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Chinese Herbal Treatment of Chronic Digestive Disorders

by Andrew Gaeddert

Digestive disorders are extremely common in the United States. Many Americans who consume antacids in large quantities do not even consider themselves to be suffering from a chronic digestive disorder. Flatulence, tiredness after eating, heartburn, fullness of the stomach, abdominal bloating, sharp stabbing pain, diarrhea and constipation are common signs of chronic digestive disorders. The American dietary habits of eating on the run, consuming cold and raw foods, drinking iced beverages, adults eating a preponderance of dairy products, fondness for sweets, fried foods, and alcohol, are perhaps the greatest contributing factors to digestive disorders.

The spirit in which food is eaten is also quite important, according to Chinese medicine. While eating, concentration should be focused on that activity. Worrying or thinking while eating may cause the body harm. Also, returning to work immediately after a meal, or working while eating, could compromise the digestive process.

Proper digestion is necessary for good health. Undigested or incompletely digested food molecules that are absorbed into the system can lead to various diseases and the development of food allergies. Conditions of the small intestine often cause malabsorption syndromes.

This article discusses the Traditional Chinese Medicine (TCM) syndromes and treatment of the following biomeical diseases: ulcerative colitis, Crohn's disease, peptic ulcers and irritable bowel syndrome.

Symptoms and Syndrome Patterns
TCM treatment of diseases is based on the correct differentiation of syndrome patterns. Thus, while the Western diagnosis of some conditions may differ, the TCM pattern may be the same. For example, Crohn's disease and ulcerative colitis are biomedically different. Crohn's disease is characterized by an inflammatory reaction throughout the entire bowel wall; the condition is also known as regional ileitis. The disease can extend over many years with exacerbations and remissions of symptoms that include diarrhea, abdominal pain, anemia, weight loss, fistula formation, and eventually intestinal obstruction. Stools are soft and grayish or brownish, with abundant fecal particles. Any part of the gastrointestinal tract may be involved, but the ileum is the most common site. Current Western treatment is usually long-term antibiotic or steroid therapy.

Ulcerative colitis is characterized by passage of watery stools with mucus and pus. Accompanying symptoms may include abdominal pain, tenderness or colic, as well as intermittent or irregular fever. Serious cases may present hemorrhaging and perforation. Both Crohn's disease and ulcerative colitis are considered inflammatory bowel diseases (IBD). Males between 15-35 years are most commonly affected. In 15 to 40 percent of cases, multiple members of a family are sufferers of Crohn's disease or ulcerative colitis. Although immune dysfunction is common in IBD, it is unclear if it is the cause or the result of IBD. The actual cause of IBD is unknown. A virus or bacteria may be at fault, or a breakdown of the body's immune system, or a combination of the two. IBD is not caused by emotional stress, although flare-ups may occur during such times.

Irritable bowel syndrome (IBS) is quite common in the US. IBS is not associated with pathologic changes in the intestine, or with inflammation.

It is widely believed that emotional fluctuations play a strong role in causing IBS. Also known as spastic colon or nervous indigestion, IBS symptoms include abdominal pain and distention with relief upon bowel movements, constipation, diarrhea, excess mucus production in the colon, and indigestion.

A peptic ulcer, which occurs in the upper gastrointestinal tract, is a circumscribed ulceration of the mucous membrane penetrating through the muscularis mucosa. The most common type of peptic ulcer, a duodenal ulcer, is found in the first few centimeters of the duodenum. Another common form occurs along the lesser curvature of the stomach and is known as a gastric ulcer.

The typical pattern of pain in patients with duodenal ulcers is: It is absent upon wakening in the morning, but appears in mid-morning; it is relieved by food, but recurs two to three hours after a meal; pain that awakens the patient at 1 or 2 a.m. is common. The symptoms of gastric ulcers often do not follow the duodenal ulcer pattern, and eating may cause rather that relieve the pain. Certain drugs, especially aspirin, other non-steroid anti-inflammatory drugs, and possibly corticosteroids, predispose to the formation of upper gastrointestinal ulcers that tend to heal when the drug is discontinued. In diagnosing chronic digestive disorders, parasitic infections, and more importantly, food allergies, must be ruled out.

Gastroenterologists generally recommend a low fiber diet, although good nutrition is very important, especially for IBD sufferers, since anemia is quite common. Successful treatment of chronic digestive disorders necessitates first treating any parasitic and/or candida infections that may be present. According to TCM, stress while eating and even returning to work immediately after eating, can cause digestive problems. Many Americans tend to be Qi deficient, which affects both our energy and our ability to convert foods into energy.

Pharmaceuticals as well as recreational drugs may induce Stomach Yin deficiency. The root of digestive disorders is usually Liver Qi invading the Spleen/Stomach. Stagnant Liver Qi disrupts the ability of the Spleen to transform food into energy. When stagnation of Liver Qi predominates, constipation with tiny dry stools is a common presentation, while with Spleen deficiency, loose stools are. Other symptoms of Liver and Spleen/Stomach Qi stagnation include distention, fullness in the upper abdomen that is aggravated after meals or by emotional stress, frequent belching, pain relived by bowel movements, nausea, regurgitation, and a thin white tongue coating. Individuals who are in the habit of drinking cold beverages, eating ice cream and raw foods are particularly prone to a Cold-dampness pattern. Their symptoms include pain that is relieved by pressure, distention and fullness of the stomach after meals, tiredness, cold limbs, pale tongue with white coating and a weak pulse. A burning pain in the upper abdomen relieved by meals, thirst without the desire to drink much, irritability, red tongue with dry yellow coating, and a rapid pulse all point to Yin deficiency pattern.

In all chronic digestive disorders food stagnation is present. Chronic dampness precludes complete digestion of food. Overeating, eating too quickly, or eating while emotionally upset can all lead to food stagnation. Symptoms include a sensation of fullness in the stomach, foul breath, sour regurgitation, belching, and insomnia, along with a thick yellow or white tongue coating. Damp-heat in the Large Intestine is another common syndrome of chronic digestive disorders. Qi deficiency is also present along with abdominal pain, diarrhea, mucus and blood in the stools, smelly stools, heaviness in the body, fever, anal burning, and a red tongue with a sticky yellow coating. Individuals with this pattern are generally diagnosed as having candida by holistic physicians, whether or not tests indicate higher than normal candida counts. Many cases of candida are iatrogenic because of the over-prescribing of antibiotics by Western physicians. When colonies of yeast are established in the mucous membrane, they can survive for years and even decades if the patient's diet is composed of high sugar, yeast or fermented foods. Yeast can attach to the wall of the colon, small intestine, or any other part of the gastrointestinal tract, and release toxic byproducts into the circulatory system. These byproducts inhibit the function of T-suppresser cells.

According to Seattle physician Ralph Golan, MD, a yeast-impaired immune system has less than normal tolerance for ordinarily safe levels of common chemicals such as gasoline and oil fumes, cleaning fluids, and pesticide residues found on supermarket produce. Dr. Golan also notes than an impaired immune system may produce antibodies to the body's own tissues resulting in auto-immune disease. Other pharmaceuticals that may lead to candida include cortisone, immunosuppressants, and birth control pills.

Patients suffering Crohn's disease or colitis have a propensity of developing both candida and Damp-heat in the Intestines. Thus, in addition to following a TCM diet, herbs in a well-balanced formula should be taken for extended periods. Several cases of IBD involve Blood stasis, which is characterized by fixed stabbing pain, a tongue that is purple in the center, dark blood in the stools, and epigastric pain. Because inflammation is a major symptom of IBD, the standard medical treatment is long-tem administration of steroids, antibiotics, or sulfa drugs. Surgery is now rare because steroids are almost immediately effective. However, TCM views the use of steroids as harmful to the Kidney. From a Western medicine standpoint, steroids may cause gastrointestinal disorders, and a myriad of other problems. Long-term antibiotic use may cause gastrointestinal complaints, fungal overgrowth, and allergic reactions. Sulfa drugs may also lead to gastrointestinal disturbances and allergic skin reactions.

Treatment
Chinese herbs that have an anti-inflammatory action are effective not only in reducing inflammation, but also in attacking bacteria, which may be the cause of flare-ups of IBD. Isatis leaf (Da Qing Ye) and root (Ban Lan Gen) are very effective as they are both antibiotic and anti-viral according to Chinese research. They are also cool in nature, and thus are anti-inflammatory. In studies described by Bensky and Gamble in Chinese Herbal Medicine: Materia Medica, 300 patients were administered Isatis and their "fevers would usually disappear entirely within one day, and frequency of bowel movements usually returned to normal within five days." Smilax (Tu Fu Ling) is also an important herb as it clears Damp-heat toxin and treats ulcers. According to Michael Murray, ND, in his Healing Power of Herbs, Smilax is an endotoxin binder. Endotoxins are cell wall constituents of bacteria that are absorbed in the gut. If the Liver is in dysfunction, the endotoxins may seep into the bloodstream and activate the alternate complement system, which plays a critical role in the inflammatory process.

One of the most suitable formulas for treating IBD is Phellostatin because of its anti-fungal properties, since many IBD patients are also afflicted by candida. The main ingredient is Phellodendron (Huang Bai) which treats diarrhea and eliminates Heat and Dampness. The remaining herbs in the formula tonify the Qi, clear Heat and Dampness, and are anti-inflammatory and anti-fungal. Phellostatin may be combined with Quiet Digestion. The primary ingredient in the latter formula is Shen Qu, which is composed of fermented herbs that are rich in enzymatic activity. For severe cases of gas and bloating, Quiet Digestion may be taken every two hours until the gas subsides. The formula is designed to break down rapidly in the gut for immediate relief. It should be started slowly, one table three times per day and then gradually increased to three tablets three times per day after two to three weeks. Quiet Digestion is taken just before meals in order to help the assimilation of food. It may also be taken after meals when gas-inducing foods are consumed, usually two tablets until the symptoms are alleviated.

It is recommended to combine Quiet Digestion with other formulas when treating chronic digestive disorders, since food stagnation is so common among these cases. For chronic digestive disorders that are accompanied by pain and inflammation, Isatis Cooling is appropriate. In addition to isatis extract, its other ingredients tonify the Spleen, promote blood circulation, clear Dampness and Heat, and are anti-inflammatory, anti-fungal, and antibacterial. Under proper medical supervision, Isatis Cooling may be tried as steroids are slowly withdrawn. Underlying the Heat and inflammation is Deficiency, thus after a course of Phellostatin or Isatis Cooling, Six Gentlemen with Cardamom and Saussurea (Xiang Sha Liu Jun Zi Wan) may be used to tonify the Spleen (especially cold pattern), or Astra Essence, as it is a balanced formula with Kidney Yin, Yang, and Blood tonics. In treating IBS and peptic ulcers, Stomach Tabs have proven to be an effective remedy. Based on Ping Wei San (Relieve the Stomach Powder), this formula is modified with Bupleurum since many individuals with chronic digestive disorders tend to repress their emotions; it is also included for its anti-inflammatory effect.

The other herbs in the formula stimulate digestive enzymes, remove Phlegm, treat gas, and remove food stagnation. For Stomach Yin deficiency pattern, Clearing may be used as it does not contain Rehmannia (Shu Di Huang) which some patients cannot tolerate because it can sometimes aggravate the symptoms of chronic digestive disorder.

The above formulas are very effective in treating the complex syndrome patterns that are presented in patients with IBD, IBS, and ulcers. I have been using prepared formulas with much success because they are well tolerated. Sufferers of chronic digestive disorders generally have mal-absorption problems, thus herbal teas may not be suitable for these cases. Also, herbal teas are absorbed too quickly to be effective in these patients. Interestingly, persons with digestive conditions are unusually sensitive, and in particular to bitter tastes, so that again, herbal teas may not be well tolerated. Perhaps these individuals would do well to consume more bitter substances as prescribed in the European tradition that encourages taking herbal "bitters" for indigestion. Herbal teas, however, should not be eliminated completely from the therapeutic regimen. I generally advise clients to drink at least three cups of hot peppermint tea daily, because this herb relieves stomach and bowel spasms and alleviates nausea. On occasion I have also administered simple, pleasant tasting herbal decoctions with herbal tablets in order to tonify the Qi and Blood. Therefore, by using teas and tablets, patients can consume more herbs (inexperienced practitioners often do not use high enough dosages).

Andrew Gaeddert suffered from Crohn's disease and IBS. His search for therapies to treat his own symptoms led to the discovery of techniques which have made it possible for him to help thousands of other people. Mr. Gaeddert has studied nutrition, herbology, and Chinese medicine with masters from the U.S. and China. He has been on the protocol team of several scientific studies sponsored by the NIH Office of Alternative Medicine and the University of California. He is the author of "Chinese Herbs in the Western Clinic."

To order a copy of "Healing Digestive Disorders", please call 1-800-233-9355.