Dum Laga Ke Haisha: How to Achieve the Perfect Motion

Oh! no, no. This is not a movie review. This is the state in which an increasing number of Indians are finding themselves in the morning, on the shitpot. Constipation, one of the most common conditions worldwide has been variously defined as passing less than three stools in a week, or passing hard stools, or having to strain while pooping. However, in India, where it is a national preoccupation, at least in the yesteryear generation, people describe constipation as a feeling of incomplete evacuation, which actually compels them to go to the toilet more than 2-3 times in a day.

It is not a disease per se, but a symptom, which may be both the cause and effect of certain potentially serious diseases. For example, certain diseases like piles, fissure and diverticulosis are thought to be arising out of constipation in some way, if not as a direct consequence. On the other hand, tumours, polyps and other obstructive diseases like tuberculosis can lead to constipation as a consequence of the disease. Certain psychological factors also play an important role. For example, just the thought of using an unclean toilet while travelling, or for that matter anywhere, dissipates the urge to evacuate.

A dominant viewpoint in Ayurveda is that a number of systemic diseases arise because of retained impurities/toxins/wastes due to an unclean digestive system. Therefore, a clean bowel is a prerequisite for practically every treatment in Ayurveda.

Other than the disease, constipation sometimes becomes a cause of social embarrassment also because retained poop produces more gas, the sound or smell of which cannot be concealed despite your best efforts. And you are forced to listen to your ‘inner voice’!

So, what do you do about it?

Following are the do’s and don’ts.

• Drink at least 2 litres of water every day.
  
• Take at least 5 servings* of fruit and raw vegetables in a day.
  
• Exercise at least 45 minutes in 6 days out of 7.
  
• Increase fibre in your diet in the form of multigrain atta. Fibre is the indigestible portion of your diet that provides bulk to the stool.
  
• Last week we extolled you not to rest in the restroom and finish your business quickly. We also said “be Indian use Indian”. For good reason. It not only corrects the angle which facilitates the evacuation, it also stretches the acupressure point just below the knee joint which is supposed to relieve the constipation.
  
• A yogic kriya by the name of Laghu Sankh Prakshalan is a good purging technique. But it MUST be practiced ONLY after learning it properly from a trained Yoga teacher.
  

And the don’ts are:

• Junk food is a big no.
  
• Avoid refined flour like maida.
  
• Do not indulge in deep-fried food very often.
  
• No smoking please.
  
• Avoid strong laxatives available over-the-counter. Use something like Isabgole husk, if you must.
  
• Try not to spend a fortune on ‘natural’ remedies. A lot of them do not have any safety and efficacy data to support their use. Probiotics are not well understood. Touted as harmless, some probiotics can cause bloating or nausea. They are certainly not a panacea.
  

See your doctor if you are following all this for more than six months and still not pooping easily.

*(According to American Heart Association, One serving for vegetables is 1 cup of raw leafy vegetables (about the size of a small fist), 1/2 cup of other vegetables or 1/2 cup of vegetable juice. And for fruits: 1 medium fruit (medium is defined as the size of a baseball); 1/2 cup chopped, cooked or canned fruit; or 1/2 cup juice.)

(Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. His endeavour is to help people lead a healthy life without medication. He can be reached at [e-mail])