Constipation is a common problem which usually refers to persistent, difficult, infrequent, or seemingly incomplete defecation. Other expressions of constipation include passage of unduly dry and hard faeces, sluggish action of bowel, etc. It is important to note that it is virtually impossible to define what constitutes a “normal bowel movement” in terms of frequency. Generally, frequency of bowel evacuation varies from person to person. As per a person’s tendency, lifestyle and dietary habit, frequency of defecation of 1-2 per day to thrice a week is considered as normal bowel habit for that individual, unless it creates any discomfort or disturbs his routine life. The volume of stool passed differs greatly in different races.
Various causative factors for constipation are given below.
(1) Irritable bowel syndrome
(2) Related to diet factors:
- Too bland food, e.g. with low fibre residue
- Too dry and astringent food
- Inadequate fluid intake
(3) Intake of hard water
(4) Metabolic disease like hypothyroidism
(5) Obstructive diseases of lower gastrointestinal tract
(6) Drugs: opium, iron, blood pressure medicines
(7) Irregular bowel habit
(8) Sedentary lifestyle
(9) Depressive disorders
(10) Old age
(11) Suppression of natural urge of defecation
In Ayurveda, various laxative drugs are mentioned to treat such conditions. Out of these Haritaki powder is a simple herbal laxative which is frequently used for treating constipation following certain lifestyle changes. Some do’s and don’ts given in the Ayurvedic texts are helpful in preventing constipation:
(1) Persons suffering from constipation should not ignore defecation urge nor should they strain for a long time to pass out stools.
(2) Drinking of warm water and milk improves intestinal movements and is beneficial in relieving constipation.
(3) Much deviation from the normal timing of meals and quantity of food should be avoided. It is beneficial to take soft, digestible and semi-solid food.
(4) Heavy and untimely meals, eating food before the digestion of earlier food, and intake of dry, astringent and cold foods hamper intestinal movements adding to constipation.
(5) Regular walking, physical activity and deep breathing and certain edibles like, ginger, lemon, resins, dates, figs and almond oil help in alleviating constipation.
Dose and mode of administration
To achieve laxative action of Haritaki, adult dose of powder is 3 to 6 grams and for children, the dose of Haritaki is 500 mg to 1 gram, to be taken with lukewarm water once a day on an empty stomach. It is preferably taken early in the morning or minimum three hours after dinner.
Precautions and safety aspects
(1) No side or toxic effect of Haritaki is reported in classics with its recommended dose. Clinical studies have also shown no adverse effect in patients treated with Haritaki alone or with formulations.
(2) It should not be prescribed to pregnant women. It is safe for the baby if the nursing mother is taking this medication.
(3) The astringent and dry property of Haritaki may induce nausea in sensitive individuals. This may be masked by consuming it in tablet form or by preparing its decoction and adding jaggery to it.
(4) Dose of Haritaki as a laxative varies from person to person according to their constitution, digestive power and bowel habit. Administration of Haritaki should be stopped if the desired effect is not achieved.
(5) Sudden altered bowel habit, alternate diarrhoea and constipation or persistence of the constipation in spite of proper administration of Haritaki, are the signs of some serious pathological conditions inside the gut. Therefore, the underlying cause must be properly investigated and treatment should be taken under medical supervision only.
(6) Too dry a diet should be avoided and a diet with higher fibre content and liquids is advisable for the patient. Regular and proper lifestyle plays an important role in keeping the gut healthy.
References – Traditional Herbal Remedies for Primary Health Care