1. Acupuncture Treatment of Diseases Colorectal 2: Constipation 便秘

2. Definition: 1.Refers to difficulty defecating with a production of dry and impacted stools. 2.Or even lack of defecation for over 3 to 4 days. 3.In western medicine, constipation results from medications or a bowel dysfunction such as habitual constipation, intestinal neurosis, recovery period from enteritis or a weak constitution and other diseases include those of the rectum and anus.

3. Causes and Pathogenesis : Constipation is mainly caused by the disturbed transmitting function of the large intestine. Excess type: A.Constitutional yang preponderance or indulgence in spicy, greasy food leading to accumulation of heat in the stomach and intestine.. B.Some febrile diseases leading to the remnant heat and insufficiency of body fluids that gives rise to dryness and heat in the intestines. C.Emotional factors such as anxiety and depression or lack of movement leading to a descent Qi f the lung qi and stagnation of intestinal qi dynamics.

4. Causes and Pathogenesis : Deficiency type: D.Co-existent deficiency in qi and blood after an illness or delivery or in elderly leading to weakness of the large intestine in transmission and a shortage in body fluids. E.Yang insufficiency in the lower energizer resulting in retention of internal cold, obstruction of yang qi and failure in body fluid distribution and body wastes are unable to move down..

5. Clinical Manifestations: For both excess and deficiency types of constipation. Chief symptoms: i.Infrequent and difficult defecation. ii.Discharge of dry and impacted stools..

6. Clinical Manifestations: 1.Excess Constipation A.Constipation due to heat type i.Fullness and distending pain in the abdomen. ii.Flushed face. iii.Fever. iv.Thirst. v.Foul breath. vi.Preference to cold drinks. vii.Scanty yellow urine. viii.Red tongue with dry and yellowish coating. ix.Rapid pulse.

7. Clinical Manifestations: B.Stagnation of qi type i.Urge to defecate but with difficulty. ii.Frequent belching. iii.Fullness and distending pain in the abdomen and hypochondriac region. iv.Aggravated by emotional disturbance. v.LOA. vi.Bitter taste in mouth. vii.Reddish tongue. viii.Thin sticky tongue coating. ix.Wiry pulse.

8. Clinical Manifestations: 2.Deficiency constipation A.Qi deficiency type i.Sweating and SOB after straining. ii.Dry stools. iii.Pale complexion iv.Lassitude. v.Pale tongue with white coating. vi.Forceless pulse.

9. Clinical Manifestations: B.Blood deficiency type i.Pale complexion. ii.Dizziness. iii.Palpitation. iv.Pale lips and tongue with thin coating. v.Thready pulse.

10. Clinical Manifestations: C.Agglomeration of cold type i.Difficult defecation. ii.Abdominal pain with cold sensation. iii.Clear and profuse urine. iv.Pale complexion. v.Coldness over limbs with aversion to cold and preference to warmth vi.Pale tongue with white coating. vii.Deep, slow pulse.

11. Treatment : General principle for both excess and deficiency constipation. Promote flow of qi in the LI. Promote transmissions in the LI. Promote flow of qi in the TE. Regulate spleen and stomach. Disperse stagnation. Principle channels: 1.ST channel. 2.TE channel.

12. Principle acupoints for both excess and deficiency constipation: 1.ST 25 Tianshu 天枢. 2.ST 28 Shuidao 水道. 3.ST 29 Guilai 归来. 4.ST 40 Fenglong 丰隆. 5.TE 6 Zhigou 支沟.

13. Prescription explanation (Principle acupoint): 1.ST 25 Tianshu 天枢 : Channel acupoint of the ST channel and Front-Mu acupoint of the LI, chosen to promote the flow of qi in the large intestines. 2.TE 6 Zhigou 支沟 : Channel acupoint of the TE channel, chosen to promote the flow of qi in the TE (when the qi of the TE is in normal circulation, the qi of the Fu-organs will circulate freely).. 3.ST 28 Shuidao 水道, ST 29 Guilai 归来, ST 40 Fenglong 丰 隆. Channel acupoint of the ST channel and Luo-Connecting acupoint of the ST, chosen to regulate the spleen and stomach, disperse stagnation and promote qi circulation of the Fu- organs.

14. Principle of treatment Excess Constipation: Constipation due to heat type: Regulate qi dynamics, transmission and disperse heat evils. Principle acupoints: as stated Supplementary acupoints: 1.LI 4 Hegu 合谷. 2.ST 44 Neiting 内庭

15. Principle of treatment Excess Constipation: Stagnation of qi type: Regulate qi dynamics and promote flow of qi in the intestines. Principle acupoints: as stated Supplementary acupoints: 1.LR 3 Taichong 太冲. 2.CV 12 Zhongwan 中脘.

16. Principle of treatment Deficiency Constipation: Qi deficiency type : Regulate qi dynamics and tonify spleen. Principle acupoints: as stated Supplementary acupoints: 1.BL 20 Pishu 脾俞. 2.CV 6 Qihai 气海.

17. Principle of treatment Deficiency Constipation: Blood deficiency type: Regulate qi dynamics and vigorate blood. Principle acupoints: as stated Supplementary acupoints: 1.ST 36 Zusanli 足三里. 2.SP 6 Sanyinjiao 三阴交.

18. Principle of treatment Deficiency Constipation: Agglomeration of cold type: Regulate qi dynamics and disperse cold evils. Principle acupoints: as stated Supplementary acupoints: 1.CV 8 Shenque 神阙. 2.CV 4 Guanyuan 关元．

19. TCM medical advises: 1.Regular light diet habit avoiding raw, cold and greasy, pungent and spicy food. 2.Eat more vegetables and fruits. 3.Bowel training. 4.Stop smoking and drinking. 5.Exercise regularly.