ACUPRESSURE SHODH PRASHIKSHAN

EVAM UPCHAR SANSTHAN, PRAYAGRAJ

(ASPEUS)

ADVANCE DIPLOMA IN ACUPRESSURE HEALTH SCIENCE

DECEMBER – JULY 2019

SEMESTER 4- PROJECT WORK

CONSTIPATION

BY
PRABHA VANNIAR

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 ACUPRESSURE SHODH PRASHIKSHAN
EVAM UPCHAR SANSTHAN
(ASPEUS)

ADVANCE DIPLOMA IN ACUPRESSURE HEALTH SCIENCE

DECEMBER – JULY 2019

SEMESTER 4- PROJECT WORK

CONSTIPATION

PRABHA VANNIAR
ROLL NO.

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 CONSTIPATION
A PROJECT REPORT
SUBMITTED
TOWARDS PARTIAL FULFILMENT FOR THE AWARD OF THE
ADVANCE DIPLOMA IN ACUPRESSURE HEALTH SCIENCE
CERTIFICATE
This is to certify that the project entitled ‘CONSTIPATION’ submitted by
Prabha Vanniar to ASPEUS Allahabad, for the award of the award of advance
diploma in acupressure health sciences is a bonafide record of the work
carried out by her under my supervision and guidance. The content of the
project, in full or parts have not been submitted to any other institute for the
award.

PLACE:
DATE: PROJECT GUIDE

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 Acknowledgement

In Studying The Subject And In Preparing Of This Project Report, Immense Help Has Taken
From Various Sources; The Book ,The Internet And Personal Discussions. These Invaluable
Sources Have Been Cited In The Bibliography At The End Of The Report.

I Feel Indebted To Acupressure Shodh, Prashikshan Evam Upchar Sansthan Allahabad For
Developing Such Wonderful Treatise On The Subject Of Acupressure.

I Am Grateful To my Guru Mrs. Pratima Kulkarni & Col.(Retd)Shreeram Pendse For

Introducing & Encouraging Learning Acupressure And Guiding At Every Step. Besides, I
would like to thank my classmates and other members of Acupressure Vikas Sanghatan for
providing me with a good environment and facilities to complete this project.

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 INDEX
1. Introduction........................................................................................................................................................................ 7

1.1 Definition.................................................................................................................................................................... 7

1.2 Scope of Acupressure............................................................................................................................................ 8

2. Functional Anatomy of Digestion Process.............................................................................................................9

2.1 Structure & Function of the Digestive System............................................................................................9

2.2 Blood & Nerve Supply of the Digestive System.......................................................................................17

3. Functional Anatomy of Excretion Process..........................................................................................................18

3.1 Structure & Function of the Excretory System........................................................................................18

3.2 Blood & Nerve Supply of the Excretion System......................................................................................22

4. Constipation..................................................................................................................................................................... 23

4.1 Types of Constipation.........................................................................................................................................24

4.2 Signs & Symptoms of Constipation...............................................................................................................26

4.3 Complications.........................................................................................................................................................27

4.4 Bristol Stool Chart................................................................................................................................................ 28

4.5 Causes of Constipation.......................................................................................................................................29

4.6 General Treatment Approach.........................................................................................................................34

5. Treatment through Acupressure.............................................................................................................................37

6. Traditional Chinese Medicine (TCM).....................................................................................................................38

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 6.1 Pattern of Qi based on Symptoms.................................................................................................................39

6.2 Treatment of Constipation based on TCM.................................................................................................41

7. Electro Acupuncture According to Voll (E. o. V.)..............................................................................................46

7.1 Treatment of different parts of large intestine........................................................................................47

7.2 Treatment of lymph vessel of large intestine...........................................................................................49

7.3 Treatment on Nerve Supply of Large Intestine.......................................................................................50

7.4 Control Measurement point of Large Intestine.......................................................................................51

7.5 Treatment on Peritoneum Point....................................................................................................................52

8. Eight Extra Ordinary Vessels (E.O.V.)....................................................................................................................53

8.1 Treatment of Constipation based on E.O.V...............................................................................................54

9. Ayurvedic Acupressure............................................................................................................................................... 56

9.1 Ayurvedic Acupressure Treatment Fields.................................................................................................57

9.2 Treatment Protocols Based on Ayurvedic Acupressure.....................................................................61

10. References......................................................................................................................................................................... 62

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 CONSTIPATION

1. INTRODUCTION
Constipation is a very common digestive complaint now-a-days. Rather than a definable
disease it can be summarized as constellation of symptoms. Despite its frequency, it often
remains unrecognized until the patient develops any serious disorders. Constant condition
of constipation usually leads to piles, hemorrhoids, hernia and many more etc. It is very
common, and for some people especially older adults, it can be an ongoing concern. Many
factors can dispose a person to constipation. Some can easily be prevented by changing
habits and lifestyle. In serious conditions, medical aid is required. However, it is very much
necessary to study the root cause of the problem and cure it accordingly by adapting
lifestyle changes and correct treatment. This project aims in studying the process of
digestion and excretion, knowing the various causes of constipation, understanding the
imbalance from bio-energy point of view and how to cure it from the root.

1.1 DEFINITION

All living organisms consume food to generate energy that allows them to perform their
biological processes. At the same time, they have certain by-products that are generated
during these processes and these need to be expelled. This is known as excretion. In the
human body, a specialized system is present, known as the excretory system.

When the excretion process is hampered or the waste product is not expelled out
completely in proper manner it leads to a condition called constipation. Defining
constipation has been difficult. Many patients describe constipation as the passage of hard
stools, a sense of incomplete evacuation, excessive straining, or excessive time spent in
unsuccessful defecation. From a medical standpoint, constipation has been defined as the
inability to evacuate stool completely and spontaneously more than 3 times per week.

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 1.2 SCOPE OF ACUPRESSURE

Acupuncture and acupressure are two widely known alternate therapies and practiced
around the world with varying degree of spread, popularity and acceptance. In addition to
these two main acu therapies, there are scores of allied acu therapies being practiced in
various part of the world. Examples of such acu therapies are: sujok acupuncture/pressure,
ayurvedic acupuncture/pressure, yogic acupuncture/pressure, electro acupuncture, laser
puncture, sono puncture, aqua puncture, seed therapy, magneto therapy, chromo (colour)
therapy, acupuncture - moxibustion, auricular therapy (ear acupuncture), periosteal
acupuncture, reflexology, etc.
While the two main therapies of acupuncture and acupressure are believed to have
originated in China around 2000 – 3000 B.C., some of the acu therapies are of as recent an
origin as the late twentieth century. This project explains the following Acu therapies and
how it can be used to cure various diseases.
i. Traditional Chinese Medicine (TCM)
ii. Electro Acupuncture According to Voll (E. A. V)
iii. Eight Extra Ordinary Vessels (E. O. V.)
iv. Ayurvedic Acupressure
Acupressure is a natural science, philosophy and a rational method of therapy based on an
inbuilt mechanism provided in the human body by nature. These therapies are non-
invasive, cheap and effective method which works on balancing the internal bio-energy of
the human body. The concept of each of the methods are different and is based on different
principles.
i. Removing stagnation or stasis of energy at any location in the body
ii. Correcting the rebellious direction or contravections
iii. Raising the sinking or collapsing energy
iv. Expelling pathogenic factors
v. Balancing all body systems
vi. To arrest any type of degeneration
vii. Rectify musculo structural problems

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viii. Balancing the physical and meta-physical elements

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 2. FUNCTIONAL ANATOMY OF DIGESTION PROCESS

The digestive system is responsible for:

i. receiving food
ii. breaking it down into nutrients
iii. absorbing these nutrients in to blood stream
iv. eliminating the undigested parts of food & wastes from the body

2.1 STRUCTURE & FUNCTION OF THE DIGESTIVE SYSTEM

FIGURE 1 :STRUCTURE OF DIGESTIVE SYSTEM

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The digestive system consists of:
i. Mouth
ii. Throat
iii. Esophagus
iv. Stomach
v. Small Intestine
vi. Large Intestine
vii. Rectum and anus
viii. Liver, Gall Bladder, Spleen and Pancreas

MOUTH

The mouth is the beginning of the digestive tract. In fact, digestion starts here as soon as
you take the first bite of a meal. Chewing breaks the food into pieces that are more easily
digested, while saliva mixes with food to begin the process of breaking it down into a form
your body can absorb and use. The chewing process is done by the teeth. Enzyme amylase
present in saliva undertake the chemical breaking down process. Amylase initiates the
conversion of starch into sugar. A rounded mass of masticated food known as bolus is
ready to be swallowed.

FIGURE 2 :STRUCTURE OF MOUTH

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 THROAT

Also called the pharynx, the throat is the next destination for food you've eaten. This is the
junction of both the digestive and the respiratory systems. In its front are oral and the nasal
cavities and esophagus & larynx are to the back. This is a sensitive structure; it catches
microbes in food and air to inform the body about infection. From here, food travels to the
esophagus or swallowing tube.

FIGURE 3 :ANATOMY OF PHARYNX

ESOPHAGUS

The esophagus is a muscular tube extending from the pharynx to the stomach. The bolus
after swallowing comes to esophagus. This is a fibro-muscular tube-like structure, about
23cm long and 2.2 cm in diameter. It is lines with stratified epithelium & has innumerable
mucous glands that facilitate the movement of bolus. By means of a series of contractions,
called peristalsis, the esophagus delivers food to the stomach. Just before the connection to
the stomach there is a "zone of high pressure," called the lower esophageal sphincter; this
is a "valve" meant to keep food from passing backwards into the esophagus.

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 STOMACH

The stomach is a large, bean shaped sac-like hollow organ with strong muscular walls.
It consists of three parts:
i. The cardia
ii. The body of stomach
iii. The antrum
The food enters the stomach through lower esophageal sphincter. The upper stomach
works as a storage area for food. The cardia and body of stomach relax to accommodate
food which enters the stomach. Then the antrum (lower stomach) contracts rhythmically,
mixing the food with acids and enzymes. These acids and enzymes are called stomach
juices.In addition to holding the food, it's also a mixer and grinder. When it leaves the
stomach, food is the consistency of a liquid or paste. From there the food moves to the
small intestine.

FIGURE 4 :ANATOMY OF STOMACH

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 SMALL INTESTINE

Made up of three segments, the duodenum, jejunum, and ileum, the small intestine is a long
tube loosely coiled in the abdomen (spread out, it would be more than 20 feet long). The
small intestine continues the process of breaking down food by using enzymes released by
the pancreas and bile from the liver. Bile is a compound that aids in the digestion of fat and
eliminates waste products from the blood. Peristalsis (contractions) is also at work in this
organ, moving food through and mixing it up with digestive secretions. The duodenum is
largely responsible for continuing the process of breaking down food, with the jejunum and
ileum being mainly responsible for the absorption of nutrients into the bloodstream. Three
organs play a pivotal role in helping the stomach and small intestine digest food: Pancreas
Among other functions, the oblong pancreas secretes enzymes into the small intestine.
These enzymes break down protein, fat, and carbohydrates from the food we eat. Liver The
liver has many functions, but two of its main functions within the digestive system are to
make and secrete bile, and to cleanse and purify the blood coming from the small intestine
containing the nutrients just absorbed. Gallbladder The gallbladder is a pear-shaped
reservoir that sits just under the liver and stores bile. Bile is made in the liver then if it
needs to be stored travels to the gallbladder through a channel called the cystic duct.
During a meal, the gallbladder contracts, sending bile to the small intestine. Once the
nutrients have been absorbed and the leftover liquid has passed through the small
intestine, what is left of the food you ate is handed over to the large intestine, or colon.

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FIGURE 5 : ANATOMY OF SMALL INTESTINE

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 PANCREAS

The pancreas is a gland organ. It is located in the abdomen. It is part of the digestive system
and produces insulin and other important enzymes and hormones that help break down
foods.
The pancreas consists of two parts:
i. The acini, which produce digestive enzymes
ii. The islet, which produce hormones

FIGURE 6 : LOCATION AND STRUCTURE OF PANCREAS

The pancreas has an endocrine function because it releases juices directly into the
bloodstream, and it has an exocrine function because it releases juices into ducts.
Enzymes, or digestive juices, are secreted by the pancreas into the small intestine. There, it
continues breaking down food that has left the stomach.
The pancreas also produces the hormone insulin and secretes it into the bloodstream,
where it regulates the body's glucose or sugar level. Problems with insulin control can lead
to diabetes.

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 LIVER

Liver, the largest gland in the body, a spongy mass of wedge-shaped lobes that has many
metabolic and secretory functions. The liver secretes bile, a digestive fluid; metabolizes
proteins, carbohydrates, and fats; stores glycogen, vitamins, and other substances;
synthesizes blood-clotting factors; removes wastes and toxic matter from the blood;
regulates blood volume; and destroys old red blood cells.

FIGURE 7 : LOCATION & STRUCTURE OF LIVER

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 GALL BLADDER

Gallbladder, a muscular membranous sac that stores and concentrates bile, a fluid that is
received from the liver and is important in digestion. Situated beneath the liver, the
gallbladder is pear-shaped and has a capacity of about 50 ml (1.7 fluid ounces). The inner
surface of the gallbladder wall is lined with mucous-membrane tissue similar to that of
the small intestine. Cells of the mucous membranehave hundreds of microscopic
projections called microvilli, which increase the area of fluid absorption. The absorption of
water and inorganic salts from the bile by the cells of the mucous membrane causes the
stored bile to be about 5 times—but sometimes as much as 18 times—more concentrated
than when it was produced in the liver.
Contraction of the muscle wall in the gallbladder is stimulated by the vagus nerve of the
parasympathetic system and by the hormone cholecystokinin, which is produced in the
upper portions of the intestine. The contractions result in the discharge of bile through the
bile duct into the duodenum of the small intestine.
Bile flows from the two lobes of the liver into the hepatic and common bile ducts. If food is
present in the small intestine, the bile will continue directly into the duodenum. If the small
intestine is empty, the sphincter of Oddi will be closed, and bile flowing down the common
duct will accumulate and be forced back up the tube until it reaches the open cystic duct.
The bile flows into the cystic duct and gallbladder, where it is stored and concentrated until
needed. When food enters the duodenum, the common duct’s sphincter opens, the
gallbladder contracts, and bile enters the duodenum to aid in the digestion of fats.

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FIGURE 8 : LOCATION & STRUCTURE OF GALL BLADDER

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 2.2 BLOOD & NERVE SUPPLY OF THE DIGESTIVE SYSTEM

The superior mesenteric artery (a branch of the abdominal aorta) and the superior
pancreaticduodenal artery (a branch of the hepatic artery) supply the small intestine with
blood. These vessels run between layers of the mesentery, the membrane that connects the
intestines with the wall of the abdominal cavity, and give off large branches that form a row
of connecting arches from which branches arise to enter the wall of the small bowel. The
blood from the intestine is returned by means of the superior mesenteric vein, which, with
the splenic vein, forms the portal vein, which drains into the liver.
The small intestine has both sympathetic and parasympathetic innervation. The vagus
nerve provides parasympathetic innervation. Sympathetic innervation is provided by
branches from the superior mesenteric plexus, a nerve network underneath the solar
plexus that follows the blood vessels into the small intestine and nally terminates in the
Auerbach plexus, which is located between the circular and longitudinal muscle coats, and
the Meissner plexus, which is located in the submucosa. Numerous brils, both adrenergic
(sympathetic) and cholinergic (parasympathetic), connect these two plexuses.

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 3. FUNCTIONAL ANATOMY OF EXCRETION PROCESS
Defecation, also called bowel movement, the act of eliminating solid or semisolid waste
materials (feces) from the digestive tract. In human beings, wastes are usually removed
once or twice daily, but the frequency can vary from several times daily to three times
weekly and remain within normal limits. Muscular contractions (peristaltic waves) in the
walls of the colon move fecal material through the digestive tract to the rectum.
Defecation is usually voluntary but some disorders may result in involuntary
action. Incontinence—the loss of control over the evacuative process—can develop with
age; it may also result from surgical, obstetric, spinal, or other bodily injuries or with
neurological impairment resulting from diabetes, stroke, or multiple sclerosis. Defecation
may also be influenced by pain, fear, temperature elevation, and psychological or
neurological complications. Diarrhea, or abnormally frequent defecation, is a characteristic
symptom of many diseases and disorders—most strikingly in such diseases as cholera
and dysentery.

3.1 STRUCTURE & FUNCTION OF THE EXCRETORY SYSTEM

FIGURE 9 : STRUCTURE OF ABDOMINAL ORGANS

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 LARGE INTESTINE

The large intestine consists of:

i. The cecum
ii. The ascending colon (right side)
iii. The transverse colon
iv. The sigmoid colon
v. The rectum

FIGURE 10 : ANATOMY OF LARGE INTESTINE

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The large intestine, or colon, serves as a reservoir for the liquids emptied into it from the
small intestine. It has a much larger diameter than the small intestine (approximately 2.5
cm, or 1 inch, as opposed to 6 cm, or 3 inches, in the large intestine), but at 150 cm (5 feet),
it is less than one-quarter the length of the small intestine. The primary functions of the
colon are to absorb water; to maintain osmolality, or level of solutes, of the blood by
excreting and absorbing electrolytes (substances, such as sodium and chloride, that in
solution take on an electrical charge) from the chyme; and to store fecal material until it
can be evacuated by defecation. The large intestine also secretes mucus, which aids in
lubricating the intestinal contents and facilitates their transport through the bowel. Each
day approximately 1.5 to 2 litres (about 2 quarts) of chyme pass through the ileocecal valve
that separates the small and large intestines. The chyme is reduced by absorption in the
colon to around 150 ml (5 uid ounces). The residual indigestible matter, together with
sloughed-off mucosal cells, dead bacteria, and food residues not digested by bacteria,
constitute the feces.
The colon also contains large numbers of bacteria that synthesize niacin (nicotinic acid),
thiamin (vitamin B ) and vitamin K, vitamins that are essential to several metabolic
activities as well as to the function of the central nervous system.

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 STOOL

Waste left over from the digestive process, is passed through the colon by means of
peristalsis (contractions), first in a liquid state and ultimately in solid form as the water is
removed from the stool. A stool is stored in the sigmoid colon until a "mass movement"
empties it into the rectum once or twice a day. It normally takes about 36 hours for stool to
get through the colon. The stool itself is mostly food debris and bacteria. These bacteria
perform several useful functions, such as synthesizing various vitamins, processing waste
products and food particles, and protecting against harmful bacteria. When the descending
colon becomes full of stool, or feces, it empties its contents into the rectum to begin the
process of elimination.

RECTUM

The rectum (Latin for "straight") is an 8-inch chamber that connects the colon to the anus.
It is the rectum's job to receive stool from the colon, to let you know there is stool to be
evacuated, and to hold the stool until evacuation happens. When anything (gas or stool)
comes into the rectum, sensors send a message to the brain. The brain then decides if the
rectal contents can be released or not. If they can, the sphincters (muscles) relax and the
rectum contracts, expelling its contents. If the contents cannot be expelled, the sphincters
contract and the rectum accommodates, so that the sensation temporarily goes away.

ANUS

The anus is the last part of the digestive tract. It consists of the pelvic floor muscles and the
two anal sphincters (internal and external muscles). The lining of the upper anus is
specialized to detect rectal contents. It lets us know whether the contents are liquid, gas, or
solid. The pelvic floor muscle creates an angle between the rectum and the anus that stops
stool from coming out when it is not supposed to. The anal sphincters provide fine control
of stool. The internal sphincter keeps us from going to the bathroom when we are asleep,
or otherwise unaware of the presence of stool. When we get an urge to go to the bathroom,
we rely on our external sphincter to keep the stool in until we can get to the toilet.

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 3.2 BLOOD & NERVE SUPPLY OF THE EXCRETION SYSTEM

The arterial blood supply to the large intestine is supplied by branches of the superior and
inferior mesenteric arteries (both of which are branches of the abdominal aorta) and the
hypogastric branch of the internal iliac artery (which supplies blood to the pelvic walls and
viscera, the genital organs, the buttocks, and the inside of the thighs). The vessels form a
continuous row of arches from which vessels arise to enter the large intestine. Venous
blood is drained from the colon from branches that form venous arches similar to those of
the arteries. These eventually drain into the superior and inferior mesenteric veins, which
ultimately join with the splenic vein to form the portal vein.
The innervation of the large intestine is similar to that of the small intestine.

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 4. CONSTIPATION

Constipation refers to bowel movements that are infrequent or hard to pass or a feeling of
incomplete evacuation. The stool is often hard and dry. Other symptoms may include
abdominal pain, bloating, and feeling as if one has not completely passed the bowel
movement. Complications from constipation may include hemorrhoids, anal fissure or fecal
impaction.
Constipation is a symptom, not a disease. Most commonly, constipation is thought of as
infrequent bowel movements, usually less than 3 stools per week. However, people may
have other complaints as well including:

 Straining with bowel movements

 Excessive time needed to pass a bowel movement
 Hard stools
 Pain with bowel movements secondary to straining
 Abdominal pain
 Abdominal bloating.
 the sensation of incomplete bowel evacuation.

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 4.1 TYPES OF CONSTIPATION

PRIMARY CONSTIPATION

Functional, or primary, constipation can be divided into three types: slow-transit

constipation, pelvic floor dysfunction, and normal-transit constipation.

Slow-transit constipation. In this type of constipation, motility (gut movement) is

decreased, and transit time (the time it takes for food to pass from the beginning to the end
of the digestive tract) is increased. Slow-transit constipation symptoms may include
infrequent bowel movements, bloating, and abdominal discomfort.

Outlet constipation, or pelvic-floor dysfunction. In this type of constipation,

discoordination of the musculature of the pelvic floor results in either inappropriate anal
contraction, a failure of anal relaxation, or inefficient propulsion of stool. Outlet
constipation symptoms often include straining to pass stool, soft stools that do not pass
easily, and discomfort in the rectum. This type of constipation is less likely to respond to
traditional medical therapies.

Normal-transit constipation. Some individuals with primary chronic constipation have

neither slow transit nor an outlet problem, but rather a condition known as normal-transit
constipation. Those with normal-transit constipation may even have daily bowel
movements, yet describe themselves as constipated due to a persistent sense of difficult
evacuation, with hard stools and abdominal bloating and discomfort. This type of
constipation may be associated with elevated psychosocial distress. Normal-transit
constipation is a very common type of chronic constipation.

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 SECONDARY CONSTIPATION

Secondary constipation can be caused by metabolic disturbances like hypothyroidism;

neurological problems like Parkinson’s disease, multiple sclerosis, and spinal cord
injuries; celiac disease; and diseases of the large intestine such as colon cancer
and diverticular disease. Several medications can cause secondary constipation as well.

ASSOCIATED CONDITIONS

Individuals with chronic constipation often have other digestive problems that involve
disordered motility, such as indigestion, gastroesophageal reflux disease, diverticular
disease, and irritable bowel syndrome (IBS). In fact, the overlapping symptoms of primary
constipation and constipation-predominant irritable bowel syndrome (IBS-C) make them
difficult to distinguish, leading some researchers to suggest they may be the same
condition. Hemorrhoids are associated with constipation as well.

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 4.2 SIGNS & SYMPTOMS OF CONSTIPATION

Constipation is generally described as having fewer than three bowel movements a week.
Though occasional constipation is very common, some people experience chronic
constipation that can interfere with their ability to go about their daily tasks. Chronic
constipation may also cause excessive straining to have a bowel movement and other signs
and symptoms.
Signs and symptoms of chronic constipation include:
 Passing fewer than three stools a week
 Having lumpy or hard stools that is difficult to pass
 Straining to have bowel movements
 Feeling as though there's a blockage in your rectum that prevents bowel movements
 Feeling as though you can't completely empty the stool from your rectum
 Needing help to empty your rectum, such as using your hands to press on your
abdomen and using a finger to remove stool from your rectum
 stomach ache
 stomach cramps
 feeling bloated and nauseous
 losing appetite
 sluggishness and/or lethargy
 Constipation may be considered chronic if you've experienced two or more of these
symptoms for the last three months.

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 4.3 COMPLICATIONS

Complications of chronic constipation include:

 Swollen veins in your anus (hemorrhoids). Straining to have a bowel movement
may cause swelling in the veins in and around your anus.
 Torn skin in your anus (anal fissure). A large or hard stool can cause tiny tears in
the anus.
 Stool that can't be expelled (fecal impaction). Chronic constipation may cause an
accumulation of hardened stool that gets stuck in your intestines.
 Intestine that protrudes from the anus (rectal prolapse). Straining to have a
bowel movement can cause a small amount of the rectum to stretch and protrude
from the anus.

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 4.4 BRISTOL STOOL CHART

There are seven types of stools (faeces) according to the Bristol StoolChart. The Bristol
Stool Chart or Bristol Stool Scale is a medical aid designed to classify faeces into seven
groups.
The type of stool or faeces depends on the time it spends in the colon. After you pass faeces,
what you see in the toilet bowl is basically the result of your diet, fluids, medications and
lifestyle. You can use the Bristol Stool Chart to check what your stools are telling you.
The Bristol Stool Chart shows seven categories of stool. Every person will have different
bowel habits, but the important thing is that your stools are soft and easy to pass – like
types 3 and 4 below.
 Type 1–2 indicate constipation
 Type 3–4 are ideal stools as they are easier to pass, and
 Type 5–7 may indicate diarrhoea and urgency.

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 4.5 CAUSES OF CONSTIPATION

Constipation usually happens because the colon (part of the digestive system) absorbs too
much water from your food. If the food moves through the digestive system too slowly, too
much water may be absorbed. The bowel motions at the end of the digestive process
are then too dry and hard.
Many things can cause or worsen constipation including:
 not eating enough fibre (fruit and vegetables, wholemeal bread, high fibre cereals)
 not drinking enough - always drink more when you increase fibre in your diet
 not doing enough exercise
 anxiety, depression, grief
 delaying the urge to go to the toilet
 using laxatives for a long time
 the side effects of some medicines (even some common ones like pain killers or iron
tablets)
 antacid medicines that have calcium or aluminium
 pregnancy
 being overweight
 stress
 resisting the urge to poop
 not being able to go to the toilet because of poor mobility
 problems with the nerves and muscles in your digestive system
 some bowel problems like haemorrhoids, irritable bowel syndrome, or diverticulitis
 anorectal pain caused by haemorrhoids, fissures (tear in the skin of the anus) or
birth trauma, or
 a slow transit bowel which means it takes longer for the faeces to travel all the way
to the rectum, so more water is removed over time and constipation is much more
likely. This occurs where there is nerve damage such as with stroke, Parkinson's,
multiple sclerosis or trauma.
 Underactive thyroid (called hypothyroidism)

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These are the most common causes of constipation:

BLOCKAGES IN THE COLON OR RECTUM

Blockages in the colon or rectum may slow or stop stool movement. Causes include:
 Anal fissure
 Bowel obstruction
 Colon cancer
 Narrowing of the colon (bowel stricture)
 Other abdominal cancer that presses on the colon
 Rectal cancer
 Rectum bulge through the back wall of the vagina (rectocele)

DIFFICULTY WITH THE MUSCLES INVOLVED IN ELIMINATION

Problems with the pelvic muscles involved in having a bowel movement may cause chronic
constipation. These problems may include:
 Inability to relax the pelvic muscles to allow for a bowel movement (anismus)
 Pelvic muscles don't coordinate relaxation and contraction correctly (dyssynergia)
 Weakened pelvic muscles

LACK OF FIBER IN THE DIET

People whose diets include a good quantity of fiber are significantly less likely to suffer
from constipation.
It is important to consume foods rich in fiber such as fruits, vegetables, and whole grains.
Fiber promotes bowel movements and prevents constipation.
Foods that are low in fiber include high-fat foods, such as cheese, meat, and eggs.

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 PHYSICAL INACTIVITY

Constipation can occur if someone becomes too physically inactive. This is especially the
case in older adults.
For individuals who have been bedridden for a long time, perhaps for several days or
weeks, their risk of having constipation is significantly increased. Experts are not sure why.
Some believe that physical activity keeps the metabolism high, making the processes in the
body happen more rapidly.
Older adults tend to have a more sedentary life compared with younger people and are
therefore at higher risk of constipation. Physically active people are much less likely to
become constipated than inactive people.

MEDICATIONS

The most common medications to cause constipation are:

 narcotic (opioid) pain drugs including codeine (Tylenol), oxycodone (Percocet), and
hydromorphone (Dilaudid)
 antidepressants including amitriptyline (Elavil) and imipramine (Tofranil)
 anticonvulsants including phenytoin (Dilantin) and carbamazepine (Tegretol) iron
supplements
 calcium channel blocking drugs including diltiazem (Cardizem) and nifedipine
(Procardia)
 aluminum-containing antacids including Amphojel and Basaljel
 diuretics including chlorothiazide (Diuril)

MILK

Some people become constipated when they consume milk and dairy products.

IRRITABLE BOWEL SYNDROME

People who suffer from irritable bowel syndrome (IBS) get constipation much more
frequently, compared with the rest of the population.

35
 PREGNANCY

Pregnancy brings about hormonal changes that can make a woman more susceptible to
constipation. Also, the uterus may compress the intestine, slowing down the passage of
food.

AGING

As a person gets older, the metabolism slows down, resulting in less intestinal activity. The
muscles in the digestive tract do not work as well as they used to.

CHANGES IN ROUTINE

When a person travels, their normal routine changes. This can affect the digestive system,
which sometimes results in constipation. Meals are eaten at different times, or a person
might go to bed, get up, and go to the toilet at different times. All these changes can raise
the risk of constipation.

OVERUSE OF LAXATIVES

Some people believe a person should go to the toilet at least once a day - this is not true.
However, to make sure this happens, some people self-medicate with laxatives.
Laxatives are effective at helping bowel movements. However, using them regularly allows
the body to get used to their action and gradually the dose needs to increase to get the
same effect.
Laxatives can be habit-forming. When a person becomes dependent on them, there is a
significant risk of constipation when they are stopped.

NOT GOING TO THE TOILET WHEN NEEDED

If individuals ignore the urge to have a bowel movement, the urge can gradually go away
until the individual no longer feels the need to go. The longer it is delayed, the drier and
harder the stool will become.

36
 NOT DRINKING ENOUGH WATER

If constipation is already present, drinking more liquids might not relieve it. However,
regularly drinking plenty of water reduces the risk of constipation.
Many sodas and drinks contain caffeine which can cause dehydration and worsen
constipation. Alcohol also dehydrates the body and should be avoided by individuals who
are constipated or very susceptible to constipation.

PROBLEMS WITH THE COLON OR RECTUM

Tumors can compress or restrict the passages and cause constipation. Also, scar tissue,
diverticulosis, and abnormal narrowing of the colon or rectum, known as colorectal
stricture.
People with Hirschsprung disease are susceptible to constipation (a birth defect in which
some nerve cells are absent in the large intestine).

SOME DISEASES AND CONDITIONS

Diseases that tend to slow down the movement of feces through the colon, rectum, or anus
can cause constipation.
These include the following:
 Neurological disorders: Multiple Sclerosis (MS), Parkinson's disease, stroke, spinal
cord injuries, and chronic idiopathic intestinal pseudo-obstruction can lead to
constipation.
 Endocrine and metabolic conditions: Uremia, diabetes, hypercalcemia, poor
glycemic control, and hypothyroidism.
 Systemic diseases: These are diseases that affect a number of organs and tissues, or
affect the body as a whole, they include lupus, scleroderma, amyloidosis.
 Cancer: Constipation occurs in people with cancer, mainly due to pain medications
and chemotherapy. Also, if a tumor blocks or squeezes the digestive system.

37
 4.6 GENERAL TREATMENT APPROACH

Constipation is usually easier to prevent than to treat. Following the relief of constipation,
maintenance with adequate exercise, fluid intake, and high-fiber diet is recommended.

PREVENTION

The following can help you avoid developing chronic constipation.

 Include plenty of high-fiber foods in your diet, including beans, vegetables, fruits,
whole grain cereals and bran.
 Drink two to four extra glasses of water a day, unless your doctor told you to limit
fluids for another reason.
 Try warm liquids, especially in the morning.
 Eat fewer foods with low amounts of fiber such as processed foods, and dairy and
meat products.
 Drink plenty of fluids.
 Stay as active as possible and try to get regular exercise.
 Try to manage stress.
 Don't ignore the urge to pass stool.
 Try to create a regular schedule for bowel movements, especially after a meal.
 Make sure children who begin to eat solid foods get plenty of fiber in their diets.

In the majority of cases, constipation resolves itself without any treatment or risk to health.
The treatment of recurring constipation can include lifestyle changes such as doing more
exercise, eating more fiber, and drinking more water.
Usually, laxatives will successfully treat most cases of constipation - but should be used
with care and only when necessary. In more difficult cases, the person may need a
prescription medication.

38
It is important to understand the cause of constipation - there could be an underlying
illness or condition. Some people with recurring constipation use a daily diary where they
record their bowel movements, stool characteristics, and other factors that may help both
the doctor and patient devise the best treatment.
Some gastroenterologists comment that there are people who do not allocate enough time
for their defecation. Set aside enough time to allow your toilet visit to be unstressed and
uninterrupted, and do not ignore an urge to have a bowel movement.

OTC LAXATIVES

The following laxatives are given as the last resort when no other prevention measures
work out:
 Stimulants: These make the muscles in the intestines contract rhythmically. These
include Correctol, Dulcolax, and Senokot.
 Lubricants: These help the stool move down the colon more easily. These include
mineral oil and Fleet.
 Stool softeners: These moisten the stool. Stool softeners include Colace and Surfak.
 Fiber supplements: These are perhaps the safest laxatives. They are also called
bulk laxatives. They include FiberCon, Metamucil, Konsyl, Serutan, and Citrucel and
should be taken with plenty of water. If you want to buy bulk laxatives, then there is
an excellent selection online with thousands of customer reviews.
 Osmotics: These facilitate the movement of fluids through the colon. These include
Cephulac, Sorbitol, and Miralax.
 Saline laxatives: These draw water into the colon and include milk of magnesia.
 Chloride channel activators: These require a prescription and include
lubiprostone (Amitiza).
 5-HT-4 agonists: They increase the secretion of fluid in the intestines and speed up
the rate at which food passes through the colon. They include Prucalopride.
 If the constipation does not respond to any treatment, as a last resort, surgery to
remove part of the colon may be undertaken. In the procedure, the segment of the
anal sphincter or rectum that causes the constipation is removed.

39
40
 NATURAL REMEDIES

There are a few ways to ease the symptoms of constipation without using medication.
These include:
 Increasing fiber intake: People with constipation should eat between 18 and 30
grams (g) of fiber every day. Fresh fruits and vegetables and fortified cereals have
high fiber content.
 Drinking water: Consuming lots of water can help to rehydrate the body.
 Bulking agents: Adding these to your diet can help soften stools and make them
easier to pass. Examples of bulking agents include wheat bran.
 Regular exercise: This can help to make bodily processes more regular, including the
passing of stools.
 Routine: Having a place and time of day where you can put aside time to visit the
bathroom without forcing a stool.
 Avoiding holding in stools: Responding to your body's natural urges to pass stools
when they happen is key to reducing the impact of constipation.
 Elevate your feet: Place your feet short platform, such as a step, and make sure the
knees are above hip-level while passing stools. This can reduce constipation.
 Homeopathic remedies: While their effectiveness is disputed, some studies have
suggested that treatments for constipation offered by homeopathic doctors can be
successful. These include calcarea carbonica, nux vomica, silica,
bryonia, and lycopodium.

41
 5. TREATMENT THROUGH ACUPRESSURE
Ordinary therapists treat the disease. For the time being the disease goes away. But the
same disease recurrs after sometime. Acupressure therapy aims at treating the root cause
of disease. On treating the root cause of the disease, the disease is cured and it rarely
recurr. Acupressure is a natural healing method. The origin of this Self Healing Therapy lies
in the natural acts of human when they relieve these pains by pressing on the painful areas
of the body thereby getting relief.

Acupressure is a word composed of Acu+Pressure. Acu means needle and pressure means
to apply force. Thus, to press a point which is as small as a needle tip and thereby treat a
disease is known as acupressure. In the whole body or on its corresponding zones, specific
points are selected, pressed or applied seeds, colors or magnets to create an electro
magnetic field in the organ or related body parts, which is known as bio-energy. The
balance of this very bio-energy is the aim of acupressure therapy.

There are various streams of Acupressure Therapy based on different concepts. They are as
follows:
i. Traditional Chinese Medicine (TCM)
ii. Electro Acupuncture According to Voll (E. A. V)
iii. Eight Extra Ordinary Vessels (E. O. V.)
iv. Ayurvedic Acupressure

There are many symptoms of Constipation and accordingly each symptom may have different root
cause. Different treatment protocols based on the types, constitution and symptoms have been
explained for each of these stream of Acupressure Therapy.

42
 6. TRADITIONAL CHINESE MEDICINE (TCM)
Acupuncture is the foremost and most basic amongst all the acu therapies prevalent in various
parts of the world. The word ‘acupuncture’ has two parts, ‘acu’ and ‘puncture’. Acu means needle.
Puncture is self-explanatory and means ‘to pierce’. Acupuncture hence refers to a therapy wherein
needles are inserted at specified locations of therapeutic value on the human body to heal diseases.
It is a very effective system of treatment and can cure a vast majority of diseases known to
mankind.

Acupuncture seeks to cure diseases by restoring the imbalance of energy flow in the human body.
As per the basic principle of the therapy, energy is constantly flowing in the human body along
defined pathways known as meridians. A disease occurs if this energy flow becomes excess or
deficient, gets impeded or counter flows due to various external or internal factors. A number of
points known as acu points are located along these meridians and control the flow of energy on
these pathways, just the way electrical switches/regulators control the flow of current in a circuit.
Stimulation of these acu points with needles using specific techniques corrects the energy
imbalance along a meridian and the disease gets cured.

If instead of using needles, pressure is applied on these same very acu points with the help of
thumb, fingers or any object, the therapy is known as acupressure. The principles underlying both
acupuncture and acupressure therapies are exactly the same.

Acupuncture is an invasive method of treatment involving some degree of pain and often a sense of
fear on part of the patient. On the other hand, acupressure does not involve any needle insertion
although some degree of pain is still experienced when an acu point is pressed. While both these
therapies are equally effective, acupuncture appears to give faster relief than acupressure. One has
the advantage of faster relief, whereas the other has the advantage of lesser pain in the application
of the therapy. That is perhaps the reason why these two similar therapies have existed
concurrently through the centuries.

According to Traditional Chinese Medicine, bio-energy is termed as "Qi". The Chinese

concept of disease divides life into two parts: Ease and Disease. Ease is when the Qi of the
body is balanced on the physical, mental and emotional level. Disease is when the Qi is
either imbalanced, stagnant or in contravection.

43
44
 6.1 PATTERN OF QI BASED ON SYMPTOMS

In TCM, the diagnosis and treatment of a disease is done based on the eight guiding
principles. They are as follows:

i. Yin Disease v. Hotness Disease

ii. Yang Disease vi. Coldness Disease
iii. External Disease vii. Deficiency Disease
iv. Internal Disease viii. Excess Disease

Various conditions of stool indicate different root cause resulting in constipation.

According to TCM, diagnosis of different constitution is done by examining the stool as
follows:

Sr.
Symptoms of Constipation Pattern of Qi Imbalances
No.
1. Round, small like pebbles and dry Heat
2. Round, small like pebbles and not dry Liver Qi Stagnation
3. Long and thin stool like pencils Spleen Qi Deficiency
4. Dry stools with intense thirst Heat
5. Dry stools with no thirst Deficiency of Stomach Yin or Kidney Yin
Loose stools which are difficult to
6. Spleen Qi Deficiency + Liver Qi Stagnation
expel
Watery yellow & non frothy explosive
7. Humid Heat
stools spreading in all directions of pot
8. Severe and spastic abdominal pain Cold
Mild abdominal pain and excess
9. Liver Qi Stagnation
distention
10. Difficult defecation with great effort Deficiency of Qi or Yang
11. Exhaustion after bowel movement Deficiency of Qi or Yang
12. Cramps after defecation Cold or Stagnant Qi

45
13. Pale Stools Humid Heat in Gall Bladder
14. Dark Stools Heat
15. Green Stools in Children Cold
Acute Constipation with thirst, pale
16. Heat in stomach & Intestine
dry yellow film on tongue
17. Constipation in old age people Deficiency of blood
18. Constipation of woman after delivery Deficiency of blood
Stool passing in very small amount and
19. Liver Qi Stagnation + Heat in Intestines
resembling goat's stool
20. Alternate constipation & diarrhoea Stagnation of Liver Qi attacking Spleen
Constipation along with cough, sore
21. Wind Diseases
throat, dry skin, dry stool, brittle nails
Strain in navel region, stomach and
22. Occlusion of Qi
coastal areas

46
 6.2 TREATMENT OF CONSTIPATION BASED ON TCM

6.2.1 DIFFERENT TYPES OF CONSTIPATION

1. Normal Constipation
Treatment: Group I - St25, Tw6 ↓ all
Group II - K6, 7, Sp6 ↑ all

2. Acute Constipation
Symptoms: Thirst, pale dry yellow film on tongue
Cause: Heat in Stomach & Intestines
Treatment:
Heat in Stomach: P6, Sp6, CV12, 13, St21, 44, 45 ↓ all
Heat in Large Intestine: Li2, 11, St37, 44 ↓all CV4, Sp6, K6 ↑ all

3. Constipation of Old aged people

Cause: Deficiency of Blood
Treatment: P6, H7, UB17, 18, 20, CV14, 15, Sp4, Lu7, K6 ↑ all

4. Constipation of woman after delivery

Cause: Deficiency of Blood
Treatment: P6, H7, UB17, 18, 20, CV14, 15, Sp4 ↑ all

5. Constipation with intense abdominal pain

Cause: Deficiency of Yang leading to Internal Cold
Treatment: St25, 36,37, 39, CV6, 4, Sp6, Liv3, UB20, 27 ↑ all

6. Constipation with no thirst

Symptoms: Dry Stool, No Thirst
Cause: Kidney Yin Deficiency & Stomach Yin Deficiency
Treatment:

47
Kidney Yin Deficiency: K3, 6, 9, 10, Sp6, CV1, 4 ↑ all
Stomach Yin Deficiency: St36, Sp3, 6, CV12 ↑ all

7. Constipation resembling goats stool

Cause: Anxiety and worry leads to Stagnation of Liver Qi and Heat in Intestines
Treatment:
Stagnation of Liver Qi: P6, Liv3, 13, 14, GB34, Tw6 ↓ all
Heat in Intestine: Liv2, 11, St37, 39, 44 ↓ all and Sp6, K6, CV4 ↑ all

8. Alternate Constipation & Diarrhoea

Cause: Stagnation of Liver Qi attacking Spleen
Treatment: Liv3, 13, 14 ↓ all St36, Sp6, CV12, GB34 ↑ all

9. Constipation due to wrong diet

Symptoms: Cracked lips, Low Appetite, Abdominal pain, Sticky coat on tongue
Cause: Wrong diet
Treatment: CV12, St36 ↓ all

10.Constipation due to deficiency of energy

Symptoms: Disturbed equilibrium, palpitation, general weakness, emaciation, insomnia
Treatment: UB17, 18, St25 ↑ all

11.Constipation due to wind diseases

Symptoms: Cough without expectoration, sore throat, dry skin, brittle nails, dry faeces
Treatment: UB12, 25, GV16 ↓ all

12.Constipation due to Occlusion of Qi

Treatment: CV6, Tw6 ↓ all

13.Constipation due to heat

Treatment: K6, Liv1, Li4 ↓ all

48
 6.2.2 DIFFERENT PATTERNS OF CONSTIPATION

Different patterns of constipation along with their symptoms and treatment are as follows:

Sr.
Pattern Symptoms Treatment
No.
Dry Stools, Infrequent bowel
Chronic internal heat in
movements, Foul breath, Dry Tw6, Li4, 11, St28,
1. stomach & large
Mouth, Thirst, Scanty & dark 29, 44, Sp14, 15 ↓ all
intestine
urine, Abdominal pain
Dry stools, bitter taste, red shot
Liv2, Tw6, Li4, 11,
Chronic internal heat in eyes, Irregular bowel movement,
2. St28, 29, 44, Sp14,
liver thirst, Dark Urine, Headache,
15 ↓ all
Irritation
Constipation, Dry Stools, High
Acute Constipation fever, Red Face, Feeling of heat, Tw6, Li4, 11, St28,
3.
after fever Profuse Sweating, Thirst, Dry 29, 44, Sp15 ↓ all
Mouth
Stools shaped like pebbles but
not dry, Difficulty in opening the Liv3, GB34, CV10, 6,
4. Liver Qi Stagnation
bowels, Belching, Abdominal Sp15 ↓ all
distention, Irritation
Thin and long stools which are
not dry, Exhaustion after bowel
Spleen and lungs Qi Sp6, St36, CV6, Sp15,
5. movements, difficulty in opening
deficiency UB21, 25 ↑ all
bowel inspite of repeated
attempts, Tiredness,
6. Blood Deficiency Dry Stools, Difficulty in Sp6, St36, CV4, Sp15,
defecation, glowless face, UB20, 23, 25 ↑ all
dizziness, numb limb, blurred

49
 vision
Difficulty in defecation,
exhaustion & sweating after
defecation, Sometimes stool is
passed after a gap of 2-3 days, K7, CV4, UB23, 25,
7. Kidney Yang Deficiency
lower backache, knee pain, St36, Sp6 ↑ all
feeling of cold, frequent pale
urination, reduced will power,
dizziness
Dry Stools, Dry mouth in evening,
Dry throat in evening, night K3, 6, CV4, UB23, 25,
8. Kidney Yin Deficiency
sweating, lower backache, knee Sp6, 15, St36 ↑ all
pain, tinnitus, night sweat
Difficult defecation, no stool for
Cold in intestines due to
several days, cold limb, severe K18, CV6, 18, UB23,
9. spleen and kidney yang
spastic abdominal pain, cold 25, 26 ↑ all
deficiency
limbs, feels cold
Cold in intestines due to K18, CV6, 18, UB23,
10. Difficult defecation
internal cold 25, 26 ↓ all

50
 6.2.3 TREATMENTS BASED ON VARIOUS LAWS & THEORIES

1. Law of Distal Points:

Sp6 : For any problem from navel till the base of foot
Tw6 : Important distal point for constipation, Irritable Bowel Syndrome (IBS) and stasis of Qi
and/or body fluids.
GV20: Important Distal Point for anorectal disorders

2. Law of Xi- Cleft Points OR Accumulating Points:

Liv6 : Disorders of Evacuation ( constipation, bloody faeces etc.)

3. Law of Regulating Bowels:

Constipation: UB25, St25, 28, Tw6, UB57, K6

51
 7. ELECTRO ACUPUNCTURE ACCORDING TO VOLL (E. O. V.)
Electro acupuncture refers to the therapy in which acu points are stimulated by electrodes carrying
minute electrical currents, the principles of treatment being the same as that of classical
acupuncture. Whereas this therapy was already in vogue in many parts of the world, pioneering
research in electro acupuncture was carried out by Dr. Reinhold Voll, an allopathic physician of
Germany, around the mid twentieth century. This research was so extensive and its results so
promising that it evolved into a therapy of its own and came to be known as ‘Electro Acupuncture
According to Voll’ (EAV) after the name of its inventor.
The western world had hitherto looked upon Chinese acupuncture therapy as an invalidated
system and not having a scientific base. Dr. Voll, with the help of electrical measuring instruments,
demonstrated and validated the scientific base of various Chinese acupuncture points. He
discovered eight new meridians on the palms and the feet to treat tissue disorders such as
disorders of nervous tissues, skin tissues, fibrous tissues, etc. Dr. Voll also discovered a new eye
meridian around the eye orbit to treat various disorders of the eyes.
Dr. Voll not only scientifically validated the existing Chinese acupuncture points, he discovered a
large number of new points on the existing Chinese meridians. He also redefined a number of
existing acu points and discovered new locations for these points. The high point of Dr. Voll’s
research was his linking of minute parts of various body organs to specific acu points. For example,
Dr. Voll found that specific points existed to treat individual parts of organs such as appendix,
transverse colon, rectum, etc. in case of large intestine; cardia, fundus, pylorus, etc. in case of
stomach; cardiac plexus, endocardium, myocardium, pulmonary valve, A.V. node, etc. in case of
heart and similarly for all the parts of all the organs of the body.
Dr. Voll devised an instrument by the name of dermatron to measure the electrical resistance on the
acu points. Depending upon the current reading obtained at various acu points, it became possible
to tell whether an organ part related to that acu point was diseased and at what stage the disease
process was at that point of time, i.e., acute, inflammatory, degenerative, chronic, etc. It became
further possible to treat these diseased organs or their affected parts by stimulating their related
acu points with the required dosage of electrical current.
Though the work of Dr. Voll holds vast promise in the field of diagnosis and treatment of most
complex of diseases in an extremely simplistic, effective and comparatively inexpensive manner, it
is yet to get due recognition from most of the medical fraternity.

52
 7.1 TREATMENT OF DIFFERENT PARTS OF LARGE INTESTINE

There are various parts of the Large Intestine. Any problem with any of the part can be
treated by the following E.O.V. points:

53
 Part of the Large
Sr.No. E.O.V. Point Description
Intestine
A problem here affects local organs and
1. Li4 (R) Caecum
psoas muscle
This is a M.P. for appendix and ilioceacal
lymph nodes.
2. Li4a (R) Appendix Treat Appendicitis here.
Provides mucous to lubricate and protect
local wall
3. Li3 (R) Ascending Colon M.P. for ascending colon
4. Li2 (R) Rt flexure of colon M.P. for Rt flexure of colon
Transverse Colon (Right
5. Li1 (R) M.P. for Transverse Colon (Right Part)
part)
Transverse Colon (Left
6. Li4 (L) M.P. for Transverse Colon (Left Part)
part)
7. Li3 (L) Left flexure of colon M.P. for left flexure of colon
8. Li2 (L) Descending Colon M.P. for Descending Colon
9. Li1 (L) Sigmoid Colon M.P. for Sigmoid Colon
Rectum swelling during constipation is
treated here.
10. K6 Rectum Hemorrhoids, Inflammatory irritation of the
anal canal, Fissure in rectum, Eczema in
rectum/anus
Treats Hemorrhoids, Inflammatory irritation
11. K5 Anal Canal
of the anal canal, Fissure, Eczema
When anus shrinks and there is difficulty in
passing stool, treat this point.
12. K4a Anal Sphincter
When anus dilates and retaining capacity of
stool decreases, tone this point.

54
 7.2 TREATMENT OF LYMPH VESSEL OF LARGE INTESTINE

There are lymph drainage points related to various parts and various organs of the body. It
treats the lymph system of human body. The points that treat the lymph vessel of large
intestine are given as below:

E.O.V.
Sr.No. Part of the Large Intestine Description
Point
M.P. Intestinal Lymphatic It is an important point for the
1. Ly7 (L)
Trunk treatment of intestines
M.P. for lymphatic drainage It is related to mesentry of the colon
2. Ly8 (L&R) of left side of intestines and and connects large intestine to
intestinal roots centre.
If lymph nodes are present in rectum
Lymph drainage of rectum
3. K6a and anal canal, this is an important
and anal canal
treatment point.
M. P. for mesentric lymph It is a point of lymphatic gland of
4. Ly7 (R)
nodes membrane for captivating intestines.
M. P. for lymph vessel of
5. Li1-1 (R)
caecum and colon
M. P. for lymph vessel of
6. Li1-1 (L)
colon and sigmoid colon
All types of piles can be treated on
M. P. for lymph of rectum
this point. Problems related with
7. UB49 S. M. P. for lymphatic system
coccyx and nearby regions also
of lumbar and sacral region
treated here.

55
 7.3 TREATMENT ON NERVE SUPPLY OF LARGE INTESTINE

E.O.V.
Sr.No. Part of the Large Intestine Description
Point
Controls acid base ratio in colon
which prevents ulcers in colon
1. Li1a (R) Superior Hypogastric Plexus
Governs vascular function of lower
part of body
Iliac Plexus & femoral Controls arteries of lower portion of
2. Li1a (L)
Plexus & Popliteal Plexus body
Innervates Ascending Colon &
3. Si1a (R) Upper Mesentric Plexus
Transverse Colon
Energies the left half of colon and
4. Si1a (L) Lower Mesentric Plexus
upper rectum
Autonomic innervation point of
Rectal and Hemorrhoidal Plexus
This is sympathatic nerve supply and
Medial and Inferior Rectal innervates lower Rectum and Middle
5. K4
Plexus Rectum
Treatment on this point closes
sphincter and stops motions. Very
usefu in controlling motions.

56
 7.4 CONTROL MEASUREMENT POINT OF LARGE INTESTINE

Control Measurement Point (C. M. P.) gives the information about the pathological
disturbances in the internal part of the body or the organ itself. It is being observed that
treatment on the control measurement point cures the problem and malfunctioning of the
organ amazingly and restores the balance of the functionality of that organ.

E.O.V.
Sr.No. Part of the Large Intestine Description
Point
Li1b (L & C.M.P. for whole of large C.M.P. for whole of large intestine
1.
R) intestine including rectum, anal canal and anus
It innervates spleen, pancreas,
Parasympathetic branch of duodenum, small intestine, large
2. K20
coelic plexus intestine including transverse colon,
liver and gall bladder.

57
 7.5 TREATMENT ON PERITONEUM POINT

Outer covering of organs is called peritoneum. This peritoneum does two activities:
Activity of serous coat of organ.
Activity of keeping the organ in place.

Treatment on this point restores the serous coat and cures ulcer. Proper treatment of ulcers of
stomach, small intestine, large intestine is successfully possible with the serious membrane point
discovered by Dr. Voll.

E.O.V.
Sr.No. Part of the Large Intestine Description
Point
Treats chronic large intestine
disease.
Peritoneum Point of Large Colitis
1. Li1c
Intestine Diverticulitis (a pouch or sac
protruding from the wall of large
intestine)
M. P. for great Omentum which
connects bowel to stomach
Treat omenitilis
When organs of abdomen start
suspending towards bottom, treat
2. Li3a M. P. for great Omentum
this point.
Blood secretion in ulcer and on
digestive tract, treatment on this
point establishes the serous coat and
cures the disease.
Front Shu Point of Large
3. St25 Alarm Point of Large Intestine
Intestine
Back Shu Point of Large
4. UB25 Treats Constipation
Intestine

58
59
 8. EIGHT EXTRA ORDINARY VESSELS (E.O.V.)
The word extra ordinary refers to wonderous, rare, strange, something exceptional, unusal
& unparallel. The word vessel means a larger, less linear container. The largest vessels of
water ont he earth are seas or oceans. The largest reservoirs of Qi in the human body are
these extra ordinary vessels. The main meridians are like rivers and the extra ordinary
vessels are like reservoirs or dams or seas, where excess of energy is stored & kept
reserved for use as and when needed.
The main function of the eight extra ordinary vessels is to absorb the excess energy of the
main meridians and to transfer this energy to the main meridians, when needed.
Each of the eight extra ordinary vessels has one master point. This master point is also
called opening point. As a master controls his men, so a master point controls the
functioning of the concerned extra ordinary vessel. Each extra ordinal vessel is coupled
with another extra ordinary vessel. The first meridian is called main meridian and second
meridian is called coupled meridian.

Name of eight extra ordinary vessels & their master points:

YIN VESSELS YANG VESSELS

Name of Extra Name of Extra
Master Point Master Point
ordinary Vessels ordinary Vessels
Conception Vessel or
Governing Vessel or
Ren Mo or Lu7 Si3
Du Mo
Directing Vessel
Chong Mo or Dai Mo or
Vital Vessel or Sp4 Girdle Vessel or GB41
Penetratin Vessel Belt Meridian
Yin Heel Vessel or Yang Heel Vessel or
K6 UB62
Yin Quio Mo Yang Quio Mo

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Yin Linking Vessel or Yang Linking Vessel or
Yin Wei Mo or P6 Yang Wei Mo or TW5
Yin Regulating Vessel Yang Regulating Vessel

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 8.1 TREATMENT OF CONSTIPATION BASED ON E.O.V.

Conception Vessel or Ren Mo or Directing Vessel

Master Point: Lu7
Coupled Point: K6
Starting Point: CV1
Passes through: CV1 to CV24
Luo Point: CV15
Cleft Point: St30

Treatment Protocol:
For Male: Lu7 (Left) ↑ K6 (Right) ↓ St30 (L&R) ↕
For Male: Lu7 (Right) ↑ K6 (Left) ↓ CV1 (L&R) ↕

Treats:

i. Pain in abdominal wall

ii. Treats Yin Deficiency
iii. Pain in sides of navel
iv. Empty heat symptoms
v. Swollen anus
vi. Blood in stool
vii. Haemorrhoids
viii. Constipation
ix. All diseases that occur post delivery

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Yin Heel Vessel or Yin Quio Mo
Master Point: K6
Coupled Point: Lu7 or UB62
Starting Point: K8 or K6
Passes through: K2, K6, K8, St9, St12, UB1
Cleft Point: K8

Treatment Protocol:
For Male: K6 (Left) ↓ Lu7 or UB62 (Right) ↓
For Male: K6 (Right) ↓ Lu7 or UB62 (Left) ↓

Treats:
i. Constipation and piles
ii. Bladder pain
iii. Intestinal bleeding
iv. Bladder spasm
v. Seven types of acute bladder pain
vi. Undigested food in stool
vii. Deficient Spleen
viii. Abdominal pain
ix. Abdominal masses & lumps

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 9. AYURVEDIC ACUPRESSURE
Ayurvedic acupuncture/acupressure as generally understood across the world refers to the
therapy in which ayurvedic principles of 'Vat', 'Pitta' and ‘Kapha’ are applied to points of
Chinese acupuncture meridians. As per the basic principle of this new therapy as
enunciated in the ancient Indian text of ‘Charak Sanhita’, the universe as well as the human
body is composed of ten elements. Diseases occur as a result of disbalance of these ten
elements in the body. The Sansthan has discovered that these ten elements can be
represented on the ten fingers of the two hands as well as on the ten toes of the two feet.

As generally known in India, these elements are 'Akash' (Space), ''Vayu' (Wind/Air), 'Jal'
(Water), 'Agni' (Fire) & 'Prithvi' (Earth). However, practically no one knew or gave a
thought to the fact that ancient Indian Ayurvedic texts actually mention ten elements that
are present in the universe and in all living beings. These additional elements, all meta
physical, are 'Kaal' (Time), 'Disha' (Direction), 'Man' (Mind as opposed to brain which is
physical), 'Atma' (Soul; its physical manifestation is 'Prakash', i.e., Light) & 'Shunya/Tam'
(Zero or Darkness, the source of origin of universe). Every thing in this universe, whether
non living or living, must necessarily fall within the ambit of these ten physical/meta
physical elements.
As per this new therapy, the ten elements are represented on the ten fingers of the two
hands and similarly on the ten toes of the two feet. There are thirty basic ayurvedic
meridians on each finger/toe including thumb/big toe. That makes it 300 basic meridians
on the two hands and 300 basic meridians on the two feet, a total of 600 basic meridians.
Each meridian has ten points corresponding to the ten elements, thus giving us 6000
points. Many secondary meridians have been developed by combining various basic
meridians, thus giving us additional meridians and points running into thousands. In the
Traditional Chinese Medicine, treatment is done with the help of 14 main meridians only. It
can thus be seen that the Ayurvedic Acupressure has vastly expanded the scope and reach
of Chinese Traditional Medicines in the treatment of diseases.

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65
 9.1 AYURVEDIC ACUPRESSURE TREATMENT FIELDS

The ten elements of Ayurvedic Acupressure based on which treatment is done are shown in
below table. Each element has energy associated with it which is also known as tanmatra.
These elements have been placed in a definite sequence- Akash, Vayu, Agni, Jal, Prithvi,
Kaal, Disha, Mann, Atma and Tam. The position if these elements are depicted from 0-9 as
the 10 numbers. There is a lot of significance of numbers in the diagnosis and treatment.
Each element is thus represented on each finger of both hands. They are associated with
particular organ, endocrine gland, body holes, action and sense organs and tissues based on
the energy. Each finger has three joints and they are named Vata(upper), Pitta (middle) and
Kapha(lower) joint. Each organ is plotted on different joints accordingly. The concept is
summarized in the ten origin diagnostic table below:

FIGURE 11 : TEN ORIGIN DIAGNOSTIC TABLE

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Based on the ten origin diagnostic chart, the main meridians are plotted on each finger joint as
below:

FIGURE 12 :ORGANS&TISSUES ON JOINTS

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On the basis of above perspective, there are three types of Ayurvedic meridians in the body
-
i. Vertical Meridians
ii. Horizontal Meridians
iii. Spiral Meridians
FIGURE 14 : VERTICAL MERIDIANS FIGURE 13 : HORIZONTAL MERIDIANS

These vertical and horizontal meridians are plotted on finger as follows:

FIGURE 15 :HORIZONTAL MERIDIAN

PLOTTING ON FINGERS 68
FIGURE 16 :VERTICAL MERIDIAN PLOTTING ON FINGERS

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The route of reception of food is physically the GIT in which the movement of food is
longitudinal. Hence, the power to receive energy, post natal is related longitudinally
therefore of any ailment, related to digestion should be done by vertical meridian. The ten
vertical meridians of large intestine are shown as follows:

FIGURE 17 : TEN VERTICAL MERIDIANS OF LARGE INTESTINE

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 9.2 TREATMENT PROTOCOLS BASED ON AYURVEDIC ACUPRESSURE

Constipation can be treated by following methods according to Ayurvedic Acupressure:

 Samanya Upchar (General Treatment)
Methi Patti on related organ correspondence: Rt SF V Jt methi patti
Rt. SF 9VM methi patti

 Vishesh Upchar (Specific Treatment)

Both SF V Jt - 1,2,6↑ 5↓
Concept of the treatment: Both SF V Jt correspond to large intestine and small intestine. In
constipation, as the stool is dry and movement is obstructed, Akash (1) and Vayu (2) are
toned to provide space and movement for the bowel to pass. Kaal (6) represents timely
action and since the timing of bowel movement is hampered, it has to be toned to correct.
Prithvi (5) is sedated to remove the hard and heaviness of the stool.

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 10. REFERENCES
Books:
 TREATISE 1 –TCM - M.P. Khemka
 TREATISE 3,4,5 – EAV – M.P. Khemka & Suman Khemka Choudhary
 TREATISE 6 – EOV – M.P. Khemka & Suman Khemka Choudhary
 TREATISE 7 – EOV – M.P. Khemka & Suman Khemka Choudhary
 TREATISE 15 - Treatment of gastro-intestinal diseases – M.P. Khemka & Suman
Khemka Choudhary
 CHARAK 1 (Vol-1) – AYURVEDIC ACUPRESSURE – J.P. Agarwal, A. K .Dwivedi &
Parul Agrawal
 MAHARSHI BHARDWAJ AYURVEDIC ACUPRESSURE - J.P. Agarwal
 TREATMENT HANDBOOK TCM -1 - M.P. Khemka
 TREATMENT HANDBOOK AA- 1,2,3 - J.P. Agarwal & Parul Agrawal

Websites:
 www.britannica.com
 www.emedicinehealth.com
 www.medicinenet.com
 www.medicalnewstoday.com
 en.wikipedia.org

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