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Functional Constipation: A Chinese Medicine Perspective

What Is Constipation

The definition of Constipation is for an individual to have three or fewer bowel movements in a week. The stool can be hard, dry and/or pellet like. Sometimes it is painful to pass and at times there may be blood.

Research has shown that when compared with medication, acupuncture was more effective and had fewer adverse side effect [1,2]. Acupuncture increased stool frequency, improved stool formation, alleviated constipation symptoms, and improved quality of life [3].

Functional Constipation

Causes and risk factors for functional constipation:

1. Diet

  • Low Fiber Intake: Dietary fiber is crucial for bowel health. It adds bulk to the stool and helps it pass more quickly and easily through the intestines. A diet low in fiber, often found in processed and fast foods, can lead to constipation.
  • Poor Hydration: Water and other fluids help make stools softer and easier to pass. Inadequate fluid intake can result in hard, dry stools that are difficult to evacuate.

2. Lifestyle

  • Lack of Physical Activity: Regular physical activity is key to maintaining a healthy bowel function. Sedentary lifestyle, common in modern work environments and among the elderly, can contribute to constipation.
  • Irregular Eating Patterns: Irregular meal times can disrupt the body’s natural digestive rhythms. Skipping meals or erratic eating schedules can lead to less frequent bowel movements.

3. Psychological Factors

  • Stress: Chronic stress can interfere with the body’s normal digestive process and bowel function. It can lead to changes in the gastrointestinal system, which may manifest as constipation.
  • Anxiety and Depression: These conditions can alter the body’s autonomic nervous system, which in turn affects intestinal motility and can lead to constipation.

4. Medications

  • Opiates: These pain-relieving medications are well-known to slow bowel movements and can cause significant constipation.
  • Certain Antacids: Especially those containing aluminum and calcium, can slow bowel movements.
  • Antispasmodics: Used to treat muscle spasms in the intestines, these drugs can also reduce intestinal motility, leading to constipation.

5. Age

  • Elderly Population: As people age, their metabolism slows down, and they are more likely to have reduced physical activity and dietary changes. All these factors, combined with an increased use of medications, contribute to a higher prevalence of constipation in the elderly.

6. Gender

  • More Prevalent in Females: Hormonal changes, especially during menstruation, pregnancy, and menopause, can affect bowel function. Additionally, women might be more susceptible due to differences in pelvic floor anatomy and function.

Additional Considerations

  • Genetic Factors: There may be a genetic predisposition to constipation in some individuals.
  • Chronic Health Conditions: Diseases like diabetes, hypothyroidism, and neurological disorders (e.g., Parkinson’s disease) can affect bowel movements.
  • Lifestyle Choices: Excessive use of caffeine or alcohol, smoking, and the misuse of laxatives can contribute to constipation.

How Does Traditional Chinese Medicine (TCM) view Constipation

Functional constipation is a common clinical complaint.  While this may not be the primary complaint patients present with, moving the bowels will often help in a patient’s overall treatment progress and improve their general health.

Essentially, one or more of the following can contribute to constipation:

  • Inappropriate diet,
  • Chronic dehydration,
  • Lack of physical exercise/activity, and
  • Excessive stress
  • Overwork and childbirth
  • Febrile disease

Chinese medicine asserts that a normal bowel movement should occur once or twice a day and be relatively easy to pass. The stool will ideally be formed in the shape of a banana without being too hard or dry and any smell should be mild. There should be no pain or burning when passing the stool and it should not contain any blood or mucous. At the end of the movement one should feel cleared and completely empty.

In traditional Chinese medicine (TCM), a disease has two aspects: disease entity/symptom and pattern/cause. Pattern is more important because it explains the aetiology of a disease entity, and the therapy will be chosen according to the pattern rather than disease: patients with the same disease entity (symptom) but different patterns will receive different therapy; vice versa, patients with similar patterns may receive similar therapy even if their diseases or clinical manifestations are different [4].

When looking at constipation, there are usually underlying TCM patterns. These can be summarised as follows:


  • Chronic interior heat: 
— Heat in the Stomach and Large Intestine 
— Heat in the Liver
  • Acute heat in febrile disease: 
— Acute Large Intestine- and Stomach-Fire 

2. QI

  • Stagnation of Liver-Qi


  • Qi deficiency
  • Yang deficiency
  • Blood deficiency
  • Yin deficiency COLD
  • Spleen- and Kidney-Yang deficiency with Cold

At Kurrajong Natural Medicine Centre our team of highly qualified and experience practitioners will identify the underlying issue and help you in regaining normal bowel health. Simply call (02) 4573 0784

What You Can Do to Help Yourself if You Suffer from Constipation

  • Eating healthy, fresh, unprocessed foods. Avoid processed and fast-foods at all times.

  • Eating three meals a day. Your body requires energy during the course of a day, thus eat a good, healthy breakfast (this should be a substantial amount of fresh food); the least amount of energy required by your body is at night, therefore eat the smallest meal at night.

  • Physical activity/exercise daily e.g.: Yoga, Tai Qi or Qi Gong. Practicing any one of these or going to the gym, walking, swimming, etc. at least 4x a week for at least 30 min each time will improve movement of the intestines.

  • Increase fiber intake: Consuming a diet rich in fiber can promote regular bowel movements. Include foods like fruits, vegetables, whole grains, legumes, and nuts in your meals. Gradually increase your fiber intake to avoid sudden changes that may cause discomfort.

  • Stay hydrated: Drinking an adequate amount of water helps soften the stool, making it easier to pass. Aim to drink at least eight glasses of water per day, unless advised otherwise by your healthcare provider.

  • Regular exercise: Engaging in regular physical activity stimulates the muscles in your intestines, promoting bowel movements. Try to incorporate exercises like walking, jogging, or yoga into your routine.

  • Establish a regular bathroom routine: Train your body to have a regular bowel movement routine by visiting the bathroom at the same time each day. This can help condition your body and encourage regularity.

  • Avoid delaying the urge to go: When you feel the urge to have a bowel movement, try not to delay it. Ignoring the urge can lead to harder stools and worsening symptoms.

  • Manage stress: Chronic stress can affect your digestive system. Find healthy ways to manage stress, such as practicing relaxation techniques, engaging in hobbies, or seeking support from friends and family.

  • Consult a healthcare professional: If your constipation persists despite making lifestyle changes or if you experience severe discomfort, it’s important to consult a healthcare professional. They can evaluate your symptoms, provide appropriate guidance, and recommend further treatment options if necessary.


1. Bai, T., Song, C., Zheng, C., & Huang, G. (2016). Acupuncture for the treatment of functional constipation. Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan, 36(5), 578–587. https://doi.org/10.1016/s0254-6272(16)30076-0

2. Lee, H. Y., Kwon, O. J., Kim, J. E., Kim, M., Kim, A. R., Park, H. J., Cho, J. H., Kim, J. H., & Choi, S. M. (2018). Efficacy and safety of acupuncture for functional constipation: a randomised, sham-controlled pilot trial. BMC complementary and alternative medicine, 18(1), 186. https://doi.org/10.1186/s12906-018-2243-4

3. Wang, L., Xu, M., Zheng, Q., Zhang, W., & Li, Y. (2020). The Effectiveness of Acupuncture in Management of Functional Constipation: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2020, 6137450. https://doi.org/10.1155/2020/6137450

4. Shen, M., Cui, Y., Hu, M., & Xu, L. (2017). Quantifying traditional Chinese medicine patterns using modern test theory: an example of functional constipation. BMC complementary and alternative medicine, 17(1), 44. https://doi.org/10.1186/s12906-016-1518-x

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Page last updated: 26th June 2023

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