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One should pass stools twice a day — once after getting up from bed and once in the evening. This is more essential for vegetarians because their food contains lot of roughage. Some people, however, evacuate their bowels only once in day, usually in early morning. For them it is normal. They do not suffer from any discomfort because of the non-movement of bowels for the second time. This habit is commonly found amongst city- dwellers whose evening programmes are uncertain. The roughage content of those who take non-vegetarian diet is so little that they do not feel any discomfort even if it remains inside the intestines for 24 hours or more. In European countries where people live mostly on meat, they pass stools once in three or four days, and they consider it normal.

Apart from the roughage from food, stool contains some metabolic waste products. They come out from the blood. Therefore, even if a man does not take anything, he has to pass stools, because the metabolic process that is going on in his body yields some waste products which are to be eliminated only through stools. If they are not eliminated, they cause lot of discomfort locally in the abdomen. There is wind formation, heaviness in the stomach, and loss of appetite. It may also result in headache, sleeplessness and even high blood pressure. Some diseases like asthma, bronchitis, chronic cold and tonsillitis are associated with constipation and once the constipation is removed, the disease automatically disappears. It is therefore, necessary to take care of constipation well in time.

Chronic constipation may be caused by (a) poor bowel habits, improper eating habits, irritable colon, spastic colitis or emotional disturbances; or (b) paralytic or mechanical obstruction to the passage of stools. Such things as adhesions, tumours of the bowel, structure of the anus, or rectum, or inflammatory conditions may produce organic constipation.

Ayurvedic Treatment for Chronic constipation: Triphala powder is very popularly used by ayurvedic physicians for the treatment of chronic constipation. It contains three drugs, namely, haritaki, bibhitaki and amalaki. Of these three drugs, haritaki alone works as a purgative. But while manifesting its action, it produces some adverse effects like gripping pain and wind formation in the stomach. To prevent the adverse effects of this drug and to make it more useful as a tonic, the remaining two drugs are added. Haritaki taken alone works as a strong purgative in the beginning, but as days pass by, it does not produce that purgative effect. When added with the remaining two medicines, the purgative effect of this drug continues for a prolonged period. Thereafter, even if purgative effect of this drug is not manifested, it is useful to the patients suffering from constipation because it indirectly helps the bowels to move by stimulating the liver.

Triphala powder is used in two different ways. One or two teaspoonfuls of this are mixed with a cup of warm milk, and some sugar is added to it. The whole thing is taken hot at bedtime. It does not cause any motion during night and its purgative effect is manifested only in the early morning. In the case of persons having chronic constipation and simultaneously a costive bowel, the powder alone does not help. It is to be taken in the form of a decoction. The decoction is prepared by boiling 20 gm. of the powder in 16 times of water and reducing it to one-fourth. Then the powder is to be filtered and the liquid is to be given to the patient.

For those having laxed bowel, triphala is used in a different manner. In a glass of water, one teaspoonful of triphala powder is soaked overnight. In the morning, it is filtered with a clean cloth. The liquid is taken internally. It is a little astringent in taste and may not be liked by children and people having tender habits. It is, therefore, necessary to add about 2-4 teaspoons of honey with a view to make the potion sweet in taste. Processing of triphala in this way is called Shita kashaya.

There are many other medicines which help in removing chronic constipation by strengthening the intestinal valves and their functions. They also cure inflammatory conditions of the intestine. One such drug is known as Agastya rasayana. Two teaspoonfuls of this drug should be taken regularly, .twice a day with any hot drink of choice. Slowly it relieves the individual of his constipative tendency. As the very name indicates, it is also an excellent tonic.

Diet to taken by Chronic constipation patients: The patient suffering from chronic constipation should be advised to take fruits, leafy vegetables and fruit juice in plenty. Wheat is better than rice. The bran of both rice and wheat are useful in relieving constipation. The patient should, therefore, use whole meal flour and not refined flour. Similarly, he should use rice along with its bran, and not polished rice. Among the vegetable, surana and papaya are very useful in relieving constipation. Fried things, pulses and preparations of pulses are extremely harmful for patients suffering from chronic constipation. There are some vegetables which work in both ways — spinach relieves constipation of patients and it also produces constipation tendency in some patients who are suffering from chronic diahorrea. Same is true about banana and papaya. Taking sugarcane juice is very useful for relieving constipation.

Other regimens: Regularity in the habit of evacuating bowels, is very important for a person to keep himself free from chronic constipation. Whether he gets motion or not, he should attend to the call of nature. Persons who are given to sedentary activities are often exposed to constipation and constipation produces several other diseases like fistula and piles in them. It is, therefore, necessary that persons suffering from chronic constipation should undertake some physical exercises regularly. Walking a few kilometers is also sufficient for a person to get himself relieved of his constipation. Excessive intake of tea and coffee is harmful for such person. Mental worries and anxieties have a great role to play in causing constipation. It is, therefore, necessary that the patient should change his daily habits and lead a care-free life to keep himself free from this ailment.