Ayurveda places great emphasis on two processes for gaining and maintaining physiological balance--elimination and digestion. We have discussed elsewhere the idea that digestion is the root of balance and well being. We have talked about the role of elimination as being the basis for imbalance or disease. Ama is that Sanskrit word which identifies those things--physical, emotional, or mental--which the body can not use, which interfere with physiology, and  must be eliminated. We have suggested a few simple ways the elimination of ama might be effected- by avoidance of causes such as improper food combining, suppressing natural urges, by purification themes such as daily hygiene, exercise, diet, and rest.


The colon is an area of the mind-body system which is especially critical for two important reasons: 1) nutrients (the products of digestion--(vitamin K is synthesized there by bacterial action) are absorbed into the body in the colon and 2) wastes may accumulate here causing a disruption of absorption and elimination (this is called an imbalance of physiology). Any imbalance here can affect physiology anywhere. For example, improving colon physiology can effectively treat some types of asthma. Likewise, bone metabolism is functionally related to the colon physiology as well. There are numerous strategies for re-setting physiology, which vary from cheap to expensive and slow to fast. The most important technique for eliminating most colon imbalances is one of the treatments of an Ayurvedic regimen called pancakarma (meaning five actions or techniques)—medicated enema (basti). Commercially available, panchakarma is somewhat expensive and not widely available in the U.S. at this time. Enemas, however, can be done by individuals at home, with some care and preparation. Instructions for this are given in another instruction article. We will briefly discuss some other approaches here which we believe are effective, inexpensive, and easy to follow.


As a general proposition, normal functioning of the colon relates to “the 4 F’s”—fluid/water, fat/oils, fiber, and fire/digestion. When one or more of these is defective then one might expect problems with elimination. There are other causes of colon imbalance—trauma, physical obstruction of pregnancy or tumor, neurological defects, genetic factors, congenital defects, and so on, but this article will not consider this latter category of causes.

1)      Fluids—it’s important to maintain proper hydration. Dehydration tends to produce hard stools and difficult or sluggish elimination. Some recommend daily 8 glasses of water (not teas, cokes, etc.). Beverages are not the same as water for this purpose as they may have pharmacological action of their own. This action may promote or inhibit elimination. Beverages stimulate digestive activity whereas plain water does not;

2)      2) fats/oils are important to form the cell membrane and to help lubricate the GI-tract. In this light oils have both structural and functional significance. They form part of liver bile, which is necessary for easy elimination;

3)      3) fiber--it’s important to have adequate fiber/bulk in the diet. Without fiber the peristaltic action of elimination lacks stimulus and leads to constipation, gas, bloating, etc. There is much written in the journals about the soluble and insoluble fiber. We chose not to involve ourselves with this issue, but we do suggest that the term “roughage” is important for a reason---it irritates/stimulates the colon mucosa to promote cleanliness and timely elimination. This suggests that whole grains and plenty of vegetables are important dietary components;

4)      4) fire or digestion is that process of transformation that helps or hinders elimination. When digestion is cold then elimination is sluggish. Maintaining proper level of intestinal heat is crucial to proper elimination. All of these themes work well for prevention as well as for remedy. Now some discussion about more remedies.


Other Maintenance or Remedial Techniques

Many Ayurveda experts recommend an herbal compound of three common Indian fruits called Triphala (trifala). This combination of the powdered form of bibhitaki, haritaki, and amalaki is said to be balancing to all three doshas. It is useful to normalize both constipation and diarrhea--depending upon the dosage. It nourishes all tissues and even vision. It has amalaki, the highest known natural source of vitamin C, and is used as a colon cleanser and toner. It has a laxative action by improving the tone of the intestines. This action does not lead to dependence. Indications for the use of this compound are found on the tongue--dental impressions on the tongue’s margin and  the presence of a coating--white, yellow, brown or black--which indicates the presence of ama in the digestive tract. To help restore balance Ayurvedic doctors recommend 1/4t to 1t triphala powder with 2 to 4 oz. of warm water 1 hour before going to bed—this approach has a cleansing value, too. It may be taken 1 hour after the evening meal when other factors are involved (e.g. nocturia). Some find it softer on the body by soaking it overnight and drinking it in the morning. If one prefers the tablet form take 1 tablet is about 1/4t. [Tablets are discouraged for several reasons: they are not always broken down and digested by the body; they are slower to be digested than powders and their action may not take place throughout the entire digestive tract. The taste of the compound is an important means for promoting balance in the body as taste gives instructions to physiology to behave or perform in a certain way. Taste is also an indicator of the state of balance, which is given by the predominant taste experienced when swallowing it.]


The dosage above should not produce a strong laxative effect but a laxative effect may be experienced, none-the-less. Persons having a strong pitta nature or pitta imbalance may experience one, however (for pitta imbalances amalaki is preferred). Take a smaller dose if warranted. This program is gentle and gradual so some months may be needed for full effect to be realized. The process may be increased by taking triphala in the morning and at night. Also, remember that other aspects of physiology, such as digestion, may need to be addressed.


Other herbal approaches include Psyllium seed--called sat isobgol in Sanskrit. While this is mainly desired as a bulk-increasing laxative it is also useful for those with high pitta because it absorbs the pitta in the GI tract. For bulk increase take by adding 1t to a glass of warm water 1 hour before bed. For soaking up excess pitta try only ¼ cup water. Proper amount of water is important when using this herb. The herbs—senna, Pau D’arco, Cascara Sagrada, aloe vera, and rhubarb (Turkey or Chinese) also have laxative action. The mode of operation varies considerably, as well as the strength of action, so use appropriately.  Other gentle and gradual herbal approaches are available from health-food stores. Follow label directions for these products. As a general caution, Ayurveda does not recommend long-term use of laxatives of any sort, as it is felt their use builds dependency.


Other strategies for promoting proper bowel function include balancing digestion. Frequently, digestion is so strong that diarrhea results. Elimination that is too fast may result in lack of absorption of nutrients leading to chronic fatigue and so on. Herbs that help this aspect include aloe vera, Asparagus racemous, kamadudha, and conch ash, even ghee. Other states of imbalanced digestion, which may present as disturbed colon function, are variable and slow digestion. Variable digestion tends to give rise to variable elimination—even irritable the previous meal is digested and this leads to production of ama also. When ama is produced then this slows digestion further and impedes elimination. The antidote to poor elimination in this event is the improvement of digestion—not taking dependency-creating laxatives.


Another consideration for improvement of intestinal function is suggested by yoga. Yoga is associated with stretching to become very flexible. Unfortunately, flexibility is misinterpreted by Westerners. Flexibility means that the body is free from stress—mental, emotional, physical. Stretching exercises help the body eliminate these toxins. Moreover, this aspect of yoga, by the position and motion, causes the stimulation of internal organs and reflex-like points. The entire inner physiology is improved by doing yoga stretching. Postures which help elimination focus on stimulating the waist such as: spinal twist, bow, bridge, locust, forward bend, peacock, camel, cow, boat pose. Yoga meditation and breathing are also useful in this context of eliminating stress. By calming the mind and body we eliminate emotional stress from the body and the nervous system functions better. Many times emotions are the root cause of poor elimination, digestion, and absorption.


Another strategy involves exercising daily. Exercise helps build strong digestion, which from the above we have seen is helpful. Exercise also helps stimulate and tone muscles and organs. It is the pump for the movement of lymph which contains nutritional and immunity-related fragments. It helps remove wastes from tissues, which helps improve their physiology indirectly also.


Another consideration for helping to restore proper bowel function involves just sitting on toilet upon rising. This technique uses awareness to culture habit and peristalsis when there is no desire from the body to eliminate. Awareness brought to the body helps improve physiology. Drinking a glass of warm water just before may help to trigger the gastro-colic reflex to eliminate when food enters the stomach. There is a protocol in Ayurveda called usha jala panam—drinking water at dawn. This protocol requires large amounts of water (up to 1.5 liters) to be consumed upon rising—not to stimulate the gastro-colic reflex but to promote hydration and elimination of cells and tissues (especially the colon). Consult with an expert before undertaking this protocol.


There remains but two final points. Nature has provided for the natural squatting pose during elimination to help with this process. Pressure from the thighs on the abdomen gently aids in evacuation. There is a stool in the marketplace that has been designed to help achieve this posture during evacuation. Its cost is about $50.  And to help prevent irritation from using dry toilet paper some vaidyas recommend moistening it with water prior to wiping the anus. Castor oil, neem oil, or sesame oil may be applied to the anus for preventive purposes also.


One final comment--refined grains are milled to a very subtle state which slows elimination. Further it has a sticky quality which further slows elimination. Remember that wheat paste acts as a glue for paper mâché. This same effect impairs elimination. Avoid refined flour products of any type.


In summary, the colon function, i.e.: digestion, absorption, and elimination, are affected by many factors. One symptom has the potential for many causes. The approach to maintaining good physiology involves a complex of factors including maintaining healthy, balanced digestion, not suppressing the urge to defecate, avoiding toxic food combinations, eating at regular times without snacking, drinking adequate fluids and eating fiber-rich foods, and getting a balance of rest and daily exercise, including yoga. Balanced physiology is a way of life.


© Copyright 1994 Michael S. Dick All Rights Reserved