The Great British Med Off!

Digestive System Disorder 2

In today’s post I am going to conclude the discussion we started in the last one: the treatment of digestive system conditions using Western Medicine (WM) versus Chinese Medicine (CM). Meds and operations versus Acupuncture and Chinese herbs, which one is more effective? I hope you’re not starting to get a bit bored with the matter. The reality is that different conditions will react differently to WM and CM and therefore need to be discussed separately. I think this comparison is important, although I’ll consider having a little break from it in the next post, and find something maybe more exciting to talk about before coming back to complete the mission!
So, back to our subject. We are going to carry on down the GI tract with Diverticulitis, Anal conditions and IBS. Diverticulosis is a very common diagnosis given to people with GI symptoms. The pathology here is the formation of pockets in the wall of the large colon. The problem I have with this diagnosis is that studies have shown that 70% of the over sixties will have diverticulosis in their large colon. Of course, most of these won’t have any GI symptoms. I have seen many patients over the years who had general GI symptoms like abdominal pain, bloating, diarrhea, constipation etc. These were diagnosed as diverticulosis just because that’s what came up in the scan. In most of these cases, in my opinion, the diverticulosis was obviously present but wasn’t the reason for the symptoms. In these cases the condition should have been diagnosed as IBS! They were treated as IBS and they got better. However, in some cases, the symptoms are as a result of the diverticulosis and in these cases the typical symptoms are localised abdominal pain or discomfort, usually after food and often in one specific location (where the pocket is). These cases are a bit more difficult to treat as there is a structural change in the colon which disturbs the normal function. The WM approach is to improve the smooth movement of digested material by creating a better bulk. This is done with bulking agents which are basically fibre rich powder like Fybogel. The idea is that better formed stools will be less likely to get stuck in the pockets. It tends to work reasonably well. The CM approach is to improve the general function of the large colon and to clean away any toxic stuff which is actually stuck in the pockets. This approach is often successful in alleviating the symptoms.
To sum up: the majority of the diverticulosis sufferers will be treated better with Acupuncture and Chinese herbs due to the fact that most of their symptoms are caused by IBS and not diverticulosis. For the few experiencing diverticulosis symptoms the CM and WM treatments are of about equal effectiveness. In some rare cases the diverticulosis pocket will get infected and this condition (called diverticulitis) is considered to be a medical emergency requiring hospitalisation and, often, an operation.
Next, Anal conditions, namely piles and anal fissures. These two are fairly common. The treatment with WM is initially with creams to soothe the symptoms in conjunction with meds to maintain bowel movement, but, if the condition persists then the next step is an operation to remove the fissure or a procedure to remove the piles. The Chinese medicine understanding of these conditions is that they are caused by blood stagnation and heat in the lower end of the digestive tract. The treatment aims at remedying that in conjunction with keeping the bowel movement regular and soft. The results are usually good and long-lasting. Piles and anal fissures, then, are treated more efficiently with Acupuncture and Chinese herbs than with the WM cream. However, in difficult cases we may have to resort to an operation or a procedure.

I’ve left the best to last. The most common of digestive system conditions is IBS (Irritable Bowel Syndrome). IBS refers to a situation where the patient experiences a symptom, or a mix of symptoms, like abdominal pain, swelling of the stomach, diarrhoea, constipation or both without having any pathological findings in medical tests.
From the definition you can understand why WM is struggling to get its head around this condition. If there are not pathological findings then what the hell is wrong here? What causes these symptoms? I was present once in a lecture given at a TCM convention regarding IBS. The lecturer was a Doctor from a world-leading centre for the study of IBS. The subject was “IBS , the WM view”. It went more or less like this: fifteen years ago we thought that IBS was caused by this, then we discovered we were wrong and it is actually caused by that, but then we found out that we were wrong again and ,actually, it was caused by that and so it went until now we are almost sure it is caused by this and that. Forgive me for not boring you with the details of this and that theories. I am not sure I can remember them anyway. I am not being disrespectful to the Lecturer. He was obviously a very intelligent man who was trying his best and besides, he did agree to come and give a presentation to a TCM convention- a thing that most WM doctors probably decline to do. It wasn’t his fault. It is the wrong assumption that IBS is one condition with one cause. It’s the WM model that a disease has a cause, certain pathological changes and a pattern of symptoms and this simply doesn’t work in the case of IBS. It follows that the treatment on offer is poor; doctors will try different medicines like Omeprazole or Mebeverine with very limited success in relieving the symptoms. Chinese medicine, however, understands IBS very well, a lack of pathological findings makes no difference to a good TCM practitioner. IBS is a functional condition. A lack of function of the digestive system is bread and butter in TCM. No two IBS sufferers will be the same. Each individual case should be initially assessed to understand the causes of the condition and the symptom patterns as well as the patient constitution. When this has been achieved the treatment will be very effective. Generally speaking, the common patterns that cause disruption of the digestive system functions are as follows:
• Weakness of the digestive system
• Too much fluid in the gut
• Problems with the movements and the energy flow in the digest tract
These can be combined and intertwined. They can be caused by stress and worry or by eating the wrong food or by overworking etc. This is a significant simplification. I don’t want to bore you with all the details. I just hope it will help you to understand that Chinese medicine has a very thorough understanding of IBS and therefore the treatment with Acupuncture and Chinese herbal medicine is very often successful.

To sum up our comparison, in this post we looked at Digestive tract conditions and which sort of treatment would be most effective: Diverticulosis -TCM, Anal fissures and Piles-TCM but some difficult cases will need WM, IBS -Acupuncture and Chinese herbs any day.

Good Health,
Dr Ilan Shahor