Chinese Herbs for Treating C. Difficile InfectionAdina Stanescu, R.TCMP July 1, 2011
Clostridium difficile, or c. difficile, is an aggressive bacteria which causes intestinal infections and colitis in patients treated with antibiotics, often in a hospital setting.
The infection causes symptoms such as extreme watery diarrhea with blood, intestinal cramping and urgency, abdominal tenderness, fever, and progressive weakness and weight loss. As it is, this infection tends to attack those who are weak and vulnerable already, including: the elderly, immune compromised, chemotherapy patients, or those receiving protracted antibiotic treatment for Lyme disease and other recalcitrant bacterial infections.
C. difficile overgrowth is a perfect example of the importance of our intestinal flora to keeping us well, and the deleterious effect that antibiotics sometimes have on this delicate balance. This organism normally lives in our colons, but is kept in check by all of the good bacteria that oppose it. However, when these good bacteria are indiscriminately killed by the antibiotics, c. difficile, which is largely resistant to these medications, is able to proliferate freely.
The conventional method is to treat with still more antibiotics, one of a couple that work on this particular organism, and indeed, in most cases it works reasonably well. However, in a significant minority of cases – up to 20 percent – the infection returns after the medications are discontinued, and the patient enters a vicious cycle of recurrence, more antibiotics, another recurrence, and so on.
THE CHINESE MEDICINE APPROACH
Chinese herbal treatment offers a solid alternative treatment for c. difficile infection and its associated inflammation of the bowel mucosa, pseudomembranous colitis.
To treat it, a TCM practitioner will call upon the traditional formulas that have been used for millenia to treat dysenteric disorders, i.e. any disorder manifesting with bloody diarrhea, and generally caused by any number of bacteria such as c. dif, e. coli, as well as micro-organisms such as amoebas, protozoa, and viruses.
The beauty of the treatment is that it employs multiple herb combinations, attacking the problem from all sides, and therefore greatly lessening the chances that the wily bacteria will be able to develop their notorious resistance. The other advantage is the practitioner’s ability to treat according to the exact stage of the infection and the relative strength or weakness of the patient’s body, thereby maximizing the chance for success.
The initial onset of symptoms is often characterized by smelly, burning bouts of diarrhea, intestinal cramping, and urgency and frequency of bowels. The tongue will have a slimy, yellow coating, reflecting infection in the gut. If the patient is relatively strong, the treatment is quite straightforward: a combination of Paeony Decoction and Pulsatilla Formula will address the damp-heat of this condition quite easily. Herbs such as Pulsatilla root, Scutellaria root, and Coptis root provide strongly antibacterial and anti-inflammatory action, while Paeony root, Areca, and others simultaneously work to regulate intestinal peristalsis. If the symptoms are severe, an enema may also be given to deliver the herbal liquid directly to the site and facilitate immediate absorption. The symptoms will often improve within one to two days of starting the herbal decoction.
On the other hand, if the patient is weak or elderly, treatment must proceed a little more cautiously so that the bitter herbs are balanced with a small amount of immune boosting herbs, to simultaneously supplement the fighting strength of the body while attacking the bacterial infection. Herbs such as Atractylodis root and Diascorea root may be used in such cases.
If there is bleeding, herbs such as Rhubarb, Hawthorn, and Sanguisorbia are charcoaled and added to the decoction. Charcoaling these herbs at a high temperature essentially modifies their chemical composition such that they become excellent hemostatics, i.e. able to stop this type of inflammatory bleeding. Stopping the bleeding will go a long way toward preserving the strength of the patient, and recovery will soon follow.
When the infection has persisted or recurred for many months, the resources of the body are severely depleted. The diarrhea will be increasingly watery, and there will be weight loss and extreme fatigue, paleness, and a feeling of coldness. At this stage, it is more important to boost the body’s strength, and only secondary to attack the bacteria with bitter herbs. We call this stage extreme deficiency and cold of the abdomen. Food will pass through undigested, as the digestive “fire” has been put out.
At this stage, we need to use herbs such as Ginseng, Atractylodis, processed Aconite, and baked Ginger to reset the flame and repair the digestive function, while still using small doses of the anti-infective herbs.
Another fascinating ingredient choice here is not a “herb” per se, but rather the baked, powdered earth from a clay oven – called Zao Xin Tu in Chinese. This warming substance is very good at stopping cold and deficient bleeding, and refuelling our “digestive ovens” in cases of such profound resource depletion. A study in the Henan Chinese Medicine Journal reported striking effects in the treatment of bacterial dysentery with the use of Zao Xin Tu combined with bitter herbs. Ninety children were treated, with 17 of them showing marked effect after just one dose, 34 after two doses, and 19 after three doses.
Long-term cases in immune-compromised people will necessarily take longer to treat and require a more complex strategy. An improvement can be expected within one to two weeks, but it will take several weeks to get the patient back on his or her feet.
A 44-year-old woman came to my clinic with a recent case of c. diff. She had been treated with a couple of courses of antibiotics for an upper body infection, and when she developed the typical intestinal symptoms described previously, she insisted on being tested. A stool sample revealed the overgrowth of c. difficile.
An “initial stage” formula built largely around bitters was used to great and immediate effect, with all symptoms improving right away. Continuing treatment for three weeks cleared the infection completely, without the need for the toxic drug Flagyl, for which she had been prescribed. As she was otherwise in good health, no strengthening treatment was needed afterwards.
As I write this article, Europe is struggling with an outbreak of a particularly virulent strain of e. coli, which has killed and sickened many. Antibiotics are not effective against intestinal e. coli, and hydration is the only Western treatment.
On the other hand, herbal constituents such as berberine, found in Coptis root and Phellodendron bark, and Baicalin, found in Scutellaria root, have been found to exert strong effects against various aspects of e. coli pathology. Taken in enema form especially, they immediately begin to disable the toxin, which ultimately leads to the kidney damage from which many of the victims are suffering.
We should never underestimate the strength and power of herbs, even in the face of modern superbugs. Herbs have been used for virulent infections for thousands of years, and their complex synergies and multiple biochemicals can weave a web of destruction for intestinal bacteria of all stripes.
Adina Stanescu, R.TCMP is director of The TCM Skin and Internal Clinic in Toronto. She has 25 years experience treating inflammatory skin disease, allergic and autoimmune conditions, and gastrointestinal disorders with Traditional Chinese Medicine. She is the TCM Dermatology professor at Humber College. For appointments email email@example.com or visit www.thetcmclinic.com