Barbara Heller - BHpurple.aol.com
What is constipation
Constipation, the "difficult, incomplete, or infrequent evacuation of dry hardened feces from the bowels" (The American Heritage Dictionary) can be an occasional, acute, or chronic problem. It can be caused by many factors including lack of fluids, poor diet, sedentary lifestyle, emotional state, or as a side-effect of specific medications. Be aware of the constipating effect of other drugs or supplements you may be taking, like iron tablets,opiates, antidepressants, and antihistamines. Constipation is almost always a nuisance; it can also be a sign of a more serious condition. Chronic constipation should be evaluated in conjunction with a healthcare professional.
Natural remedies to treat constipation
Laxatives, even herbal laxatives, should be used with caution. Other natural remedies should be tried first. The gentlest remedies for constipation include increased movement and exercise, certain yoga postures, increase of fluid intake, and dietary changes including increased fiber and fruit. Acidophilus liquid or powder relieves chronic constipation (says herbalist Susun Weed in her Wise Woman Ways for the Menopausal Years). And prune juice may be the most effective and gentlest remedy for constipation.
Dr. James Duke, a scientist who worked for the USDA, recommended in his typical iconoclastic fashion, that Dan Rather ask the commissioner of the Food and Drug Administration (FDA) if he considered prune juice a safe and effective laxative. "If he answered no, I suggested that Rather request that Dr. Kessler (the commissioner) drink some and experience the results for himself. If he answered yes, I suggested that Rather ask why FDA labeling regulations prohibit prune juice marketers from stating that prune juice is a safe, effective, gentle laxative." "...(It) is probably the cheapest, least unpleasant laxative now available." (The Green Pharmacy, p140)
Apple-pear juice is also highly recommended; and stewed fruits like prunes, figs, or dates especially when mixed in licorice tea makes a tasty laxative snack
Some other options
Not a usual topic of discussion, at least here in middle-class America, is the position in which one attempts a bowel movement. Squatting can really help alleviate mild constipation - but may be awkward on traditional toilets. Some families find that using a small footstool to raise and open the legs helps to facilitate an easier evacuation. Massaging the abdomen with essential oils with laxative properties (in a carrier oil base) like chamomile, marjoram, or peppermint can also be helpful.
There are three classes of herbal laxatives - bulk, mild (but not bulk) and purgative.
Whichever category you use, remember that it takes time for laxatives to work. The bulk herbs may need 12 to 24 hours to encourage a bowel movement, and irritating herbs somewhat less time, perhaps 6 to 12 hours. So be patient, and do not take another dose prematurely.
Bulk laxatives are the gentlest for occasional constipation. Flaxseed (also known as linseed), psyllium, and fenugreek are three well-known herbal bulk laxatives. In The Family Herbal, the authors recommend flaxseed as a "laxative without side effects". You can take one tablespoon of whole seeds two to three times a day, followed by two cups of liquid. To help bulk laxatives do their job properly, one must drink a lot of water, otherwise gastrointestinal obstructions can occur.
Psyllium, another bulk laxative, is more well-known to most consumers as the main ingredient in Metamucil. A combination of psyllium seeds and a large glass of water can help lubricate the bowels and ease the passage of dry stools. In addition, this seed may also help cut cholesterol. It is quite popular in Germany to take 3 to 10 tablespoons a day for chronic constipation. The seeds swell; they also need plenty of water to motivate their transit through the digestive tract. Caution - asthmatics shouldn't take this herb; if you generally have allergies, take only with caution. ("There have been several reports of allergic reactions to psyllium, including a few serious asthma attacks from inhaled seed dust." - reported by James Duke in The Green Pharmacy)
Mild (not bulk) herbal laxatives
Dandelion root is a mild laxative often recommended by practicing herbalists. Susun Weed says it is especially helpful for bed-ridden elders and others with chronic constipation. "The root in tea will have little effect on constipation due to nervousness, diet, fevers, and such occasional causes, but acts reliably when it is chronic, related to age, long-tern illness, or general intestinal blahs; a teaspoon of the root boiled in water three or four times a day." Use dandelion leaves in salad, or 1-2 teaspoons of dandelion vinegar or 10 - 20 drops of tincture taken with meals.
Chickweed as a laxative is controversial but not seemingly harmful. It would seem from the debate surrounding it that the worse that can happen while using chickweed for constipation is - more of the same. Varro Tyler heavily disparages its medicinal use "...there is no indication (in the "extensive scientific literature devoted to chickweed") that any of the plant's constituents possess pronounced therapeutic value; ... most writings concern various methods of controlling this pesky weed. (HeK comment: check this to see why Tyler isn't very respected as a herbal authority: http://www.herbological.com/deconstructingtyler_review.htm)" This is in sharp comparison to how Susun Weed sings this herb/weeds virtues:
"Those with digestive system problems crave plates of chickweed salad, for mineral-rich bulk and soothing, cooling energies to nourish their weak stomachs and bowels. Chickweed eases and helps those with yeast overgrowth, constipation, hard stools, hemorrhoids,stomach ulcers, intestinal ulcers, colitis, internal inflammation, stomach cancer, and those healing after treatment for appendicitis, peritonitis, or the like." (Healing Wise, p 121).
Both Susun Weed and Deb Soule also recommend yellow dock root tincture as a remedy for constipation.
Constipation as a menopausal symptom
In Wise Women's Ways for the Menopausal Years, herbalist Susun Weed explains that "Menopausal constipation and indigestion are generally due to the slowing of the gastrointestinal tract (estrogen is a gastrointestinal stimulant) and heavy demands on the liver." Again yellow dock root, as vinegar or tincture, and dandelion are highly recommended. "Menopausal women will want to avoid the use of bran as a laxative in deference to building strong bones." Instead try prunes, figs, or rhubarb with maple syrup. Daily doses of 1 teaspoonful vinegar or 5 - 10 drops tincture of yellow dock eliminate constipation, indigestion, and gas. "Yellow dock is especially recommended for the woman who finds her early menopausal menses getting heavier."
Purgative or cathartic laxatives
Purgative laxatives is the category most utilized; and purgative herbs are used in healthfood store formulations and in many commercial over-the-counter laxatives. This group includes aloe, buckthorn, cascara sagrada, rhubarb, and senna. All the herbs in this category contain anthraquinones, strong and irritating chemical compounds that force the bowels to evacuate. They should be used only as a last resort.
Pregnant or nursing mothers should not use these irritants, nor should people with gastrointestinal problems including ulcers, ulcerative colitis, irritable bowel syndrome, and hemorrhoids.
Avoid the prolonged use of purgative laxatives. The continual use can cause lazy bowel syndrome. When this negative cycle develops the result is a sluggish digestive system unable to evacuate without the use of more laxatives. Studies also show that chronic over-use of constipation relieving drugs can lead to disturbances of the bodies electrolyte equilibrium. In turn this can result in potassium deficiency and a concomitant problem for those who are taking heart medications. ("In Germany, the law requires that the labels on all anthraquinone preparations must bear the warning that possible potassium deficiency can intensify the effect of chemical heart drugs -cardiac glycosides"; The Family Herbal, p.188)
The gentlest of this class of cathartic laxative herbs is cascara sagrada, known as "sacred bark" from a native American tree (Rhamnus purshiana). Michael Castleman says cascara sagrada is the "World's most popular laxative". Many herbalists claim that in addition to its laxative quality it also tones the intestinal tract and colon. It can be purchased in over- the-counter preparations or taken as a tincture (½ teaspoon at bed). Although a decoction (tea) is sometimes recommended, it is very bitter. It should never be used for more than 2 weeks, and a reputable source is important because unless the cascara is prepared correctly it can have negative side-effects. (Fresh bark cannot be used; the bark needs to be dried and stored for at least a year).
Dr. Weil, the well-known physician/author and lecturer, says "If you must use an irritant laxative, try rhubarb root (Rheum officinale). It is one of the safest and least violent, but it should be reserved for occasional use only. You can get preparations of rhubarb root in health food stores. (Natural Health, Natural Medicine, p 274)
Senna (Cassia acutifolia) is a bit stronger and also quite popular. It, too, is a main ingredient of many over-the-counter laxatives. Kathi Keville states that it is the most often purchased laxative herb in North America. And my perusal of over-the-counter laxatives supports this. In fact, the company that manufactures Ex-Lax recently updated its formula. Senna has replaced the key ingredient, the chemical phenolphthalein, which proved to have carcinogenic tendencies. Again, taste is a reason that herbalists might not recommend this remedy in its natural state. "The taste of senna is nauseating... herbalists generally discourage using the plant material and instead recommend over-the- counter products containing it."
Some herbalists recommend blends that pair the strongly bitter herbs with others that are better tasting and more easily tolerated. Kathi Kevilles approach is to combine the irritant herbs with tasty ones like peppermint, ginger, and fennel, that also relax the intestines and prevent cramping.
A commercial example of such a mixture is the blend Smooth Move sold by Traditional Medicinals. The main ingredient is senna, combined with licorice, and cinnamon, ginger, orange peel, fennel and coriander seed.
Another herb in this category, aloe, is even more problematic. Its popularity has recently increased and it is a wonderful herb to use externally for skin care. But because of its use, its name is becoming more known, and some people assume that because it is safe for one purpose, that it is ok to try for another reason. But this is not so!
A recent magazine article suggested drinking aloe vera juice on a daily basis. But many western herbalists do not recommend aloe as a laxative because it is too strong, although it has a history of use in Ayurvedic medicine. Michael Castleman in his popular book The Healing Herbs, has a headline under aloe, "Never a laxative". He says it is the "most drastic" of the cathartics and that it is least recommended "because it often causes severe intestinal cramps and diarrhea."
Ayurvedic herb mixture
Dr. Andrew Weil suggests using Triphala, an herbal mixture from the Ayurvedic tradition. He says this mixture of three herbs is a "superior bowel regulator rather than a laxative,...take it regularly, it's benefits accumulate the longeryou stay on it." Available in health food-stores in capsule form, follow the directions on the label.
Recipes for relieving constipation
compiled from some popular herbal guides
Constipation tea/tincture (Deb Soule, The Roots of Healing, p92)
Dandelion root 2 parts
Yellow dock root 1 part
Angelica root 2 parts
Burdock root 1 part
Ginger root 1 part
Licorice root ½ part
Place 7 to 8 tablespoons of herbs in 1 quart of water and simmer, covered for 30 minutes. Drink warm as needed. As a tincture, take 25-50 drops as needed. For chronic constipation, take 3x a week for 1 to 3 weeks.
Laxative Tea (Michael Moore, Herb Formulas for Clinic and Home)
3 parts Psyllium seed
3 parts Licorice root
2 parts Rhubarb root (Rheum officinale)
2 parts Senna pods, crushed
2 parts Angelica root
Drink as a simple tea/infusion in the evening.
Herbal Laxative Syrup - for adults (Kathi Keville, Herbs for Health and Healing, p 84)
1 teaspoon honey (or barley syrup or some other natural liquid sweetener)
2 teaspoons cascara sagrada bark tincture
1 teaspoon licorice root tincture
½ teaspoon tincture of fennel, ginger, or peppermint
Warm honey enough to make it liquid. Combine it with the remaining ingredients and stir well. Take 1 teaspoon.
Keville suggests tea (recipe below); elderberry jam; catnip enema; ground psyllium seed in juice; and slippery elm gruel. For children's constipation, Susun Weed suggests violet flower syrup.
Slippery Elm gruel - for children (Kathi Keville, Herbs for Health and Healing, p 221)
1 tablespoon slippery elm powder
¾ cup water
1 teaspoon lemon juice (optional)
Combine powder and water in saucepan and heat until warm, stirring the mixture to prevent clumping. Add optional lemon juice for flavor. Can also sweeten the gruel with child's favorite herbal or fruit based sweetener. Child can drink entire amount (for every 50 lbs of body weight). Drink before it cools - as gruel cools down, it thickens and the thicker it gets, the more likely your child will push it away.
Constipation Tea - for children (Kathi Keville, Herbs for Health and Healing, p.220)
1 cup boiling water
½ teaspoon licorice root
¼ teaspoon ginger root (or fennel seeds)
¼ cup apple juice (optional)
¼ cup prune juice (optional)
Steep first 3 ingredients; strain; add juices. Recommended - 50 lb child, ¼ cup every 2 hours "until a change for the better becomes apparent".