Constipation is among the common and curiously the most debilitating of simple ailments, and often associated with a general sense of lethargy and melancholy. The pursuit of regularity therefore, besides relieving abdominal discomfort and colicky pains, has a noticeably euphoric effect. The reason is not clear. There is no doubt that a good ‘bowel action’ is satisfactory primarily due to the sense of evacuation but also because the anus is richly supplied with nerve fibers which are stimulated when the bowel opens, resulting in a most pleasing sensation. Further, the internal cleansing of the bowel with enemas or colonic irrigation is reputedly very pleasurable. The British journalist, Ysenda Maxton-Graham described it as ‘the most satisfying loo going experience of my life. Years of stored up wind and matter such as old pips, stones and undigested pills are dispensed with – it is a joy to say goodbye to them.
The colon is in a state of constant movement as contractions of the muscles in the wall impel the contents forwards. During an attack of constipation the colon is relatively inert and ‘stimulant laxatives’ are the traditional remedies. Mr. Allan Wilson from Perthshire who practiced as a pharmacist in Selkirk in the 1930s recalls:
‘I am seventy-eight. As a teenager my mother would place two or three senna pods in half a cup of water, leaving to soak overnight and then drinking the water in the morning, convinced this “infusion” kept her regular. About the same time, my grandfather, then in his eighties, described taking a dose of extract of cascara sagrada liquid. It seemed to work for him. My aunt, with whom I resided at the time, also thought it good for me but I found it absolutely horrid to take, with an aftertaste that lasted for hours.’
These stimulant laxatives, such as senna and Epsom salts, have fallen out of fashion in recent years and prolonged use is now recognized to cause the bowels to become dependent and indeed may lead to permanent damage.
The alternative approach, and this really only applies to those who are chronically constipated, is to improve the regularity of the bowel by ‘exercising’ it. The presence of fecal matter in the colon encourages colonic contractions, so the more fecal matter that is present, the greater the amount of exercise and thus the stronger, and ‘fitter’, the bowel becomes.
As the two major constituents of fecal matter are water and indigestible cellulose or ‘fiber’, then the simplest of home remedies is to increase the amount consumed.
Water
The water content of the stool is reabsorbed as it passes down the colon, thus the higher the water intake, the less that needs to be reabsorbed and the larger the bulk of the stool. Mrs. Barbara Willett from Cornwall reports: ‘I became very constipated when pregnant with my first child in 1956. My family doctor advised “on waking in the morning drink half to a pint of warm water and then lie on your right side for about twenty minutes. This has worked for me all my life – I do not necessarily remain on my right side but I always drink the water. I am seventy-five now and continue to find it infallible. Many of my friends have benefited from this advice.’
The temperature of the water, another correspondent pointed out, is important as ‘neither cold nor hot water works. It has to be lukewarm’. Mrs. Louise Dawson from Gloucestershire suggests a variant of this remedy; ‘cabbage water in which a cabbage has been boiled for ten to fifteen minutes’. It is, she says, ‘quite pleasant with just salt and pepper – but if desired add a little Marmite or Bovril.’ The alternative to warm water first thing in the morning is to drink less tea and coffee. Both are natural diuretics increasing the quantity of urine that is passed which is dehydrating. This increases the amount of water that needs to be reabsorbed from the stool which in turn decreases its bulk. Ms P. Austin from Middlesex writes: ‘I cut down on tea and coffee gradually and increased my intake of plain water until the problem went away. Now, so long as I drink more plain water than tea and coffee every day I am not constipated.
Fiber
There is no doubt that increasing the bulk of the stool promotes its passage down the colon. This was convincingly shown in experiments conducted by Dr. Denis Burkitt who compared the speed with which marker pellets were eliminated in a group of English school boys on a typical school diet with a similar number of Africans consuming plants and cereals all rich in ‘dietary fiber’. The average African stool weighs between 300-500 grams and takes 36 hours to pass, compared to that of the school boys which weighed between 100-150 grams and took twice as long to pass down the colon.
There is nothing intrinsically desirable in passing a large stool especially if it requires consuming a rather dismal African-style’ diet. Nonetheless, as is now well known, many (if not all) of those with constipation do benefit from increasing the amount of fiber in their diet by increasing the quantity of fruit and vegetables consumed, and by eating bran-based cereals and wholemeal bread. It is important to recognize, however, that this ‘high fiber’ diet is not suitable for everyone and can cause flatulence, abdominal distension and colicky pains.
Natural Laxatives
Prunes: The laxative property of prunes has been recognized for a long time and were described by the first radio doctor, Charles Hill, as ‘nature’s little workers. Following intensive research conducted by Dr. Sidney Masri of the United States Department of Agriculture, the active ingredient was identified as the chemical magnesium. In her book ‘The Food Pharmacy Jean Carper notes ‘when researchers removed the magnesium phosphate from prunes, the fruit’s laxative properties dropped to zero but when they fed the powerful prune magnesium alone to mice not much happened either. It seems the famous prune chemical works only when it is in the prunes’. Those unaccustomed to eating prunes may initially experience symptoms similar to those experienced with a high fiber diet – flatulence and abdominal distension – but the intestinal tract usually adapts within a few weeks.
Sugar: Sugar attracts water and thus generates a loose stool. Babies with constipation respond well to bottled water to which a spoonful of brown sugar has been added. In adults honey has been shown to have a similar effect.
Beer: Beer drinkers do not suffer from constipation probably because beer combines both a high fluid intake and laxative properties of the sugars of fermented alcohol.
Some people find that one particular food, though not generally recognized as having laxative properties, nonetheless works for them. These include:
Cashew Nuts: ‘I have been constipated all my life but at a rather boring cocktail party I sat near a small table on which was a saucer of cashew nuts. With nothing better to do I absent-mindedly nibbled a few. Next morning I had a beautiful easy motion – such a luxurious surprise that I tried to pin down the cause of it and decided it could only be the cashew nuts. I now take a small handful (ten to twelve) every day just before lunch. I have never looked back, and I adore cashew nuts anyway.’ Mrs. Irene Evans from West Glamorgan.
Chocolate: ‘My mother, who lived to be ninety-nine, never travelled without a supply of Cadbury’s Bourneville chocolate – her cure for constipation.’ Mrs. David Hilton from Kent.
Aloe vera: ‘After suffering from constipation for nearly forty years I have tried enormous quantities of fruit, vegetables, water and fiber to no avail. I then read about aloe vera – the nineties wonder cure. Haifa small liqueur glass either on rising or last thing at night works wonders. It bulks out the stool and gives an easy motion twice a day.’ Anon.
In addition Mrs. P. Whetton from Lincoln recommends five to six slices of beetroot twice a week and Mrs. Kathleen Macdonald finds extra strong peppermint capsules – one or two a day – before meals ‘excellent for constipation’.
Massage: Mr. Michael Keef from Herefordshire writes: ‘Find a good physiotherapist and get him or her to give a course of stomach massage. My late wife was cured from chronic constipation over a period of six months with a massage once a fortnight. This is better than all the other remedies.’
