Drinking more water or eating a banana may seem like the obvious response to constipation. Yet these measures do not work for everyone because constipation does not always arise from the same underlying problem.
Hard, dry stools; difficulty passing otherwise soft stools; and stress-related irregularity may represent different patterns, according to traditional Chinese medicine (TCM). Recognizing these differences may help people choose more appropriate dietary and lifestyle strategies.
TCM’s Lens on 3 Types of Constipation
Dr. Wen-Hao Hsiao of Ding Chang TCM Clinic in Taiwan told The Epoch Times that TCM commonly groups constipation into three patterns: heat constipation, deficiency constipation, and qi stagnation constipation.
These patterns are not Western medical diagnoses, and a person may have features of more than one. From a Western medical perspective, constipation can also result from medications, slow intestinal transit, or conditions such as diabetes and hypothyroidism. Persistent or recurrent constipation should therefore be medically evaluated.
1. Heat Constipation: Hard, Dry Stools
Hsiao estimates that heat constipation accounts for approximately 60 percent to 80 percent of the constipation cases he sees in clinical practice.
People with this pattern typically present with hard, dry stools, dry mouth, and thirst, often accompanied by signs of inflammation. In TCM, these symptoms are classically described as “excess internal heat.”
They are commonly associated with diets high in fried, grilled, spicy, and highly processed foods, as well as inherently dry foods such as crackers, dried fruit, and jerky. When combined with inadequate fluid intake, these foods may cause the colon to draw more moisture from the stool, making it harder to pass.
In addition to increasing water intake, people with dry stools should prioritize soluble dietary fiber, Hsiao said. From a TCM perspective, foods such as pears, white fungus (snow fungus), and honey are traditionally used to moisten the intestines, replenish body fluids, and relieve dryness-related constipation.
2. Deficiency Constipation: Difficulty Despite Soft Stools
Deficiency constipation is more common among people who stay up late, are chronically overworked, are older, or have inadequate nutrition.
People with this type of constipation often feel they lack the strength to have a bowel movement. Their stools may not be especially dry, but they are still difficult to pass. Drinking more water or eating bananas may have little effect.
In this case, Hsiao said, the primary focus of treatment is to restore the body’s energy through adequate nutrition and a consistent daily routine.
As part of TCM dietary therapy, moderate amounts of black sesame seeds, Chinese yam, and goji berries are commonly recommended to nourish the body, support vitality, and promote healthy bowel function.
3. Qi Stagnation Constipation: Stress and a Sedentary Lifestyle
Another common cause of constipation is stress, which can slow intestinal movement. In TCM, this is known as qi stagnation constipation.
In TCM, qi refers to the body’s vital energy, which is believed to drive many physiological functions, including intestinal motility.
When people are under stress, overwhelmed with work, or spend long hours sitting, the flow of qi may become sluggish, slowing the digestive tract. Regularly suppressing the urge to have a bowel movement can also make constipation worse.
In addition to increasing physical activity to manage stress, people with this type of constipation may benefit from foods traditionally used in TCM, including hawthorn, aged tangerine peel (chenpi), and malt, which are believed to promote qi flow and support digestion, Hsiao said.
Warmth, Abdominal Massage, and Acupressure
Once you’ve identified the type of constipation you’re experiencing, dietary changes are only part of the solution. According to Hsiao, improving abdominal circulation and establishing regular bowel habits can also help ease constipation.
He recommends applying a warm compress to the abdomen when you feel the urge to have a bowel movement but are unable to pass stool. The gentle warmth helps relax the abdominal muscles and improve local circulation. The compress should feel comfortably warm—not hot enough to cause burns.
After warming the area, gently massage the abdomen using light, circular motions. Then apply acupressure to three abdominal acupoints commonly used in TCM: Zhongwan, or Middle Epigastrium; Tianshu, or Celestial Pivot; and Qihai, or Sea of Qi.
Middle Epigastrium (Zhongwan, CV12): Located on the midline of the upper abdomen, halfway between the navel and the bottom of the breastbone. This acupoint lies over the stomach, and applying pressure may produce a mild aching or distending sensation. In TCM, it is used to support digestion.
Celestial Pivot (Tianshu, ST25): Located about three finger-widths to the left and right of the navel. It is commonly used in TCM to promote intestinal motility.
Sea of Qi (Qihai, CV6): Located about two finger-widths below the navel. In TCM, stimulating this point is believed to promote the flow of qi, which in turn supports bowel function.
To perform the massage, begin at Sea of Qi below the navel, move to the right Celestial Pivot, then up to Middle Epigastrium, across to the left Celestial Pivot, and finally return to Sea of Qi. Massage the points in a clockwise sequence, completing three to five rounds. The massage can be performed after applying a warm compress to the abdomen. Use gentle pressure that produces a mild aching or fullness sensation—firm enough to be effective, but not painful.
In addition to local heat therapy and acupressure, regular physical activity can also help stimulate intestinal movement. Even a short walk after a meal may be beneficial. Research has found that brief periods of walking can increase gastrointestinal motility or movement through the digestive tract in healthy adults.
Elevating Your Feet While Using the Toilet
Your posture while sitting on the toilet can affect how easily you have a bowel movement. Hsiao recommends raising your feet while sitting on the toilet, as this may make passing stool easier and require less straining.
The technique is simple: Place your feet on a sturdy footstool and lean your upper body slightly forward to mimic a squatting position. If you’ve been sitting for a while without success, get up and try again later when you feel the urge to have a bowel movement.
Research has found that using a toilet footstool can reduce the effort required to pass stool and shorten the time spent on the toilet.
Establishing a Morning Bowel Routine
The colon often becomes more active after eating, particularly after breakfast. Taking advantage of this natural response can help train the body to follow a more regular schedule.
Upon waking, he recommends lying on your back in bed and gently pulling your knees toward your chest. Then slowly rock your knees from side to side to lightly stimulate the abdomen. After getting out of bed, drink a glass of warm water. If you feel the urge to have a bowel movement, head to the toilet without delay.
When Constipation Needs Medical Attention
Occasional constipation often improves with changes in diet, movement, toilet posture, and daily habits. However, it can sometimes signal an underlying medical problem.
Seek prompt medical care if constipation is accompanied by constant or severe abdominal pain, marked swelling, vomiting, fever, inability to pass gas, rectal bleeding, blood in the stool, fainting, or unexplained weight loss.
Consult a clinician if constipation is new, repeatedly returns, does not improve with self-care, or begins after starting a medication or supplement.