Chinese Medicine for Crohn’s, Colitis, and IBSKate Kent, R.TCMP, R.Ac. May 1, 2010
Irritable bowel is a catch-all name for abdominal pain and bowel problems that do not have another explanation. For the sake of this article, I am going to include diseases that would normally come under the label of Irritable Bowel Syndrome, such as Crohn’s disease and ulcerative colitis. We don’t use these labels in Chinese medicine; instead we assess what is happening energetically inside each person and treat accordingly.
Different types of diarrhea include: alternating constipation and diarrhea; diarrhea which is moderate yet chronic with undigested food in the stool; severe, uncontrolled diarrhea; or explosive diarrhea with pus and blood in the stool. An added discomfort would be mild or severe pain, bloating, and gas. These patterns aren’t necessarily isolated, and one or more may occur together. All these signs need to be carefully assessed before treatment can begin.
The practitioner needs to determine whether the problem is caused by an ‘excess’ or ‘deficient’ syndrome. Excess would mean too much heat, cold, damp, liver qi stagnation, or retention of food. Deficiency would be weakness of the spleen, stomach or kidney qi. The assessment is done in many ways – by looking at the skin colour, hair, eyes, voice and general constitution and, in large part, by looking at the tongue and taking the pulse. These diagnostic tools show what is happening to the energy in every part of the body and help the practitioner to form a treatment protocol.
ALTERNATING CONSTIPATION AND DIARRHEA
This is a common problem that derives in large part from stress and emotional upheaval. The liver is energetically responsible for the free flow of qi around the body. However, it is a sensitive energy that reacts to strong emotions such as anger and stress, and in this case it either becomes stuck like a road block, causing pain, or it gathers force and overflows into the stomach or spleen, damaging their energy. The stomach and spleen act together like a seesaw and need to be balanced. The stomach qi should go down (or there will be vomiting) and the spleen qi should move up (or there will be diarrhea). If one of them is out of sync it will affect the other, causing alternating constipation and diarrhea.
Appropriate treatment would regulate liver qi and strengthen the qi of stomach and spleen. One of my patients suffered so often from this problem that she had to learn how to moderate her emotions. Her bowels were like a warning flag to her. She had a demanding job, but learned quickly that getting stressed out caused her no end of misery. In the long run, self-soothing talk and a little meditation daily improved her bowel problem as well as other areas of her life.
DIARRHEA WITH UNDIGESTED FOOD IN THE STOOL
This is also a common problem that is often accompanied by mucous in the stool, fatigue, a heavy feeling in the head, dull abdominal pain, lethargy, poor appetite, and bloating. One of the most common syndromes I see in my clinic is that of ‘dampness’. If the spleen is weak, it will not be able to send fluids and nutrients to other parts of the body. Instead, this dampness collects like a sponge holding water, and causes the above symptoms. It is always a chronic syndrome, and the treatment needs to consist of strengthening spleen qi and draining dampness.
This syndrome can be caused by poor diet, eating on the run, and over-thinking. If the kidney yang is weak, there will be a feeling of cold, in which case either a heat lamp would be used or a warming method called moxibustion. Moxibustion comes from dried mugwort leaf, Artemisia Vulgaris, which is burned on or above the skin at acupuncture points.
EXPLOSIVE DIARRHEA WITH PUS AND BLOOD
This is commonly seen in ulcerative colitis (ulceration of the large intestine), diverticulitis (inflamed hernial protrusions in the colon), and Crohn’s disease (chronically inflamed and greatly thickened small intestine, with narrowing of its lumen and ulceration of the mucousa). Patients over the age of 40 who get blood in the stool on a regular basis should be thoroughly checked out by a Western medicine doctor to rule out the possibility of carcinoma of the bowel.
The colour of the blood excreted by inflamed bowels can vary a lot (from dark brownish-red to bright red), and in Chinese medicine theory this colour is interpreted in terms of the underlying pattern rather than the site of bleeding. When the underlying pattern is addressed, the bleeding will stop. This is a chronic damp-heat syndrome consisting of inflammation mixed with dampness. It is important to clear the damp-heat to balance the energy.
It is hard to leave the house with this condition, and it is obviously very upsetting for those people who suffer from it. This condition is usually caused by extreme weakness of spleen and kidney qi, which need to be strengthened to hold the stool. This can occur after childbirth, in the elderly, after prolonged illness, and in diseases such as multiple sclerosis. The Chinese medicine approach would involve strengthening the spleen and kidney qi with acupuncture and herbs.
CHINESE MEDICINE DIET RECOMMENDATIONS
In Chinese medicine theory, diet plays an enormous role, and is one of the most important factors in treatment. We think of food energetically, and what is eaten needs to be tailored to individual cases. One diet is certainly not good for all!
I recently saw a patient who was suffering from uncontrolled bowel movements with lots of bloating. She had been following a diet of raw vegetables, salads and fruit. This is very cold for the system and takes too much energy to digest. Think of trying to light a fire with wet logs and you get the picture. We have a fire in our kidneys, the “Mingmen” or “Gate of Vitality,” which needs to be stoked and kept strong in order to keep the body functioning – in this case, to hold the stool in place.
Eating cold, raw foods is like trying to light a fire with wet logs and is going to make weak kidneys even weaker. We carefully went over her diet, replacing the raw with lightly steamed or stir-fried vegetables, lots of cooked yellow vegetables such as yams and squash which energize the spleen, and took the fruit out of her diet completely. She has had normal bowel movements since, with no bloating.
Raw vegetables would also be contraindicated in the case of diarrhea with undigested food in the stool. The spleen is not strong enough to absorb the nutrients, and consequently food passes right through. Dairy creates dampness and should also be avoided.
There is a school of thought that advocates eating vegetables raw so that their nutrients are retained. But Chinese medicine theory states that if the body is weak it doesn’t have the energy to digest the raw veggies, and so the body won’t get the nutrients anyway. If one has a strong constitution and digestion, then the raw diet makes sense during the summer months.
If the bowel problem is due to erratic liver qi, or if there is inflammation in the bowel, then foods that exacerbate liver qi or add to the existing damp-heat, such as hot spices, alcohol, dairy, and caffeine should be avoided.
These are some of the general rules of diet according to Chinese medicine theory, but each case needs to be assessed separately for the best results.
Acupuncture and Chinese medicinal herbs are very effective in treating diarrhea. If a patient cannot tolerate the medicinal teas, it is possible to have the ingredients ground and put into capsules for easy consumption.