Adoption of sedentary lifestyles and Western diets by most Nigerians has led to rise in indigestion, constipation, pile, diabetes and cancers. In fact, most people spend more time in the toilet than on the dining table.
Although so many conventional medicines promise relief, they come at a very high cost and risk.
Top on the list of natural remedies that have been scientifically validated to move your bowels are: Cassia alata (Senna alata), Aloe vera, drinking enough water, regular exercise, eat more fibre and local vegetables, drink more caffeinated coffee, among others.
Commonly called bush candle, Cassia alata/Senna alata, which belongs to the plant family fabaceae/ leguminosae is an ornamental shrub.
It is called Asunrun Oyinbo in Yoruba and Ogalu in Ibo. It is locally used in Nigeria in the treatment of several infections, which include ringworm, parasitic skin disease. Senna alata is also credited for treatment of haemorrhoids (pile), constipation, inguinal hernia, intestinal parasite, blennorrhagia, syphilis and diabetics. Blennorrhagia is an excess of such discharge, often specifically referring to that seen in gonorrhea.
A randomized controlled trial of Cassia alata for constipation published in journal PubMed concluded that Cassia alata leaves are effective as a laxative and no study done so far has shown toxicity as a result of consuming Cassia alata leaves. The plant has been found to contain anthraquinones, presumed to be the active ingredient causing the laxative effect.
The researchers investigated the efficacy of Cassia alata leaves for treatment of constipation compared with a placebo and mist alba in a multicentre randomized controlled trial carried out in one provincial and five community hospitals.
Mist alba is a conventional medicine made with a mixture of magnesium sulphate and magnesium carbonate to help bring relief from mild constipation.
According to the researchers, eighty adult patients admitted to five community hospitals and one provincial hospital with at least 72 hours of constipation were included in the study. Twenty-eight patients were in the placebo group, 28 in the mist alba group, and 24 in Cassia alata group. Each patient was given 120 ml of fluid with caramel colour; mist alba, or Cassia alata infusion at bedtime.
Evaluation was performed after 24 hours whether the patient defecated or not. The characteristics of the patients among the three groups were not different. Eighteen per cent of patients in the placebo group passed stools within 24 hours, whereas, 86 and 83 per cent of patients in mist alba and Cassia alata groups respectively, passed stools. The differences observed between placebo and mist alba, placebo and Cassia alata were statistically highly significant and clinically important. Minimal self-limited side effects, that is, nausea, dyspepsia, abdominal pain and diarrhea were noted in 16-25 per cent of the patients.
The leaf of Cassia alata was reported to be useful in treating convulsion, onolthoea, heart failure, abnormal pain, oedema and as purgative but it was especially useful in treating dermatophytosis.
The herbal laxative Senna is also available over-the-counter, and can be taken orally or rectally.
Senna is usually not recommended for people who are pregnant, breastfeeding or have certain health conditions, such as inflammatory bowel disease.
Drink more water
Being dehydrated regularly can make you become constipated. To prevent this, it’s important to drink enough water and stay hydrated.
Some studies have found sparkling water to be more effective than tap water at relieving constipation. This includes people with chronic idiopathic constipation or irritable bowel syndrome (IBS).
However, do not start drinking more carbonated drinks like sugary soda, as they are a bad choice for your health and may make your constipation worse.
Bottom line: Dehydration can make you constipated, so make sure to drink enough water. Sparkling water may be even more effective.
Research on aloe vera juice benefits for IBS is mixed. One study shows positive results for people with IBS who experienced constipation, pain, and flatulence. However, no placebo was used to compare these effects. A study on rats shows benefits as well, but it did not involve human subjects.
A 2006 study found no difference between aloe vera juice and a placebo in improving diarrhea symptoms. Other symptoms common to IBS remained unchanged. However, the researchers felt that the potential benefits of aloe vera could not be ruled out, even though they found no evidence there were any. They concluded that the study should be replicated with a “less complex” group of patients. Regardless of research, many people who take aloe vera juice report comfort and improved well-being. Even if it’s a placebo for IBS, aloe vera juice has many other health benefits.
Taken internally, aloe juice can have a soothing effect. Juice with aloe latex — which contains anthraquinones, or natural laxatives — may further help with constipation.
Studies on the effect of exercise on constipation have shown mixed results. In fact, many studies have shown that exercise does not affect the frequency of bowel movements. However, a recent randomized controlled study on constipated people with IBS found some interesting results. It found that exercise significantly reduced symptoms.
Other studies have also found similar results for this group of people. While many studies have found that exercise does not affect the number of times people go to the bathroom, it seems to reduce some symptoms of constipation. If you are constipated, then try going for regular walks. It is definitely worth a try.
Bottom line: Exercise may reduce the symptoms of constipation in some people, although the evidence is mixed.
Eat more fibre
People who are constipated are often told to increase their fiber intake. This is because increasing fibre intake is thought to increase the bulk and consistency of bowel movements, making them easier to pass. In fact, one recent review found that 77 per cent of people with chronic constipation benefited from supplementing with fibre.
However, some studies have found that increasing fiber intake can actually make the problem worse.
Other studies have found that while dietary fibre can increase the frequency of bowel movements, it doesn’t help with other symptoms of constipation. These include stool consistency, pain, bloating and gas.
There are many different dietary fibres, but in general, they fall into two categories:
*Insoluble fibres: Found in wheat bran, vegetables and whole grains. They add bulk to your stools and are thought to help them pass more quickly and easily through your digestive system.
*Soluble fibres: Found in oat bran, barley, nuts, seeds, beans, lentils and peas, as well as some fruits and vegetables. They absorb water and form a gel-like paste, which softens your stools and improves the consistency.
Studies examining the effects of insoluble fiber as treatment for constipation have been inconclusive.
This is because insoluble fibre can make the problem worse in some people with a functional bowel problem, such as IBS or chronic idiopathic constipation. Some fermentable soluble fibres may also be ineffective at treating constipation, as they are fermented by bacteria in the gut and lose their water-holding capacity.
The best choice for a fibre supplement when constipated is a non-fermentable soluble fibre, such as psyllium.
To prevent constipation, you should aim to consume a mix of soluble and insoluble fibers. The total recommended fiber intake per day is 25 grammes for women and 38 grams for men.
Local vegetables identified
Nigerian researchers have recommended regular consumption of special diet made predominantly with slightly cooked vegetables as effective treatment for piles.
The researchers from the Department of Plant Science and Applied Zoology, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, have identified 143 local plants useful in the treatment of piles.
The results of the study published recently in Nigeria Scholars Research Library Annals of Biological Research showed that special diet that was recommended apart from the herbal recipes are vegetables, which should be slightly cooked. They include green spinach, Amaranthus viridis (Amaranth, Tete in Yoruba, akwukwo nri in Ibo), Celosia spp (Lagos spinach, Soko in Yoruba), and waterleaf (Talinum triangulare). The use of Occimum gratissimum (scent leaf, Nchuanwu in Ibo, Effirin in Yoruba) as species in some soup is also very effective in the treatment of piles.
The herbal recipes or plants include among others Senna alata (Asunrun oyinbo in Yoruba, Ogalu in Ibo), Gongronena latifolium (Utazi in Ibo and Arokeke in Yoruba), Axonopus compressus (carpet grass), Anogeiessus leiocarpus (chew-stick, atara in Ibo, ayin in Yoruba and farin gamji in Hausa), Pteleopsis suberosa (wuyan giíwaá in Hausa), Tetrapleura tetraptera (Osakirisa or Oshosho in Ibo, Aidan in Yoruba), Khaya senegalensis (mahogany) and Allium spp (garlic, onion, shallots).
Hemorrhoids are vascular structures in the anal canal, which help with stool control. They become pathological or piles when swollen or inflamed.
Drink coffee, especially caffeinated coffee
For some people, coffee can increase the urge to go to the bathroom. This is because coffee stimulates the muscles in your digestive system. In fact, one study found that caffeinated coffee could stimulate your gut in the same way that a meal can. This effect is 60 per cent stronger than drinking water and 23 per cent stronger than drinking decaffeinated coffee. Coffee may also contain small amounts of soluble fibers that help prevent constipation by improving the balance of your gut bacteria.
Bottom line: Coffee can help relieve constipation by stimulating the muscles in the gut. It may also contain small amounts of soluble fibre.
Try a low-FODMAP diet
The low-FODMAP diet is an elimination diet that’s often used to treat IBS. It could be effective at treating your constipation if IBS is the cause.
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. The diet involves limiting high-FODMAP foods for a period of time before reintroducing them to determine which ones you can tolerate.
However, if you have constipation-predominant IBS, the low-FODMAP diet alone is often not enough.
You will probably need to pay attention to other aspects of your diet, such as getting enough water and fibre, to experience relief from your symptoms.