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How Do You Treat IBS?

By Andrew Gaeddert

Irritable Bowel Syndrome (IBS) is the second largest reason people miss work, and is the most common gastrointestinal disorder. Common symptoms include abdominal cramping, nausea, intestinal gas, diarrhea, constipation, and alternating stools. It is important to note that no structural abnormalities are present. Below are recent case studies seen in my clinic in Oakland, California.

Case 1

Helen was a 50-year-old minister who had chronic constipation, bloating and intestinal gas. She was underweight. Despite eating plenty of fruits and exercising daily, Helen was unable to go the bathroom more than twice per week, often requiring and enema. Helen's GI specialist had recommended surgery, as this problem had persisted her whole life. When Helen consulted me, she was taking a long list of supplements: Vitamin C, bioflavanoids, an eye supplement with Bilberry and Lutein, a bone building supplement, Iprifavone, Alpha Lipoic Acid, Curcumin, Co-Q10, milk thistle, digestive enzymes, ginkgo, bacterial cultures, Colostrom (an adrenal supplement), Reishi (an herbal cleanser), aloe vera, black cohosh, Vitex, dandelion, red clover, American ginseng, a fish protein supplement, Maitake mushroom, iron, HCL, homeopathic Lycopodium, seaweed tablets, blue green algae, chorella, spirulina, flaxseed oil, and Borrage oil. Her pulse was weak in the first and third positions, and wiry in the middle position . Her tongue was normal color, dry and flabby.

I initially recommended Aquilaria 22, one to two tablets TID. I also recommended that she stop all supplements except for the aloe vera and flax oil, which have laxative effects. In addition, I recommended Magnesium aspartate 400mg. After two weeks, there was little change so I suggested she try chewing the Aquilaria 22. I also recommended Chzyme (containing various enzymes and herbs), one to two tabs with meals and as needed to reduce bloating and gas. Finally, I suggested increasing the Magnesium aspartate to 800 mg per day, and recommended a tea consisting of Oryza sprout Guya, Cistanche Rou cong rong, Flax Huo ma ren, Immature Citrus Qing Pi, Red Peony Chi Shao, White Peony Bai Shao, Magnolia Bark Hou po, Cardamon Sha ren, Aurantium Zhi shi. Although Helen was a vegetarian, I urged her to try to eat fish as much as possible, and to go for two weeks without any soy products. This new regime was very successful, and after two weeks she was able to have bowel movements without an enema. In additio n she had much less intestinal gas and bloating. After one month we cut down the herbal tea to half a cup per day. Eventually she rarely needed the tea. She continued taking the Aquilaria 22 and Chzyme as needed.

Helen's case was unusual in that she was taking an extreme number of supplements, which I believe was compromising her absorption. I therefore suggested she go off everything, which helped her body get back into balance. Some of the supplements such as the algae, chorella, and spirulina could have been contributing to her indigestion; Colostrom can cause constipation. Instead of taking seaweed tablets, I encouraged her to take seaweed as a food. Helen seemed to get added benefit to chewing the Aquilaria 22, which has laxative effects, and a number of qi moving herbs. The tea I recommended was designed to moisten her stools and move qi. Magnesium has laxative effects and helps reduce muscle contractions.

Case 2

Marjorie was a 57-year-old housewife with a life long history of IBS. Her main symptoms were diarrhea and severe pain, which sometimes resulted in hospitalization. She also complained of panic attacks, headaches and feeling cold. Her pulse was slightly wiry, her tongue dry. Initially I recommended Source QI, three tablets TID with ginger or cinnamon tea, increased to three QID after one week. After two weeks Marjorie reported feeling warmer and more energetic, with a reduction in the frequency of diarrhea. She complained, however, of neck pain, hip pain and poor sleep. Her pulse was unchanged and her tongue was darker. At this point we added Ease 2 (Chai Hu Gui Zhi Wan), two tablets QID. After a month all symptoms were ninety percent improved. Marjorie went off the Ease 2 and stayed on the Source QI, three tabs TID. Her energy level improved, she began to take classes at a nearby college, and started to exercise and garden more.

Source QI was selected as it contains strong herbs to tonify the Spleen and stop diarrhea. A lifetime of worry and diarrhea had weakened her Spleen, so I felt that his was an appropriate long-term formula. Ease 2 was recommended short-term to help invigorate Liver qi and at the same time tonify Spleen, release shoulder and neck tension and relax her nervous system.

Case 3

Steve was a contractor who had recently been diagnosed with IBS. His main symptoms were gas, bloating, and cramping. A friend had suggested acidophilus, and that had not helped. Steve's pulse was wiry and his pulse had a yellow coating. I suggested to Steve that he reduce his intake of coffee and alcohol. He was not open to other dietary changes as he was single and didn't cook. I recommended Shu Gan, two tabs QID, and Quiet Digestion, two tabs QID, along with peppermint or chamomile tea to be brought in a thermos to work. Within two weeks Steve had almost totally resolved all symptoms. He maintained on the herbs another month, and then felt he did not need herbs.

Steve was very active and responded quickly to the herbs. No doubt reducing coffee and alcohol intake helped his digestion. Shu Gan invigorates Qi, and Quiet Digestion reduces dampness and food stagnation.

Case 4

Daisy was a 44-year-old executive who had complained of chronic constipation for at least twenty years. She had tried numerous therapies including acupuncture, nutritional counseling, and NAET, which all had made a slight improvement however she was only able to go to the bathroom completely after having Senna tea, which she reluctantly took once or twice per week. Daisy insisted that she got plenty of exercise and ate plenty of fruits and vegetables. She ate prunes daily. Her pulse was thin and slow and her tongue was dry. Figuring her constipation was due to deficiency of Qi and Blood, I recommended Eight Treasures, two tablets TID, and Aquilaria 22, two tablets TID. I also recommended one to three tablespoons of freshly ground flaxseed to be taken with oatmeal in the morning. She was counseled to slowly reduce the Senna tea, yet not to discontinue it completely. Two weeks later Daisy was starting to have more regular bowel movements. Over the next several months, I gradually increased the Eight Tre asures and reduced the Aquilaria 22, and she was weaned off the Senna.