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Viewpoints of Iranian Traditional Medicine (ITM) about Etiology of Constipation | OMICS International
ISSN: 2161-069X
Journal of Gastrointestinal & Digestive System

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Viewpoints of Iranian Traditional Medicine (ITM) about Etiology of Constipation

Hamedi SH*, Jokar A and Abbasian A
Faculty of Traditional Medicine, Tehran University of Medical Sciences, Iran
Corresponding Author : Hamedi SH
Faculty of Traditional Medicine
Tehran University of Medical Science, Iran
Received September 22, 2012; Accepted October 31, 2012; Published November 02, 2012
Citation: Hamedi SH, Jokar A, Abbasian A (2012) Viewpoints of Iranian Traditional Medicine (ITM) about Etiology of Constipation. J Gastroint Dig Syst S8:005. doi: 10.4172/2161-069X.S8-005
Copyright: © 2012 Hamedi SH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Since our life is associated with inactivity and improper nutrition, Constipation is amongst the most common
diseases nowadays. Also conventional medicine has failed to cure constipation and relies on symptomatic treatment
with the use of laxatives or purgatives Instead of lenient. It came upon us to investigate constipation according to the
principles of treatment in Iranian Traditional Medicine (ITM), with “removing reasons”- elimination of the major causes
of illness in the process of effective treatment lead to a small step in the better treatment of this disease. “Constipation”
in the traditional medicine books is under the following terms: the low stool, retention of stool, abdominal block and
dry stool. It is the start of many diseases such as different colic, gripes and generally it is known as “the mother of
diseases”. This study presents etiology of constipation.

Constipation; Iranian traditional medicine; Etiology
Constipation is one of the most common diseases in the current century (3-17%) particularly in industrialized countries and many people are affected by it, without knowing it [1,2]. Treatment of constipation in allopathic medicine is mainly symptomatic and maintaining and is given different laxatives for example bulking agents and stimulus laxative and etc. In this situation, due to the chronic length of the constipation, there is the possibility of adverse effect and reduction of motility. Therefore it doesn’t respond to drugs and leads to complications such as hemorrhoid, anal fissure, rectal prolapsed, that can lead to urinary infections, nocturia, urinary reflux in children, fecal incontinence in middle-aged women, and eventually unnecessary surgery. According to current approach to complementary medicine, the search for preventive, diagnostic and therapeutic, methods seems to be imperative [3].
At the present time, according to ITM principles of treatment “removing the reason”- elimination of the major causes of the illness in the effective treatment-not only do we try to modify the six principles of a healthy lifestyle but also we pay attention to the causes of disease. Because the wide range of the causes of constipation, only with a good history taking and physical examination, we can discover the main causes of the illness and cure them in a simple and cost effective method. On the other word, ITM protocol for management of constipation, provide a wide range of causes for it and we can consider them to cure.
This article is a review of major sources of traditional medicine in Iran in different Centuries as cannon, Al-Igraz Al-Tibbieh and Al- Mabahis Al-Alaieh, Axir Azam, Sharhe-Asbab, Akbari medicine and Kholasat-al-hekmaa. Constipation with different titles of these books were extracted and then classified.
Physiology of defecation in the perspective of ITM
Before investigation of causes of constipation in traditional medicine, it’s necessary for us to know the opinions of the old ITM physicians about the normal defecation. Normal human stool should have the following features [4-8]:
- Appearance must be convened and similar in parts.
- It should be normal in: Quantity: it means stool compared with the food, not less, not more in weight. Color: it should be light yellow and if only colored food is not taken. Fecal odor: Neither bad smell nor odorless. Consistency: stool is neither very thick nor too loose (as consistency of honey). Time of defecation: Fecal excretion should be 12-24 hours after eating food.
- Defecation should be autonomic and be done easily.
- It should be without racing and acuity.
- Abdomen should be without borborygmi and gargling.
- Stool should be similar to food in quantity and volume.
- Stool shouldn’t have foams.
In ITM, if the stool isn’t like the above mentioned characteristics, would be abnormal and physicians need to find its reasons.
ITM and definition of constipation
“Constipation” in the traditional medicine books is known as “abdominal block”. It is one of the main parts of many diseases like intestinal colic and types of colic, gripes. So, generally it is known as “mother of diseases”. Similar to the characteristics of normal stool, constipation is defined in three items: The quantity: In constipation, the stool volume is less than the volume of food. Consistency: Stool is firm and dry. Time: It is occurred more than 12-24 hours.
Etiology of constipation
After definition of constipation in traditional medicine, then we review the causes of constipation. We can consider three causes of constipation: nutritional factors, intra intestinal factors, extra intestinal factors [6,7,9-13].
Nutritional factors:
- Eating dry foods and fruits like corn, rice, chestnut, sumac, dried meat, wheat flour, walnut, dried bread, banana.
- Food components should be absorbed by the liver completely (in ITM, after the first digestion in stomach and bowels, digested food particles would be absorbed by liver in the second digestion), and it remains just a small part as stool. For example: yolk, milk, roasted chicken, meat.
- Using drugs with a dry-temperament, sudorific drugs, and diuretics.
- Eating low amounts of foods: when the food is eaten low, the power of disposal is reduced.
Intra intestinal factors: It has two categories: obstructive and non-obstructive in bowels.
i. Obstructive reasons: A) Intestinal inflammations. B) Repletion of bowels by viscous phlegm; this type of obstruction gets better by fever. C) Intense wind in intestines. D) Invagination because the ligaments that connecting the intestines to the back is broken. E) Peritoneal rupture and intestinal hernia in scrotom. F) The presence of parasitic worms. G) Very dried stool [4,9,10].
ii. Non-obstructive reasons: A) Long time stool stay in the intestine. B) Using of narcotic drugs. C) Cold intemperament of the bowel. D) Weak digestion. E) Lack of enough bile secretion. F) Dry intemperament. G) Parasites which are water consumers in the intestines [4-6,9,10,12].
Extra intestinal factors:
- Abdominal sphincter muscle weakness that occurs in people who are very cohabitation.
- Hot intemperament of the abdomen because of yellow bile high flow.
- Cold weather leads to urination increase, the water of the remaining material in intestine exits by urination and leads to a dried face. However, cold causes contraction of the anal sphincter. So, the process of disposal becomes more difficult, finally disposal will be less [4,7,8,11].
- Dried intemperament is another reason to drying feces.
- The patient’s job can also be a factor for the exacerbation of constipation for example glass casting and forging.
- Due to warm weather, the internal moisture reaches to the body surface and so the stool can be dried.
- Atrophy and dryness of body stimulates the mesenteric veins to absorb moistures of the bowels and creates constipation. On the other hand intense sweating by heavy exercise or hot baths is among the factors that cause dryness and leads to semi-obstruction of the intestines.
- Water passing through diuresis or severe diarrhea can cause dryness in the body. Compensation for this dryness, the main mechanism is water gathering from the deeper organs like intestines which leads to constipation. Despite the intense heat in the body especially the liver and the kidneys can cause this disease.
- The last factor is usage of astringents, diuretic and diaphoretic drugs. They are among the most important factors in constipation [9,10,13].
People who are prone to get constipation
The following of etiologies of constipation show people who have greater susceptibility to this illness: People who: A) Have viscous phlegm in their bowel. B) Have cold stomach and bowel. C) Eat dried food with no fiber and very low. D) Use diuretics and narcotics and diaphoretics. E) Are suffering from digestive weaknesses [10,8,5]. F) Are infected with intestinal parasites and worms. G) Feel disposed to pursue any reasons but they are refusing. H) Suffer from Hungarian biliary obstruction such as obstructive jaundice. I) People with stomach and intestinal ulcers. J) Have weak abdominal muscles. K) Working in the vicinity of high temperature and, L) Exposed to severe cold weather [11-13].
ITM physicians in the history of medicine believed that eradication of the major causes of the sickness is necessary to complete treatment of diseases. First step of the treatment is change in life style and second step is herbal drug therapy. So, by reviewing of the causes of constipation, in many cases we would definitely treat it by changing in life style and etiologies (For example changing in diet, environment, work house….).
In this study, we have only tried to collect etiology of constipation according to beliefs of ITM physicians. And according to the definition and causes of constipation, we realized the importance of taking a complete history of patients and using thorough examination by traditional methods, without the use of clinical tools. On the other hand, in this method, the stool appearance profiles are simple but an important diagnostic key to diagnose gastrointestinal diseases.
Another point is that discovering the causes and symptoms of constipation in traditional medicine, can offer new practical approaches in comparison with classical medicine. So this method can help to reduce the complications of constipation in our community.


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