Postpartum constipation shares similarities with general constipation but also has its own distinct characteristics. This condition was first mentioned in Jingui Yaolue, in the chapter "Pulse Patterns and Treatment of Postpartum Diseases in Women," and is one of the three common postpartum conditions in women (hemorrhoids, depression and dizziness, and difficulty in defecation). Therefore, Zhangshi Yitong states in "Postpartum Constipation": "Excessive blood loss after childbirth leads to dryness of the large intestine, often resulting in bowel movements only after three to five days, which is normal." This condition should be compared and contrasted with general constipation for a comprehensive understanding.

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1. Blood Deficiency and Fluid Depletion︰Several days or even ten days after childbirth, there is no bowel movement, with slight abdominal distension but no pain, or no subjective discomfort in the abdomen. It may be accompanied by general postpartum symptoms such as constitutional weakness and spontaneous sweating. The tongue is red with dry and scanty coating, and the pulse is thin, rapid, and weak. This condition is caused by excessive blood loss during childbirth or profuse sweating and vomiting leading to depletion of body fluids. As stated in Jingyue Quanshu, "Postpartum severe constipation occurs due to insufficient body fluids resulting from blood loss." Jingui Yaolue mentions, "Exhaustion of fluids leads to stomach dryness, hence difficulty in bowel movement." Here, the stomach also refers to the large intestine, as "the large intestine lacks the lubrication of body fluids, leading to unresolved constipation." (Miscellaneous Syndromes and Insights) Treatment should focus on nourishing blood and enriching yin, as well as moistening the intestines to relieve constipation. Prescriptions such as Fluid-Replenishing Decoction with modifications or Eight Precious Ingredients Decoction supplemented with Peach Kernel, Bitter Apricot Seed, and Fleeceflower can be used.
2. Yangming Fu-organ Excess︰Unlike the typical yangming fu-organ excess syndrome with difficult bowel movements, this condition occurs in postpartum women. It presents with symptoms such as epigastric and abdominal stuffiness, distension, pain, tenderness, fever, thirst, dark urine, yellow tongue coating, and rapid pulse. Although there are clinical manifestations of yangming fu-organ dryness-heat, such as fever, thirst, abdominal pain, tenderness, and yellow tongue coating, the root cause is postpartum blood deficiency and fluid depletion. The treatment should focus on replenishing fluids to promote bowel movements, and Modified Liquid-Increasing Purgative Decoction can be used accordingly.

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1. Shoushi Baoyuan．Postpartum: "Postpartum constipation is caused by excessive blood loss, leading to dryness of the large intestine, or blood deficiency causing fire and dryness. Regardless of the duration or frequency of meals, it is often necessary to use medication to moisten and unblock the bowels. If abdominal distension and fullness are felt, and there is a desire to defecate but inability to do so, this indicates a blockage in the rectum, and pig bile should be used to moisten it. If bitter and cold medicines are used to moisten and unblock, they may harm the middle energizer's original qi, potentially worsening the constipation or causing uncontrollable diarrhea, leading to a severe condition."