Constipation according to Chinese Medicine

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Constipation can be the consequence of several so-called “patterns of disharmony” in Chinese Medicine.

Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted, leading to symptoms or signs that something is wrong (like constipation here). It is similar to the concept of disease in Western Medicine but not quite: a Western disease can often be explained by several Chinese patterns and vice-versa.

A pattern often manifests itself in a combination of symptoms that, at first glance, do not seem necessarily related to each others. For instance here constipation is often associated with irritability, abdominal pain and fever in the pattern “Liver Qi Stagnation”. As you will see below, we have in record five patterns that can cause constipation.

Once identified, patterns are treated using medicinal herbs, acupuncture, and other therapies. In the case of constipation we’ve identified five herbal formulas that may help treat patterns behind the symptom.

We’ve also selected below the five medicinal herbs that we think are most likely to help treat constipation.

The five "patterns of disharmony" that can cause constipation

In Chinese Medicine constipation is a symptom for 5 patterns that we have on record. Below is a small explanation for each of them with links for more details.

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Qi Stagnation

Pulse type(s): Wiry (Xian)

Tongue color: Normal (light red)

When Liver Qi does not flow smoothly or regularly, it becomes Stagnant and in Excess. This leads to Heat accumulating in the Liver. The feeling of ‘Distension’ (zhang 胀) is the main symptom of Liver Qi Stagnation.

In addition to constipation, other symptoms associated with Liver Qi Stagnation include irritability, abdominal pain and fever.

From a Western Medicine standpoint Liver Qi Stagnation is associated with health issues such as Low Breast Milk Supply, Mastitis or Breast Engorgement.

Liver Qi Stagnation is often treated with Xiao Yao San, a herbal formula made of 6 herbs (including Bupleurum Roots - Chai Hu - as a key herb). Xiao Yao San belongs to the category of "formulas that harmonize liver-spleen", which might be why it is often recommended for this pattern. Its main action as a formula is: "Harmonizes the function of Liver and Spleen".

Read more about Liver Qi Stagnation here

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Fire Blazing

Pulse type(s): Rapid (Shu), Wiry (Xian), Full (Shi)

In addition to constipation, other symptoms associated with Liver Fire Blazing include dizziness, irritability and tinnitus.

Liver Fire Blazing is often treated with Long Dan Xie Gan Tang, a herbal formula made of 10 herbs (including Chinese Gentian - Long Dan Cao - as a key herb). Long Dan Xie Gan Tang belongs to the category of "formulas that clear heat from the organs", which might be why it is often recommended for this pattern. Its main action as a formula is: "Clears Heat and Fire from the Liver and Gallbladder".

Read more about Liver Fire Blazing here

The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine

Stomach Heat or Fire

Pulse type(s): Rapid (Shu), Slippery (Hua), Full (Shi)

Tongue coating: Yellow coating

Tongue color: Red centre

Stomach Fire indicates a true Excess of Heat in the Stomach, creating symptoms such as mouth ulcers, bad breath, intense thirst and gum bleeding. Stomach Fire can be the result of excessive intake of hot, spicy, greasy and deep fried foods or other factors such as alcohol, tobacco and sugar.

In addition to constipation, other symptoms associated with Stomach Heat or Fire include irritability, dry mouth and dry stools.

Stomach Heat or Fire is often treated with Tiao Wei Cheng Qi Tang, a herbal formula made of 3 herbs (including Rhubarb - Da Huang - as a key herb). Tiao Wei Cheng Qi Tang belongs to the category of "formulas that purge heat accumulation", which might be why it is often recommended for this pattern. Its main action as a formula is: "Removes Heat and Dryness in the Lower Burner".

Read more about Stomach Heat or Fire here

The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine

Rebellious Liver Qi invading the Spleen

Pulse type(s): Weak (Ruo), Wiry (Xian)

In addition to constipation, other symptoms associated with Rebellious Liver Qi invading the Spleen include irritability, abdominal pain and tiredness.

Rebellious Liver Qi invading the Spleen is often treated with Xiao Yao San, a herbal formula made of 6 herbs (including Bupleurum Roots - Chai Hu - as a key herb). Xiao Yao San belongs to the category of "formulas that harmonize liver-spleen", which might be why it is often recommended for this pattern. Its main action as a formula is: "Harmonizes the function of Liver and Spleen".

Read more about Rebellious Liver Qi invading the Spleen here

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Wind agitating Internally due to Liver Fire

Pulse type(s): Rapid (Shu), Wiry (Xian)

In addition to constipation, other symptoms associated with Liver Wind agitating Internally due to Liver Fire include dizziness, irritability and tinnitus.

Liver Wind agitating Internally due to Liver Fire is often treated with Ling Jiao Gou Teng Tang, a herbal formula made of 10 herbs (including Saiga Antelope's Horns - Ling Yang Jiao - as a key herb). Ling Jiao Gou Teng Tang belongs to the category of "formulas that pacify and extinguish internal wind", which might be why it is often recommended for this pattern. Its main action as a formula is: "Cools the Liver".

Read more about Liver Wind agitating Internally due to Liver Fire here

Five herbal formulas that might help with constipation

Chai Hu Shu Gan San

Source date: 1602

Number of ingredients: 7 herbs

Key actions: Disperses Stagnant Liver Qi and Blood. Alleviates pain. Harmonizes Blood.

Why might Chai Hu Shu Gan San help with constipation?

Because it is a formula often recommended to treat the pattern 'Liver Qi Stagnation' of which constipation is a symptom.

Read more about Chai Hu Shu Gan San here

Long Dan Xie Gan Tang

Source date: 1682 AD

Number of ingredients: 10 herbs

Key actions: Clears Heat and Fire from the Liver and Gallbladder. Clears and drains Damp-Heat from the Lower Burner.

Why might Long Dan Xie Gan Tang help with constipation?

Because it is a formula often recommended to treat the pattern 'Liver Fire Blazing' of which constipation is a symptom.

Read more about Long Dan Xie Gan Tang here

Tiao Wei Cheng Qi Tang

Source date: 220 AD

Number of ingredients: 3 herbs

Key actions: Removes Heat and Dryness in the Lower Burner. Removes constipation.

Why might Tiao Wei Cheng Qi Tang help with constipation?

Because it is a formula often recommended to treat the pattern 'Stomach Heat or Fire' of which constipation is a symptom.

Read more about Tiao Wei Cheng Qi Tang here

Xiao Yao San

Source date: 1107 AD

Number of ingredients: 6 herbs

Key actions: Harmonizes the function of Liver and Spleen. Relieves Liver Qi stagnation. Nourishes the Blood.

Why might Xiao Yao San help with constipation?

Because it is a formula often recommended to treat the pattern 'Rebellious Liver Qi invading the Spleen' of which alternating constipation and diarrhea is a symptom.

Read more about Xiao Yao San here

Ling Jiao Gou Teng Tang

Source date: Qing dynasty

Number of ingredients: 10 herbs

Key actions: Cools the Liver. Extinguishes Wind. Increases Fluids. Relaxes the sinews.

Why might Ling Jiao Gou Teng Tang help with constipation?

Because it is a formula often recommended to treat the pattern 'Liver Wind agitating Internally due to Liver Fire' of which constipation is a symptom.

Read more about Ling Jiao Gou Teng Tang here

Acupuncture points used for constipation

The five Chinese Medicinal herbs most likely to help treat constipation

Why might Atractylodes Rhizome (Bai Zhu) help with constipation?

Because Atractylodes Rhizome is an ingredient in several formulas indicated to treat constipation as a symptom, like Yue Ju Wan or Xiao Yao San for instance.

Atractylodes Rhizomes is a Warm herb that tastes Bitter and Sweet. It targets the Spleen and the Stomach.

Its main actions are: Tonifies the Spleen Qi. Fortifies the Spleen Yang and dispels Damp through urination. Tonifies Qi and stops sweating. Calms restless fetus when due to Deficiency of Spleen Qi.

Read more about Atractylodes Rhizomes here

Why might Cape Jasmine Fruit (Zhi Zi) help with constipation?

Because Cape Jasmine Fruit is an ingredient in several formulas indicated to treat constipation as a symptom, like Long Dan Xie Gan Tang or Yue Ju Wan for instance.

Cape Jasmine Fruits is a Cold herb that tastes Bitter. It targets the Gallbladder, the Heart, the Lung and the Sanjiao.

Its main actions are: Clears Heat and calms spirit. Drains Damp-Heat affecting the Liver and Gallbladder. Clears Heat in the Blood and stops bleeding. Anti-inflammatory.

Read more about Cape Jasmine Fruits here

Why might Liquorice (Gan Cao) help with constipation?

Because Liquorice is an ingredient in several formulas indicated to treat constipation as a symptom, like Xiao Yao San or Jia Wei Xiao Yao San for instance.

Liquorice is a Neutral herb that tastes Sweet. It targets the Heart, the Lung, the Spleen and the Stomach.

Its main actions are: Tonifies the Basal Qi and nourishes the Spleen Qi. Clears Heat and dispels toxicity. Moistens the Lungsexpel phlegm and stop coughing. Relieves spasms and alleviates pain. Harmonizes and moderates the effects of other herbs.

Read more about Liquorice here

Why might Medicated Leaven (Shen Qu) help with constipation?

Because Medicated Leaven is an ingredient in several formulas indicated to treat constipation as a symptom, like Bao He Wan or Zhi Shi Dao Zhi Wan for instance.

Medicated Leaven is a Warm herb that tastes Pungent and Sweet. It targets the Spleen and the Stomach.

Its main actions are: Assists the Stomach in removing Food Stagnation. Harmonizes the Earth element and improves digestion.

Read more about Medicated Leaven here

Why might Szechuan Lovage Root (Chuan Xiong) help with constipation?

Because Szechuan Lovage Root is an ingredient in several formulas indicated to treat constipation as a symptom, like Yue Ju Wan or Chai Hu Shu Gan San for instance.

Szechuan Lovage Roots is a Warm herb that tastes Pungent. It targets the Gallbladder, the Liver and the Pericardium.

Its main actions are: Regulates and moves the Blood. Relieves Wind-Cold and pain. Circulates the Qi in the Upper Burner, relieving headaches.

Read more about Szechuan Lovage Roots here