Constipation is a common source of frustration, discomfort and pain to many people.  In Traditional Chinese Medicine, constipation is separated into two major categories by asking the question, “Is it excessive or deficient?”  And unfortunately, there can often be a combination of both in complicated cases.  For the sake of simplicity, the focus of this blog will be about excess type constipation, which is treated differently from the deficiency type.

Excessive type constipation is due to heat in the bowels.  The stool is dry and hard and difficult to push.  It is also the easiest to treat.  A diagnosis of this form of constipation can be seen on the tongue as a thick yellowish fur coat and possible red or purple tongue body.  The pulse may be fast.

Dietary restrictions are usually required with this type of constipation, particularly foods that are warm or hot in temperature, and by that I do not mean Fahrenheit temperature, but rather the nature of the food itself.  For example take a bite of a banana and imagine it in your mouth, chew it and swallow and feel it in your belly.  It is cool by its very own nature.  Now imagine a red, hot chili pepper.  Take a bite of it, how does it feel in your mouth?  In your belly?  Quite hot!  Some foods are neutral in temperature, some slightly warm, slightly cold, very cold, and others may be very hot.  For constipation due to heat in the bowels it is important to stop adding heat to the already raging fire in the colon.

The major restrictions are alcohol, meat, animal fats, and other rich or greasy foods and diuretics such as coffee, which remove water from the colon.  It is important at this time to begin adding foods that will lubricate the intestines:  *spinach, banana, sesame oil/seed, honey, pear, prune, pine nut, almond, carrot, cauliflower, beet, seaweed.  And to combine with foods that promote bowel movements:  *cabbage, papaya, peas, black sesame seed, coconut, sweet potato, fig, and bran from oats/wheat/or rice.

There are also herbs that will increase the mucosal lining of the colon to make passage of the bowel movement easier:  *marshmallow root, flax seed, fenugreek seed, psyllium seed, and licorice root.  For intense cases it may be necessary to add laxative herbs such as:  *dandelion root, rhubarb root, cascara bark or barberry bark. Several of these herbs are very cold and are to be used with caution.  I strongly advice working with an herbalist if laxative herbs are necessary.  A practitioner will be able to advise the proper combination and duration of  herbs for treatment because these laxative herbs are  cooling or very cold in nature and are not intended for long term use.

*Flora-Enhancing Foods are safe to add and necessary for replenishing the flora of the colon for proper digestion.  Examples of these are:  miso, sauerkraut, plain yogurt, acidophilus, and kefir.

Colonics and enemas may be necessary in the first few weeks to help clear heat and move bowels that have been compacted by chronic constipation.  Again, I advise working with a TCM practitioner to determine whether this is a necessary step and to refer you to knowledgeable colonic therapists.

*Dietary advice from Healing with Whole Foods by Paul Pitchford

Unfortunately, I’ve noticed with patients that breakfast is often overlooked, undervalued, or simply ignored.  For some, it is due to deficiency and inactivity.  They simply do not have an appetite in the morning because their  digestive energies have been weakened from too many skipped meals, over-thinking, over-working, and/or not enough exercise in their daily routine to stimulate their appetite.

Others mistakenly believe they can lose weight by forgoing breakfast.  But if they looked closely they are replacing a healthy breakfast with sugary, milky lattes and chai teas, and later in the morning eating muffins, donuts, and any snacks they can get their hands on to make up for those missed calories in the morning.

Starting the day off right might be difficult in the beginning, but once your body becomes accustom to eating breakfast regularly, you’ll begin to see and feel a difference in the flow of your daily energy.  For me, the easiest breakfast to prepare and experiment with is jook, aka. congee or rice porridge.  A rice cooker with a porridge setting allows you to set the timer the night before so you can wake up to pipping hot, ready-to-eat jook.

Jook is very versatile, so telling you what to put in it is difficult.  It’s a matter of taste and experimentation.  The Book of Jook:  Chinese Medicinal Porridges by Bob Flaws is a handbook for thinking about what to add to your porridge in the morning.

For example I made up this recipe the other day:

1.5 cups rice

8 cups water

3/4 cup raw peanuts (shelled)

3/4 shitaki mushrooms sliced and diced

1/4 sliced green onions (scallions)

Put all ingredients in rice cooker at night and set timer for the next morning.

In the morning I add a little soy sauce to my bowl of jook and stir.  Yum!

Oftentimes it’s easier to begin with plain jook:  1-1.5 cups rice to 6-8 cups water.  In the morning ask yourself what you want to add…miso, green onions, pine nuts, chicken stock, an egg, soy sauce, yogart, sesame seeds, sesame oil, raisins, dates, cherries, cinnamon, maple syrup…it can be sweet or savory.  Just ask yourself what would feel good, and what does my appetite want right now.

Bon Appetit! and Best of Health!

Note of caution:  rice is a diuretic.  If you are diabetic or have problems with polyuria, you should not eat rice porridge.

However, it is at this time of year I am asked about cleanses and detox programs.  Most of which I feel are inappropriate.  This is winter, the coldest and darkest part of the year.  It is a time of inner contemplation and hibernation and as such, requires the slower, gentler changes we can make for ourselves.  The castor oil pack compliments this season with simplicity and gentleness.

Castor oil packs are used to improve circulation of the lymphatic system which assists in the elimination of toxins and improves immunity.  Castor oil packs also decrease inflammation, improve the absorption and assimilation functions of abdominal organs, especially the liver and colon, and may be used over areas experiencing aches and pains to engender healing.  Women may use castor oil packs on the lower abdomen to increase circulation to the fallopian tubes, uterus, and urinary tract.

Word of caution:  Do not use on open wounds.  Do not use castor oil packs if pregnant or menstruating.

Supplies:  Cold-pressed castor oil, piece of flannel, plastic bag, three towels, and 1 gallon sized ziploc bag.

Pack Preparations:  Through trial and error, I have found this to be the easiest way for me to handle castor oil packs.  You may need to try your own experiments to see what works best for you.  Once you establish a rhythm, this will be quick and easy. The layer method—1. short hand towel folded 14″x 8″   2.  piece of plastic that covers the hand towel   3. cotton or wool flannel 11″x 15″ double thickness and folded in thirds.  Now you have a sandwich of sorts, bottom hand towel, middle piece of plastic, and top flannel.

Castor Oil Preparation:  You want to saturate the flannel with oil.  It will take time for the flannel to absorb the oil, so begin with a dizzle of oil over the flannel, wait a few minutes and drizzle some more, continue until flannel is sufficiently saturated.

Heat Preparation:  I prefer a water bottle, but you may use a heating pad if it’s easier for you.  I like to be able to fall asleep without worry about a heating pad being left on.  So the second towel is to lay over the water bottle to retain its heat.

Preparing Yourself and Bed:  The oil will absorb into clothing, so choose clothing you don’t mind staining.  I use an old t-shirt and sweat pants.  Lay the third towel over the sofa or bed where you will by lying down to protect against oil stains.  Now pick up your castor oil pack sandwich and place the saturated oil side over your liver, spleen, upper abdomen, lower abdomen, or lower back.  Place the water bottle on top, and place a towel over the water bottle to keep it warm.

Time:  Leave the pack in place for 45-90 minutes.  Cycle 3 days of packs over the same area, then rest three days.  Depending on the condition and goals of your castor oil packs, packs may be done for one to six months.

For a simple detox program and immunity enhancement I recommend 3 days over the liver, three days rest, 3 days over the spleen, three days off, 3 days over the upper colon, three days off, 3 days over the lower colon, three days off, repeat cycle if desired.

Storage and Reuse:  Fold castor oil sandwich (hand towel, plastic, and flannel) in half, place in gallon sized ziploc bag, and store in refrigerator.  The next time you use the castor oil pack, refresh the oil by drizzling more to the flannel.  The flannel may be reused for six months.  It is not necessary to wash the flannel between uses, but keep the used flannel in the refrigerator to prevent the oil from going rancid between uses.

Cleaning up:  The oil will stick to you, so a teaspoon or two of baking soda in a quart of warm water will clean you off with ease.

Final Note:  This is a detox protocol so it is important that you drink plenty of water to flush toxins out of your body.

Heritage castor oil products are usually easy to buy at healthfood stores or online.

1.  Add 1/4 part juice to 3/4 part water with a pinch of salt

2.  Do not drink icy, cold drinks to rehydrate (that includes asking the flight attendant to refrain from adding ice to your complementary drink).  The body has to warm the fluids first before absorption can occur, so the moistening drink your body desires may pass straight to the large intestine just like the dry, potted plant in the kitchen.

3.  ReHydration homeopathic formula from Energetix added to a liter of water

Happy Travels!!

In my office experience thus far, the number one reason for diarrhea (and this excludes the stomach flues that are passed around in the summer and winter) is eating cold, damp foods. A fine example of this is a patient who came in complaining of cramping every evening before bed with a bout of diarrhea every morning. When I asked him what cold foods he eats, such as ice cream and icy cold drinks, he shook his head and said, “No, I don’t eat ice cream and I like my drinks room temperature.”  I asked him to give me a typical day’s food intake. When the patient came to evening dessert his eyes lit-up. In the evenings before bed, he liked to eat a bowl of frozen yogurt.  I asked him if he would do a little experiment—for one week he would not eat any frozen yogurt (and no ice cream for substitute). The next week, I ask the patient how the experiment went.  He confirmed there had been no diarrhea and no stomach cramps.

If I didn’t see this again and again, I wouldn’t bother writing about it.  Cold, damp foods aren’t for us.  Nowhere in our dietary evolution did we hunt and gather ice cream and frozen yogurt.  Our love affair with iced drinks–smoothies, iced coffee drinks, shakes, sodas and slurpees–wrecks havoc on our digestive tract.  It’s no wonder I see so many people with diarrhea.  Thankfully the solution is easy! Stop eating cold food and drinks.

There are other benefits to cutting out the cold and damp foods.  Cold and damp in Chinese medicine diminishes the digestive fire, which means that people can’t efficiently digest and absorb their food so they over-eat to compensate, weight gain happens more easily too as the metabolism slows down (cold slows things down, heat speeds them up–ice verses boiling water), and causes people to feel heavy and foggy in the head.

Try this experiment.  Write down how you feel after you eat and drink for the next two days.  Then for a week, cut out all cold-damp foods mentioned above.  Write about how you feel.  Compare and contrast with the first two days.

Well, I’m here to say it again, finding ways to rejuvenate ourselves is key to healthy living.  Giving our bodies and minds the opportunity to let go, unwind, and break from our day-to-day busyness is preventative health-care at it’s best.  It leads to better sleep, reduced stress, and ease with our surroundings and loved ones.  In a sense we can say it leads to sanity or skillful means to dealing with the road-rage, check-out lines, and the million and one little things that add up in a day to overload and overwhelm us.

Meditation is just one simple, easy, cost-effective habit we can develop to bring stillness and peace to our ordinary, busy lives.  I recommend a simple shamatha (calm-abiding meditation) or Zen style practice to begin.  These techniques do not require religion or belief in order to practice.  They are techniques developed to calm the mind, relax the breath, soften the eyes, and rest the body.  It is about being here and now.

By stopping for ten minutes, twenty minutes, half an hour the constant chatter of our minds planning the future, remembering the past, playing out fantasies, and day-dreaming, by stopping all of that for a few minutes a day, we return to stillness.  We return to ourselves.

Look around in your communties, churches, poster boards for different meditation classes.  Oftentime beginning a meditation practice is easier with verbal and/or visual instructions, and many find practicing with a group beneficial.

I recommend this when motion sickness or the stomach flu makes a visit.  By held, I don’t mean lightly.  The thing I like about needles is that I can put them in and not worry about pressure and my fingers getting tired.  Fortunately they sell wristbands now with a nob that pushes into PC 6, but remember it’s important to have firm pressure.

All too soon my ten minutes were up and my roommate was urging me off the massage chair while simultaneously explaining that I needed to help this man with his hiccups.  First glance confirmed he needed help.  His hiccups were constant, relentless, whole diaphragm spasms.  He was pale and sickly looking, and standing in his bathrobe and slippers.  Those hiccups had been hounding him for three solid days.  I did a quick scan of his tongue and pulses, and explained that because I didn’t have any needles on me, I was going to have to push his acupuncture points with my fingers.  And to do that, he was going to have to lay down.

Well, three days of hiccups and I imagine you’ve lost all dignity, you’ll do anything, even lay down in the middle of a video store and have some strange woman lift up your shirt and stick a finger in your belly while her other hand digs into your wrist.  Those two points, Ren 12 and Pericardium 6, are major Harmonize Qi points and regulate the Middle Jiao.  In translation that means they are good for hiccup, emotional upset, motion sickness, vomiting, chest pain, etc.  The man with the hiccups and I talked while I sat there pushing those points for fifteen minutes.  At some point the store told us it was time to close up.  The hiccups hadn’t stopped, but their intensity had lessened and the interval between hiccups had lengthened, so we said goodbye and wished him well.

Two days later I returned to the store and was told by the store owner that the man with the hiccups had come in the very next morning when the store opened and bought my roommate and I ten videos.  His hiccups had completely stopped by the time he arrived home. 

I want to share the location of these points with you today, in case you should ever need them.  Ren 12 is located on the upper abdomen.  It is on the midline of the body and the midpoint between the bottom of the sternum (feel around for the tip of the xyphoid process) and the navel.  The photo above shows how to locate it with two hands.  PC 6 is on the inside of the wrist, three fingers up from the base of the hand.  Simply put your first three fingers on the wrist crease to measure.  The point is located between the two tendons or on the midline of the wrist if you can’t feel the tendons.

One last note:  It’s always easier to have someone else hold these points for you.  The pressure should be firm.  In fact, I believe I used my elbow on Ren 12 when my fingers wore out.  Twenty minutes is standard treatment time for adults.  And I recommend pushing both points simultaneously.