Types of Constipation | TCM Treatments | When to Seek Treatment for Constipation

Constipation is an uncomfortable, frustrating, and yet common health condition in Singapore. Local studies have shown it affects 7.3% of adults, with a higher occurrence of chronic constipation in women (11.3%) compared to men (3.6%) [1]. Modern dietary habits combined with fast-paced lifestyles often worsen constipation, prompting many individuals to rely on quick fixes such as laxatives and suppositories for temporary relief.

However, these quick-fix measures fall short of resolving the underlying health issues behind constipation, and provide only short-term relief. In contrast, Traditional Chinese Medicine (TCM) offers a gentler, more all-encompassing approach by focusing on your body’s digestive wellness and natural rhythm to help you discover lasting relief without overrelying on drugs and bowel stimulants.

At EMW TCM, treatment is guided by syndrome differentiation, allowing each individual’s condition to be assessed comprehensively. Based on this evaluation, a personalised treatment plan is developed to address specific gastrointestinal concerns. Our approach focuses on regulating bowel motility, resolving underlying disruptions or stagnation, and restoring internal balance within the digestive system.

Types of Constipation from TCM’s Perspective

In Western medicine, constipation is typically managed by addressing observable symptoms such as infrequent bowel movements or a sensation of incomplete evacuation. In contrast, Traditional Chinese Medicine recognises constipation as a condition with multiple underlying patterns. According to TCM theory, there are five distinct types of constipation, each arising from specific internal imbalances, including excess heat, deficiencies of Qi (气) and Blood (血), or the accumulation of cold and stagnation within the intestines.

Type of Constipation	Causes	Symptoms
Excess Heat (Rè Mì 热秘)	Excessive internal heat from spicy foods, stress, or dehydration.	Hard stools, bad breath, dark urine, redness in the face.
Qi Stagnation (Qì Zhì Mì 气滞秘)	Irregular eating habits and stress that affect the flow of Qi to the Liver, Spleen, and Stomach.	Bloating, difficulty in passing stools.
Qi Deficiency (Qì Xū Mì 气虚秘)	When Qi is lacking, there is insufficient energy to move the stools in the colon.	Fatigue and shortness of breath.
Blood or Yin Deficiency (Yīn Xuè Kuī Xū Mì 阴血亏虚秘)	A lack of moisture in the intestines makes stools dry and hard to pass.	Dry stools, dizziness, dry skin.
Cold-Type Constipation (Hán Mì 寒秘)	Yang deficiency and a lack of heat in the body can result in difficulty in passing stools.	Abdominal pain, cold limbs, soft stools that are different to pass.

Our TCM physicians apply the Four Diagnostic Methods (Sì Zhěn 四诊) to comprehensively evaluate your symptoms, with particular emphasis on pulse and tongue analysis to identify the root patterns of imbalance. By accurately determining these underlying disharmonies, we are able to develop a treatment plan that addresses the body as an integrated whole, rather than focusing solely on the symptoms of constipation.

Our approach to constipation and related digestive concerns emphasises the restoration of regular, comfortable bowel movements by supporting healthy autonomic and vagal nerve function, thereby promoting a calmer and more efficient digestive process.

TCM Treatments for Constipation

Chinese Herbs for Constipation

The use of herbal formulas is the foundation of TCM treatment for constipation. Depending on what type of constipation you have, the following four herbal formulas can help stimulate bowel movement and regulate the flow of Qi:

TCM Herbal Formulas

Hemp Seed Pill (麻子仁丸) Má Zǐ Rén Wán

A 2021 systematic review has highlighted potential in the use of hemp seed pills for constipation relief [2]. According to TCM principles, hemp seed pills are used for dry-heat constipation, as it helps to dispel heat and regulate Qi.

Moisten Intestine Pill (润肠丸) Rùn Cháng Wán

Used to treat constipation caused by blood and yin deficiency, and when stools are difficult to pass due to a lack of lubrication.

Major Order the Qi Decoction (大承气汤) Dà Chéng Qì Tāng

This herbal formula softens hard and impacted stools, addresses abdominal fullness, and dispels severe heat.

Benefit the River Flow Decoction (济川煎) Jì Chuān Jiān

Chosen in the treatment of “cold-type” constipation caused by Qi stagnation. Stools are hard and difficult to pass because of the cold weather.

Disclaimer On the Use of TCM Herbs For Constipation

Individuals who are planning to use TCM herbs or herbal formulas for their constipation must not begin or continue the use of any TCM herbal treatment or formulas without first consulting a qualified, licensed TCM practitioner or healthcare professional. The safety and efficacy of various TCM herbs are not scientifically established, and their active compounds may interact with existing health conditions or medications. The information in this article is presented for general educational purposes and should not be used as a substitute for medical advice.

Acupuncture Points for Constipation

Clinical studies involving elderly individuals with functional constipation have shown that acupuncture can be a beneficial complementary therapy [3]. From a Traditional Chinese Medicine perspective, acupuncture works by regulating the flow of Qi along specific meridians, helping to relieve blockages that impair digestion and bowel function. In addition, acupuncture has been shown to reduce stress by promoting relaxation, which further supports normal digestive activity.

Based on an individual’s TCM pattern diagnosis, our experienced TCM physicians carefully select acupuncture points to address the underlying imbalance. The following are some of the commonly used acupuncture points in the management of constipation:

Acupoint Name and Code	Location	Function
ST35 Tiān Shū (天枢)	On the abdomen, on both sides of the navel.	Supports and regulates the large intestines.
ST36 Zú Sān Lǐ (足三里)	On the front of the lower leg, a few inches (approx. 5cm) below the kneecap and slightly towards the outer shin.	Enhances overall vitality by regulating blood circulation and digestion.
SP6 Sān Yīn Jiāo (三阴交)	On the inner side of the lower leg, about 4 finger widths (7.5cm) above the top of the inner ankle bone	A point where the three meridians of the spleen, liver and kidneys intersect. (Do not use during pregnancy)
LI4 Hé Gǔ (合谷)	On the back of the hand, between the thumb and index finger.	This point helps enhance movement in the large intestine and relieves pain. (Do not use during pregnancy

Diet and Lifestyle Recommendations

Traditional Chinese Medicine places emphasis on the consumption of warm, cooked, fibre-rich foods to support digestion and strengthen Spleen function. Examples include foods such as sweet potatoes and ginger. Reducing the intake of spicy foods helps to minimise excess internal heat, while cold or raw foods and iced beverages are generally discouraged, as they may impair digestive function by weakening digestive Yang.

Elevated levels of stress and anxiety can disrupt the smooth flow of Qi, adversely affecting digestive processes. Incorporating regular physical activity, mindfulness practices such as meditation, abdominal massage, and adequate hydration can help regulate Qi circulation, reduce stress, and promote regular bowel movements.

TCM may offer effective relief for constipation in cases where conventional treatments provide limited benefit. Through its integrated and individualised approach, TCM not only aims to alleviate symptoms but also supports long-term digestive health, with a strong emphasis on prevention and overall balance.

When to Seek Treatment for Constipation at EMW TCM?

It is advisable to seek professional assessment if you experience any of the following persistent or recurrent symptoms:

Abdominal pain that persists for more than three days
Bloating that occurs consistently after meals or lasts longer than one week
Indigestion, including sensations of fullness, excessive wind, or frequent hiccups, which in TCM may indicate food stagnation
Acid reflux (gastroesophageal reflux disease, GERD), characterised by the backflow of stomach acid into the oesophagus
Changes in bowel habits, including ongoing constipation or diarrhoea

While constipation can be a common and uncomfortable condition, Traditional Chinese Medicine offers an integrated approach to managing digestive health. When factors such as diet, stress, or lifestyle contribute to constipation, a TCM practitioner in Singapore may recommend a tailored combination of herbal therapy, acupuncture, acupressure, and lifestyle modifications to help restore internal balance.

At EMW TCM, our bilingual team of MOH-registered TCM physicians develops personalised treatment plans that take into account each individual’s lifestyle, dietary habits, and underlying health patterns. This approach is further supported by evidence-based research, which suggests that TCM may be effective in providing both symptom relief and long-term digestive support.

If you have any questions or concerns regarding TCM treatment for constipation or digestive health management, we welcome you to contact us. EMW TCM is committed to delivering personalised, holistic care to support the long-term wellbeing of our patients.

References

Gwee, K. A., & Setia, S. (2012). Demographics and health care seeking behavior of Singaporean women with chronic constipation: implications for therapeutic management. International journal of general medicine, 5, 287–302. https://doi.org/10.2147/IJGM.S29011
Yang, M., Feng, Y., Zhang, Y. L., Smith, C. M., Hou, Y. N., Wang, H., Deng, G., & Mao, J. J. (2021). Herbal formula MaZiRenWan (Hemp Seed Pill) for constipation: A systematic review with meta-analysis. Phytomedicine: international journal of phytotherapy and phytopharmacology, 82, 153459. https://doi.org/10.1016/j.phymed.2021.153459

Song, S., Hao, W., & Fu, H. (2024). Efficacy of acupuncture for functional constipation in the elderly: a systematic review and meta-analysis. Frontiers in medicine, 11, 1473847. https://doi.org/10.3389/fmed.2024.1473847