Constipation
AliasDifficult defecation
Traditional Chinese Medicine Definition
Constipation, known as "Da Bian Nan" (difficult defecation) in TCM, belongs to the category of spleen-stomach diseases. According to "Internal Medicine of Traditional Chinese Medicine", constipation refers to a condition caused by abnormal conduction of the large intestine, prolonged defecation cycles, or dry and hard stool with difficulty in defecation. Its pathogenesis is mostly related to factors such as spleen-stomach dysfunction, intestinal dryness-heat, Qi stagnation, and Qi-blood deficiency.
Constipation is a common condition in TCM clinical practice, with its core pathogenesis mostly related to spleen-stomach dysfunction, intestinal dryness-heat, Qi stagnation, and Qi-blood deficiency. Common triggers include irregular diet, emotional distress, and prolonged sitting with little activity. During syndrome differentiation, attention should be paid to the following key points:
1. Cold, heat, deficiency, and excess: Heat constipation presents with dry hard stools, abdominal distension and pain, dry mouth and halitosis, flushed face and body heat; Qi constipation presents with constipation, urge to defecate but inability to do so, frequent belching, and chest-hypochondrium fullness; deficiency constipation presents with the urge to defecate but straining without success, sweating and shortness of breath, and fatigue after defecation.
2. Key points of syndrome differentiation: Observe the texture of stool, the difficulty of defecation, and accompanying symptoms, combined with tongue and pulse differentiation.
Overall direction of regulation: In TCM clinical practice, treatment of constipation should adopt corresponding methods based on syndrome differentiation results. For heat constipation, clear heat and moisten the intestines, promote Qi movement and unblock the bowels; for Qi constipation, regulate Qi and remove stagnation, descend rebellious Qi and unblock the bowels; for deficiency constipation, tonify Qi and nourish blood, moisten the intestines and unblock the bowels. Traditional Chinese medicine holds that regulating constipation should focus on harmonizing the spleen and stomach and restoring intestinal function, thus achieving the goal of unblocking the bowels.
Common Syndrome Types and Key Points of Differentiation
Heat constipation
Main Manifestations: Constipation, abdominal distension and pain, dry mouth and halitosis, red face and feverish sensation
Management Approach: Clear heat and moisten intestines, promote Qi and relieve constipation
Qi constipation
Main Manifestations: Severe constipation, inability to defecate, frequent belching, chest and side discomfort
Management Approach: Promote Qi and relieve stagnation, descend counterflow and relieve constipation
Deficient and Hidden
Main Manifestations: Although there is a desire to defecate, there is a lack of strength to strain at the toilet, with sweating and shortness of breath, and fatigue after defecation
Management Approach: Tonify Qi and nourish blood, moisten intestines and relieve constipation
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
Patients with constipation often suffer from intestinal dryness and fluid deficiency. Treatment requires nourishing Yin and moistening dryness, but excessive cloying should be avoided.
— Chen Yan Traditional Chinese Medicine Practitioner
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This page is for the popular science of traditional Chinese medicine knowledge and does not constitute medical advice. Specific diagnosis should be completed by a licensed traditional Chinese medicine practitioner in person.
This article has been reviewed by licensed TCM physicians at Hangzhou Kezhentang TCM Clinic. It is for TCM popular science reference only and does not involve specific treatment plan recommendations.
References: Internal Medicine of TCM (13th Five-Year Plan Textbook), Diagnostic and Therapeutic Effectiveness Standards for TCM Diseases and Syndromes (ZY/T001.1-94), Classification and Codes of TCM Diseases and Syndromes (GB/T 15657-2021)