We conclude our three-part series on constipation with more information on how to conquer this serious and troublesome condition.

In order to supply more bulk to the bowel contents, psyllium seed husks can be used daily. Flax seed husks may also be used and are preferred by some. A daily dose of one or two teaspoons is mixed with a full glass of water and consumed. It is important to follow this with another full glass of water. If sufficient water is not drunk, the gelatinous mass produced may cause a lower bowel obstruction. This mass gives something for the bowel to contract against and assures movement of the stool forward. After a few weeks of this therapy, the amount should be decreased and eventually discontinued-even this product may become habit forming. Of course, all drugs should be stopped as soon as possible to allow the bowel to recover.

In some stubborn cases, a castor oil pack may be advisable. A wool flannel cloth is saturated with a good quality castor oil and placed upon the lower abdomen at bed-time, and a hot water bottle is applied. Never use an electric pad for the heat as the oil may soak into the pad and cause a fire.

In constipation due to vata disturbance it is essential to institute a routine of behavior and meals, with set times for eating and also set times for evacuating. Great amounts of water are needed to keep the stool soft so that some remaining nutrients can be absorbed in the lower bowel. Feces is not all waste products. There are some nutrients and chemicals that must be reabsorbed for physical health.

Pitta constipation is sometimes seen after a long febrile illness. It is characterized by heat and the tongue being red with a yellow coating. There is perspiration with an offensive odor. This may also be associated with some degree of liver dysfunction. Treatment emphasizes cutting back on oils and sweets in the diet. A bitter laxative usually stimulates the bowel to act. Aloe vera gel is helpful and can be taken daily until balance is returned. Strong evacuants are usually not needed. Purgation using 1-3 tablespoons of castor oil taken at night in warm milk and a little ginger will move the pitta from the small bowel and help to eliminate the heat and toxins.

Kapha constipation gives a characteristic bloating and heavy feeling with mucus often seen on the stool. The tongue may be coated white or with mucus. There is lethargy and sluggishness. The treatment is an anti-kaphic diet-eliminating heavy unctuous foods, wheat and rice, all dairy products and sweet, sour and salty tastes. The kaphic fruits-banana, avocado, pineapple, orange, melons and coconut-are to be eliminated. Fasting is helpful in this condition. However, a fast should last no more than three or four days. The bitter herb laxatives such as rhubarb and senna are useful and the hot spices like ginger, cayenne and black pepper are needed. An enema with ginger in the water may also be helpful.

Preventing constipation is easy by regulating the diet and taking into account the natural prakriti. This keeps the three doshas in balance. Plenty of exercise and drinking adequate water are necessary. It is far easier to prevent than to treat, especially the vata type. A meditative lifestyle with love and concern for the body will assure a healthy, happy life.

Dr. Devananda Tandavan, MD, is a member of the American Medical Association, the International College of Surgeons, the Society of Nuclear Medicine, the American Federation of Astrologers, the International Center of Homeopathy- and more. Send your questions to Hinduism Today, 107 Kaholalele Road, Kapaa, Hawaii, 96746, USA.