Xiuga Alo (Constipation)
Overview
In Miao medicine, constipation is called Xiuga Alo or Kewo Luo. It arises when large-intestine transit slows—due to aging or weakness, post-illness imbalance, irregular diet, emotional stress, improper medications, or external pathogens—leading to stool accumulation, prolonged intervals, or weak urge without power to evacuate.
In TCM, constipation (bianmi) reflects large-intestine dysfunction: stool stagnates, becomes dry or difficult to pass, intervals lengthen, or despite urge, evacuation is incomplete.
Western parallels include functional constipation, IBS with constipation, post-inflammatory hypomotility, anorectal disorders, drug-induced constipation, endocrine/metabolic causes, or weakened abdominal musculature.
Subtypes
Xiuga Alo is a minor syndrome with two patterns:
Hot-channel constipation
Cold-channel qi–and–blood deficiency constipation
Causes
Overindulgence in rich, spicy foods or alcohol (heat toxin)
Post-illness heat retention, inadequate fluids
Improper medication injuring qi and fluids
Sedentary lifestyle, poor hydration, emotional constraint
Mechanism
Excess heat or toxin injures stomach–intestine fluids; qi falters so stool accumulates. Or medications and illness deplete fluids and qi, impairing intestinal propulsion. Emotional stagnation further blocks qi, leading to dry, hardened stool and difficult evacuation.
Diagnosis
Key signs
Fewer than three bowel movements per week
Hard, dry stool or difficult passage despite urge
Straining, sense of incomplete evacuation, possible manual assistance
Associated: abdominal distention, pain, appetite loss, fatigue, dizziness
History: irregular diet, emotional stress, overwork, medications
Tests: stool exam, occult blood, digital rectal exam; colonoscopy if needed
Differential: Chronic Intestinal Pain (Jiuga Gangmeng)
Both present with abdominal pain and possible mass in right lower quadrant. Jiuga Gangmeng shows migrating, burning pain, thirst, acid reflux and vomiting, whereas Xiuga Alo shows fullness, dry stool, possible borborygmus, reduced appetite, and straining.
Treatment
1. Hot-Channel Constipation
Signs: Hard stool, incomplete evacuation, dizziness, abdominal fullness, thirst, irritability.
Principle: Clear heat, regulate qi, moisten intestine.
Formula:
Yuanweishang (Iris tectorum) 3g
Maidong (Ophiopogon japonicus) 10g
Tiandong (Asparagus cochinchinensis) 10g
Taoren (Prunus persica) 15g
2. Cold-Channel Qi–Blood Deficiency Constipation
Signs: Dry or difficult stool, fatigue, cold limbs, weak voice, incomplete evacuation, post-evacuation exhaustion.
Principle: Tonify qi, warm middle, moisten intestine.
Formula:
Fengmi (honey) 30g
Mayou (sesame oil) 15g
Jidan (chicken egg) 1 piece
Prevention & Care
Eat high-fiber foods, drink adequate water, avoid excessive spicy or fatty foods.
Establish regular toileting routine, gently stimulate abdominal muscles.
Maintain emotional balance and moderate exercise.
Supplemental foods (black sesame, walnut powder with honey) can nourish fluids and ease stool.
Enemas may be used if needed under guidance.
Note
Miao medicine emphasizes qi (invisible “vital wind”) and water (“wo”) interdependence. Constipation arises when qi fails to move water, leading to stool stagnation. Treatment centers on restoring qi movement, warming or clearing heat, and replenishing fluids.
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