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Constipation

Concept

Disorder of transmitting (Qi Flow) function of Large Intestine organ
3 main organs involved are Spleen, Stomach & Large Intestine (Spleen & Small Intestine are related to diarrhea, Larege Intestine & Stomach related to constipation)
The Stomach is the pivot of all organs, hypofunction of Spleen & Small Intestine = diarrhea, Small Intestine can not absorb nutrients

Etiology

Invasion of exterior pathogen, Damp Cold or Damp Heat, more diarrhea but can be constipation also
Irregular Diet - Rich & greasy = diarrhea, Hot & Spicy = constipation
Emotional disorder - Liver Qi Stagnation = constipation, Liver & Spleen disharmony = diarrhea

Differentiation & Treatment of Constipation

Constipation due to accumulation of Heat in the Yangming organs

Typical symptoms

Acute onset, fullness and distension in the ab
BM once every 3 - 5 days, very dry, hard, and difficult to expel
Pain released after BM
High fever, thirsty, desire for cold drinks
Profuse sweating, decreased appetite
Tongue body is red or scarlet red - yellow, thick, and greasy coat, could be brown or black
Pulse is slippery, fast, and forceful

Treatment Principle

Remove excess heat from yangming organs, Regulate BM

Basic points for all types of constipation

ST 25, 36, 37; Ren 6; Kid 6; SJ 6
For constipation due to Heat in yangming, you can add: Li 4, 11; SJ 5; ST 44, 45
ST 25 - Tonify for diarrhea, reduce for constipation

Constipation due to Liver Qi Stagnation

Typical symptoms

Acute onset, history of emotional disorder
BM once every 2 - 5 days, very hard at start and loose at the end
Gas & bloating in abdomen and radiating to hypochondriac region
Stress and depression, sighing time to time
Tongue body is normal with normal coat
Pulse is wiry

Treatment Principle

Soothe Liver Qi & adjust intestinal function
Turnips can adjust intestinal Qi

Points for constipation due to Liver Qi Stagnation

Basic + 4-gates; Liv 5, 13, 14; BL 18, 19

Constipation due to Qi & Blood Deficiency

Typical symptoms

Chronic onset, habitual, long lasting, 20 - 30 years
Shortness of breath, fatigue, tired, pale face, spontaneous sweating
Difficult BM, could be 1 day or every 2 - 3 days, bowel is not hard
Tongue body is pale with thin white coat
Pulse is deep and weak

Treatment Principle

Tonify Qi & Blood, Regulate BM

Points for constipation due to Qi & Blood Deficiency

Basic + Ren 4, 12; SP 6, 15; BL 20, 21; Lu 9

Constipation due to Kidney Yang Deficiency

Typical symptoms

Chronic onset, mostly elderly, could have edema on lower extremities
BM once every 3 - 5 days, bowel not hard
Gas & bloating in lower abdomen, cold pain on back, cold extremities
Tongue body is pale, swollen with teeth marks, wet or moist coat
Pulse is deep, slow, and weak

Treatment Principle

Warm Kidney Yang, Promote BM
Ji Chuan Jian is the appropriate formula

Points for constipation due to Qi & Blood Deficiency

Basic + Bai lao pts (BL 31 - 34); BL 23; Du 4; Ren 4, 8
Caution with moxa