This site may earn a commission from purchases made through links on this page, at no extra cost to you.
Constipation — defined as fewer than three bowel movements per week, hard stools, straining, or a sense of incomplete evacuation — is one of the most common gastrointestinal complaints in Canada. It affects people across all age groups but is particularly prevalent in elderly Canadians, those taking opioid pain medications, people on iron supplements or calcium channel blockers, and those with sedentary lifestyles or inadequate dietary fibre.
The foundations of constipation management are well established: adequate fibre (25–38 grams daily), 2 litres of water per day, regular physical movement, and responding promptly to the urge to go. But for many Canadians — particularly those with constipation caused by medications, postoperative recovery, pregnancy, or chronic digestive sluggishness — these foundations aren't enough. That's where acupressure offers something evidence-based and immediately accessible.
What the Research Shows
A 2019 systematic review published in the Journal of Advanced Nursing examined multiple randomized controlled trials of acupressure for constipation and found that acupressure significantly improved both stool frequency and stool consistency compared to sham and control groups. The effect was consistent across different populations: post-surgical patients, elderly care home residents, people on opioid medications, and pregnant women.
The mechanism involves two pathways. First, direct stimulation of abdominal points — particularly ST25 beside the navel — appears to promote peristalsis through local nerve stimulation. Second, acupressure reduces sympathetic nervous system tone, shifting the body toward parasympathetic ("rest and digest") dominance, which is necessary for healthy bowel motility. Chronic stress and pain are well-known constipation contributors; their autonomic mechanism is now reasonably well understood.
LI4 in particular shows a strong effect on large intestine function. As the "source point" of the Large Intestine meridian in TCM, it has long been used for both constipation and diarrhea — a bidirectional regulatory action consistent with autonomic modulation rather than simple stimulation.
Key Acupressure Points for Constipation
Location
Two finger-widths (approximately 2 inches) to the right and left of the navel, bilaterally. There are two points — one on each side. Find your navel, then place two fingers horizontally outward in each direction. ST25 is right at that location. In many people with constipation, these points are noticeably tender to direct pressure.
Why it's used
ST25 is the primary bowel regulation point in acupressure. It is the "Front Mu" or alarm point of the Large Intestine — meaning it's the point on the front of the body that most directly corresponds to large intestine function. Direct stimulation here appears to activate local peristaltic contractions. Multiple clinical trials have used ST25 as the anchor point in constipation protocols, often combined with abdominal massage in a clockwise direction.
Technique
Apply firm pressure with the fingertips of both hands simultaneously to both ST25 points. Hold 60–90 seconds. Then transition into the clockwise abdominal massage described in the protocol section below. The combination of point pressure plus directed massage is the most evidence-based approach.
Location
In the fleshy web between the thumb and index finger on the back of the hand. Press into the highest point of the muscle that bulges when you pinch your thumb and index finger together. The point is roughly at the midpoint of the second metacarpal bone on the radial side. It is typically very tender — significantly more so when constipation is active.
Why it's used
LI4 is the source point of the Large Intestine meridian and has a powerful effect on large intestine function. In clinical acupuncture, it's used for both constipation and diarrhea — appearing to regulate intestinal motility in whichever direction is needed. For constipation, firm stimulation of LI4 acts somewhat like a laxative signal — many people report a bowel urge within 20–40 minutes of strong bilateral LI4 stimulation.
Caution: LI4 is contraindicated during pregnancy because of its strong downward-moving action. Do not use if pregnant. See our pregnancy acupressure guide for pregnancy-safe alternatives.
Technique
Pinch the web of one hand firmly with the opposing thumb and index finger. Apply sustained, strong pressure for 60–90 seconds. The sensation should be an intense aching or electric feeling radiating up the thumb — this is correct and expected. Repeat on the other hand. Best applied in the morning before getting out of bed.
Location
Four finger-widths below the lower edge of the kneecap, one finger-width to the outside (lateral) of the shin bone (tibia). Run your fingers straight down from the kneecap and shift laterally just to the outside of the tibial crest. There's typically a slight hollow and noticeable tenderness at the correct location.
Why it's used
ST36 is the most broadly used acupoint in digestive protocols. It regulates the entire digestive tract from the stomach to the large intestine, improves intestinal motility, and reduces the inflammation that can inhibit bowel function. For constipation specifically, it helps normalize the autonomic balance that controls peristalsis. It's also used to address the fatigue and malaise that chronic constipation produces.
Technique
Firm thumb pressure, 90 seconds per leg. The sensation should be a strong dull ache that may radiate downward. One of the most broadly beneficial acupoints in daily practice regardless of specific condition.
Location
Six finger-widths below the lower edge of the kneecap, just lateral to the shin bone — approximately 3 finger-widths below ST36 along the same lateral tibial line. If you've found ST36, continue straight down another 3 finger-widths and you'll be at ST37.
Why it's used
ST37 is the "lower he-sea" point of the Large Intestine — a specialized category in TCM for points that most directly influence hollow organs. While ST36 has a broad digestive effect, ST37 is more specifically targeted at large intestine function, bowel movement promotion, and clearing intestinal stagnation. It's often added to constipation protocols specifically for its targeted lower bowel action.
Technique
Firm thumb pressure, 60 seconds per leg. Often less tender than ST36 but equally important for comprehensive large intestine targeting. Can be worked in sequence immediately after ST36.
Location
On the midline of the abdomen, 1.5 inches (about 2 finger-widths) directly below the navel. A single point on the centreline. It's in the lower abdominal region, between the navel and the pubic bone.
Why it's used
CV6 ("Sea of Qi") strengthens digestive qi and abdominal tone. In TCM, chronic constipation associated with weakness, fatigue, and difficulty generating the effort to defecate is classified as "Qi deficiency constipation" — and CV6 directly addresses this pattern. It's particularly relevant for elderly individuals, post-surgical patients, and those who are generally depleted. Rather than "pushing things through" like LI4 does, CV6 strengthens the foundation that allows normal bowel function.
Technique
Gentle to moderate pressure with flat fingers. Hold 90 seconds. Clockwise circular massage around this point is also effective. Suitable for elderly individuals and those in depleted states where stronger stimulation isn't appropriate.
The Clockwise Abdominal Massage Protocol
The most evidence-based self-care approach combines acupoint pressure with clockwise abdominal massage, which follows the anatomical path of the colon: from the lower right (ascending colon), up and across (transverse colon), and down the left side (descending colon to sigmoid).
Protocol steps:
- Lie on your back with knees slightly bent.
- Apply firm bilateral pressure to ST25 (both sides of the navel) for 60–90 seconds.
- Using the flat of your right hand, begin circular massage in the lower right of your abdomen.
- Work clockwise: lower right → up the right side → across the upper abdomen → down the left side → back to start.
- Complete 20–30 clockwise circles with moderate pressure. The path traces your colon's direction of movement.
- Finish with bilateral ST25 pressure again for 30 seconds.
This 5–7 minute protocol is most effective when done in the morning before getting up, which leads to the morning routine below.
The Morning Constipation Protocol
The most commonly reported effective sequence for people with chronic constipation:
Before getting out of bed (5–7 minutes):
- Upon waking, while still lying on your back: apply strong bilateral LI4 pressure for 90 seconds each hand.
- Move to ST25: bilateral pressure beside the navel, 90 seconds.
- Begin the clockwise abdominal massage: 20–30 circles.
- Finish with CV6: gentle pressure below the navel, 60–90 seconds.
- Get up, drink a glass of warm water, and go about your morning routine. The bowel urge often arrives within 20–40 minutes.
The warm water trigger is physiologically meaningful — the gastrocolic reflex (the reflex that triggers bowel movement in response to stomach stretching from a meal or drink) is most active in the morning and most easily triggered at this time. Combining it with LI4 and abdominal massage amplifies the signal.
Do the ST36 and ST37 protocol at a separate time — afternoon or evening — as a general digestive support practice.
Canadian Context
Constipation affects approximately 27% of Canadians, with rates significantly higher in elderly populations, people in long-term care, those taking opioid pain medications, and those on iron supplements, calcium channel blockers, or anticholinergic medications. Pregnancy is another major period of constipation risk — see our pregnancy acupressure guide for the pregnancy-safe protocol (LI4 is omitted during pregnancy).
Opioid-induced constipation (OIC) is a particular challenge in the Canadian context, where opioid prescribing for chronic pain remains high. Standard OIC treatments (laxatives, stimulants) have side effects and habituation risk; acupressure as an adjunct has been tested in this population specifically, with positive results in several trials. It doesn't replace medical management, but it adds a zero-cost, zero-side-effect option.
For general digestive health — including issues beyond constipation like bloating, IBS, and poor digestion — see our digestion acupressure guide. For the complete reference of all digestive acupoints and their locations, see our acupressure points directory.
When to See a Doctor
Acupressure is appropriate for functional constipation — the kind caused by diet, lifestyle, medication, or stress. It is not appropriate as the primary intervention for:
- New-onset constipation in someone over 50 who wasn't constipated before — requires colonoscopy screening
- Constipation with blood in the stool
- Constipation alternating with unexplained diarrhea (may indicate IBS or IBD)
- Constipation with unexplained weight loss
- Constipation with significant abdominal pain or bloating that's new or worsening
These symptoms require medical evaluation first. Acupressure is an adjunct for known functional constipation, not a substitute for investigation of potentially serious causes.
The Bottom Line
Acupressure for constipation has meaningful evidence — particularly the ST25-plus-abdominal-massage protocol — and a straightforward morning routine that works with the body's natural gastrocolic reflex. LI4 provides the most targeted bowel stimulation effect; ST36 and ST37 address the lower intestine; CV6 supports those with depleted energy. This is a non-pharmaceutical, zero-cost approach that complements rather than replaces dietary fibre, hydration, and any prescribed medical treatment.
Consistency is the key variable. A daily morning practice for 4 weeks will tell you whether it's helping your specific pattern of constipation.