb in the indention, because your fingertips are more narrow than the meat of your fingers.  If finding this on someone else, it is more accurate to use the method pictured above.

Acupuncture for constipation:

These are some of the classic points used for constipation.  Your practitioner may or may not use these on a given day, it depends on your pattern differentiation and their style of training.

Stomach 25: The Front Mu point of the Large Intestine

Urinary Bladder 25: The Back Shu point of the Large Intestine (tough to reach on your own)

San Jiao 6

Kidney 6

Stomach 37: the lower He Sea point of the Large Intestine

Herbs for constipation:

Senna: this moves the bowels, but it’s addictive long-term.  Meaning that your bowels will have problems moving on their own if you take this for a long time.  It’s in Smooth Move tea, and many herbal laxative solutions.

Aloe: Aloe drink may help to bring moisture into the intestines.

(We’ll do a full article on this in a future post, but here’s a great source now: https://www.chinesemedicineliving.com/uncategorized/constipated-these-foods-will-help/.)

If your constipation lasts longer than a day or two, please book an appointment with your acupuncturist or nutritionist: there may be more complicating factors to address.