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Shweta Dadarao Parwe* and Milind Abhimanyu Nisargandha


The word “constipation” has varied meanings for different individuals. Although medical personnel define constipation as 3 bowel movements per week, feelings of incomplete emptying, straining, and urge for defecation.[1] Constipation is one of the most frequently diagnosed gastrointestinal disorders. Most studies estimate the prevalence of constipation in the general population to be 12 – 19%.[2] The prevalence of constipation rises dramatically with age, with some estimates approaching 50% among adults over 80 years of age. Up to 40% of seniors living in the community and 60% of those in institutions are affected. Lower socioeconomic class, non-white race, regular medication use, female sex, and symptoms of anxiety and depression have all been associated with increased prevalence of constipation among older people.[3] According to Sushruta, he told about the lakshana of ' Atma' & ' Indriya ' & remaining is the notated with the disease of Malavstambha. (Samamalakriyaha) This is the cause of it.[4] In patient of Malavstambha, we get mainly the disturbance of „Purisha’ & „Purishkriya’ & Including „Dosha’ & „Agni’. So due to this human being become Nirutsahi & so they become the „Malavstambhi Rugna’ Vagbhatacharya explained or mentioned the importance of mala i.e. (Malochittwada Dehasya). It is the regularly habit of our body that to excrete the waste product i.e. mala in the Morning hence we get clean the body, freshness of mind & lightness of body. But due to same reason, if mala did not excrete, it gets stored at body and due to this diseases get produced. „Mala’ is an entity which is nourished by „Kitta by the action of Agni. Purisha mala is formed in Purishvaha strotas from this kitta. In large intestine about 1 lit. of slurry is delivered, where most of water, sodium, chloride, glucose and amino acid are reabsorbed. Here potassium is secreted and goblet cell secret mucus to lubricate the stool. Bacteria on intestinal flora produce Vit. K and Vit. B12 from this slurry. So initially Purish mala is functioning entity. It provides strength and support to Vayu, Agni and Pitta.[5,6] As per status of our body, age these Mala get replenished till they achieve their physiological measurement. They are produced in their quantities and qualities. This brings homeostatic condition in our body. When it becomes nuisance to body physiology, it should be excreted out; otherwise it will cause ill-effect.[7] Charkacharya advised this in „Nidan sthana’ but because of fast life or changing life style, society can't follow these concepts about „Aahar’ & „Vihar’ (e.g. Pav or Bread, fast food, Chinese, Ratri Jagarana.)[8] Hence now a day‟s maximum people are suffering from problem of constipation i.e. Malavstambha. In Ayurvedic samhitas, in 'Ashtang Hriday', Malavstambha is mentioned as a lakshana. Many types of diseases were caused by „Malavstambha’. Five varieties of salts are very commonly used in the preparation of many numbers of Ayurvedic dosage forms and as a routine dietary regimen. Sushruta describes it as stomachic, digestive and laxative.[9] Constipation is defined as delay or difficulty in defecation, causing significant distress to the patient. It is characterized by infrequent bowel evacuations, hard small feces with painful defecation. It can be divided into organic or nonorganic / functional constipation. Only 5-10% patients have an organic cause for it & 90-95 % patients have no biochemical, pathological abnormalities are identified.

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