A moving tale about your bowels - Six degrees of constipation

Many people swear by bananas as a laxative, but don't trust your gut reaction. Traditional Chinese medicine says bananas are not a cure-all when it comes to constipation. The bowels and their movement problems are very complicated, and all about yin and yang. In fact, there are six very different kinds of constipation, according to TCM.

Persistent constipation is caused by a variety of internal energy problems, requiring different treatments.

Excessive heat (yang energy), stagnant energy and insufficient energy or blood may all lead to constipation. Bananas, which are cool yin energy, are good for constipation caused by too much yang energy. But believe it or not, bananas don't help other kinds of constipation.

Which kind of constipation do you have?

Regular bowel movements are important for good health as they eliminate toxins in waste. Buildup of toxins is unhealthy as they can be reabsorbed. Bowel movements less than three times a week with a dry and hard stool is a sign of constipation.

Around 3 to 15 percent of the Chinese population suffer constipation, according to Yang Yuexin, chief of the Nutrition and Healthy Food Branch of the Chinese Nutrition Society.

More city people than rural people suffer constipation as it is linked to severe psychological pressure, fatigue, lack of physical exercise and insufficient water intake.

Persistent constipation may cause acne, facial discoloration, hemorrhoids and damage to the liver and intestines. Constipation in elderly cardiac patients can cause myocardial infarction or necrosis in heart tissue.

The two main causes of constipation are lack of fluid nourishment in the intestines and generally weak internal energy flow, making it difficult to move the bowels, according to Dr Gu Yun, chief physician of the Geriatrics Department of Longhua Hospital attached to Shanghai University of TCM. Problems of the spleen, stomach, liver and kidneys can contribute to constipation.

Excessive heat (yang energy) in the stomach usually causes intestinal dryness and makes it difficult to move bowels. Problems are also caused by insufficient energy in the spleen, stagnation of liver energy (this could cause "pathogenic fire"), insufficient kidney yin energy and generally insufficient yang energy.

TCM classifies constipation into six categories according to their different causes: excessive heat in digestive system, stagnation of energy flow, insufficient energy, insufficient blood, insufficient yin energy and insufficient yang energy.

Many Chinese people automatically assume constipation is caused by excessive heat and eat "cold" foods, like bananas, for relief.

"But bananas and other 'cold' energy foods only work for constipation caused by excessive heat-they won't do any good in other cases," says Dr Gu. In fact, he says, eating "cold" foods can damage the already-weak but healthy energy of a constipated person, worsen the constipation problem and lead to other health problems.

People with chronic constipation should see a doctor.

Those with insufficient energy and blood need to reinforce energy. Those who suffer from stagnating energy need herbal treatment to unblock energy channels.

Do not overuse laxatives, even TCM herbs, since dependence can cause pathology changes in the colon, possibly causing cancer, says Dr Gu.

Patients who use TCM herbs should quit after a period and develop the habit of a daily bowel movement. They should drink plenty of water, eat more fruit and vegetable fiber (especially coarse fiber like celery, corn, oats), and exercise.

Try massaging the belly with both hands, clockwise for 15 minutes twice a day.

Foods to promote soft stools and ease bowel movements (in cases of excessive heat or energy stagnation) include banana, papaya, orange, milk and yogurt.

Foods to relieve constipation (due to insufficient energy and blood) include walnuts, sesame, almonds and other oil-rich nuts.

Hawthorne can relieve constipation caused by eating too much high-protein and fatty food.

Relieving constipation:

Oat milk congee

Ingredients: oats, milk, honey to sweeten.

Preparation: Heat milk, add oats, stir on gentle heat until it thickens.

Eat regularly for breakfast.

Function: Helps relieve any kind of constipation; oats are a high-fiber laxative.

White fungus and pinenut soup

Ingredients: white fungus (15g), pine nuts (9g), honey to sweeten.

Preparation: Soak ingredients in hot water for 10-20 minutes. Make soup in a cooker.

Function: Helps relieve constipation by reinforcing yin energy, especially in the elderly.

Sesame and shou wu (knotweed) congee

Ingredients: shou wu (15g), dang gui (angelica, 10g), huang qi (milk veteh, 10g), honey to sweeten.

Preparation: Cook soup with shou wu, angelica and milk veteh. Filter and make congee with sesame and rice.

Eat often.

Function: Helps relieve constipation caused by insufficient energy or blood, common in children, the elderly and women who have given birth.

Mulberry jelly

Ingredients: Mulberries, konjac (tuber) powder.

Preparation: Press juice from mulberries, add konjac powder. Heat and stir. Put in molds, allow to cool.

Eat often.

Function: Mulberry reinforces the blood and nourishes yin energy. Konjac is low in calories and high in fiber,eases constipation.

Varieties of constipation:

Excessive heat in digestive system

Symptoms: dry stool, red tongue with yellow coating, stomach ache, distention, irritation, feeling hot and thirsty.

Stagnation of energy

Symptoms: difficulty moving bowels though stool is not dry, coated tongue, stomach ache and distention, belching, poor appetite.

Insufficient energy

Symptoms: pale tongue with white coating, difficulty moving bowels though stool is not dry, sweating easily, feeling fatigued, feeling exhausted after bowel movement.

Insufficient blood

Symptoms: dry stool, pale face, white coating on tongue, insomnia, poor memory.

Insufficient yin

Symptoms: dry stool (small pebbles), red tongue, thin in stature, frequent dizziness, lack of strength, night sweats.

Insufficient yang

Symptoms: difficulty moving bowels though stool isn't dry, pale in appearance, stomach ache, pain in lower back and knees, relieved by application of heat.