Crohn's disease and Colitis are inflammatory diseases of the gastrointestinal tract. Colitis affects only the rectum and occasionally the lower colon, whereas Crohn's may affect the GI tract from mouth to anus, but most commonly the small intestine.
The main symptoms, common to both conditions, are relapsing bouts of severe and frequent diarrhea occasionally mixed with mucous and blood, abdominal cramping and tenderness. Other symptoms include loss of appetite, malaise, undigested food, constipation, nausea and weight loss due to compromised absorption in the intestinal mucosa. The intestinal walls are ulcerated, swollen and inflamed.
It is important to note that Irritable Bowel Syndrome, discussed in the October issue, does not feature this degree of inflammation. In fact, scans and biopsies of irritable bowels show normal tissues – it is merely the function of the bowels that is abnormal. For this reason it is a relatively easier condition to treat.
The causes of Crohn's and Colitis are not clear, although sometimes the conditions are triggered after an infection or emotional trauma. This suggests an autoimmune as well as psychological connection, once again reminding us of the often overlooked relationship between the mind/heart and gut.
Western medicine treats these conditions with immune suppressors, and oral steroids or other anti-inflammatory drugs. In cases where there is profuse bleeding, colon perforation or other severe complications, these drugs can save the patient's life, and must always be respected as such.
However, correct herbal treatment can greatly increase the likelihood of long term remission and often, a cure.
THE TRADITIONAL CHINESE MEDICINE APPROACH
Traditional Chinese Medicine (TCM) treats Colitis and Crohn's with an arsenal of herbs and methods popularized by the great master Li Dong Yuan in the 13th century. Master Li was a pre-eminent gastroenterologist who developed complex herbal combinations to address the many factors and symptoms of bowel diseases. One of these combinations, JIAN PI LING ("Effective Remedy for Digestion"), still forms the basis of many practitioners' treatments.
In order to shed some light on how TCM treatments work, and why they work so well, it is useful to deconstruct and analyze the above formula. There are 13 herbs in the composition, grouped by their effect, as follows:
1. Astragalus root, Codonopsis root (a type of ginseng) and Atractylodis root.
These three herbs are tonics to the digestive organs, which means they strongly strengthen their function. This is indicated by the symptom of chronic, severe and recurrent diarrhea, which is both a sign of digestive weakness as well as a cause of it worsening, as precious "Qi" is lost by the excessive draining of the bowels. Codonopsis, like all ginsengs, has a very strong affinity for the digestive organs, and is slightly warming in its effect. Astragalus, which many have heard of in its capacity as a great immune system enhancer, also has a very specific function of "lifting" the body's energy. In the case of chronic diarrhea, especially accompanied by fatigue, this is a priceless function.
2. Angelica/Dang gui root and White paeony root
These ingredients are blood tonics, which are of great importance in cases with bleeding ulcerations, when anemia becomes a real possibility. Additionally, Peony root has a strong anti-cramping and anti-diarrhea action.
3. Aucklandia root, Corydalis root
These herbs normalize the movement of energy in the abdominal area. Pain, spasms and excessive urges to defecate indicate the Qi is moving in fits and starts, erratically, instead of the normal and predictable peristalsis of the intestines. The aromatic and acrid flavours of these herbs denote powerful natural chemicals which are able to regulate this process.
4. Ume plums, Catechu resin
These sour and astringent substances are used to restore and heal the mucosal linings of the GI tract, and close non-healing sores. Ume plum has powerful anti-allergic properties. Even if the person did not start out with food allergies, the chronic inflammation begins to impair absorption and assimilation, and many foods can become irritants.
5. Coptis root, Pulsatilla root
These are very bitter, strongly detoxifying and drying herbs, necessary when there is a great deal of mucous, foul and burning stool and fever or infection. They have a broad antibacterial and anti-inflammatory action, and are generally used for a short time to subdue a severe and acute flare of symptoms.
6. Roasted Ginger root and Licorice root
Ginger aids digestion by warming the digestive system, which in TCM is thought of as an oven that must be kept stoked with slightly warming, cooked foods. Additionally, roasting the ginger gives it an extra ability to stop diarrhea. Licorice root is one of the most fascinating herbs of TCM. It has many unique properties and thus figures prominently in most prescriptions. Firstly, it strongly clears fire poison (toxins), which means it has a strong antiviral and antiinflammatory effect. This also enables it to help with symptoms of withdrawal from steroids. What is unusual is that such a strongly detoxifying herb possesses such a sweet taste, many times sweeter than sugar. Usually, it is the very bitter herbs such as dandelion and goldenseal that commonly possess such qualities. However, it is precisely licorice's sweet flavour that enables it to act as a tonic and harmonizer at the same time that it detoxifies. Tonics (as we saw above) strengthen, and they are mostly sweet in flavour. Harmonizing means that licorice is able to bring together the different actions of the herbs in any given formula, so that they don't butt heads but instead work together to subdue all of the elements of the disease process. And finally, licorice root has a slippery, mucilaginous quality which can protect the stomach from the bitter herbs and their drying properties.
Of course, this formula is only a starting point. Each person's bowel condition will manifest with its own peculiarities and degrees of severity, in which case some herbs are removed and others added. Sometimes there is so much damp toxin and inflammation that the tonics are not yet included. This is why a qualified herbalist is needed and one should never attempt self-treatment.
Bleeding, in the case of ulcerative colitis, is another example. Herbs such as Notoginseng and Sophora flower would be included, or carbonized sanguisorbia root.
Carbonizing is one of the processing methods used by Traditional Chinese Medicine. It means burning to black, or charcoaling. It is a method that greatly enhances a herb's ability to stop bleeding and absorb toxins by making it extremely astringent. A simple step such as this can completely change a herb's action and effectiveness by inducing in it a complex set of biochemical changes. Other processing methods include dry roasting till brown, as in the case of the ginger root above, stir frying in vinegar to enhance pain relief, steaming with wine to enhance warming tonification, stir frying with honey to moderate spasms, and many more, depending on the condition of each patient.
DIETARY CONSIDERATIONS FOR CROHN'S AND COLITIS PATIENTS
Crohn's patients are very likely to be lactose intolerant, and should avoid all dairy. It is probably prudent to also avoid wheat, and excessive fibre, especially the insoluble roughage. TCM prescribes what is known as the "clear bland diet" for all inflammatory bowel conditions. This includes clear broths made with vegetables and or lean meats, pearled barley, white rice.
Ulcerative colitis is much more common than Crohn's, and its treatment with TCM is the subject of intense research in China in the present day. Study results have been very promising, such as one which treated 596 cases. Of these, 62% were considered cured with no relapse after 6 months, and all but 6 showed some improvement. This was gauged by colonoscopy performed after the herbal treatment was completed. The study was published in the Shenxi Journal of TCM in 1991, and there are hundreds like it in the medical literature in China.