In today’s post we are going to have a close look at the treatment of digestive system conditions from the point of view of Western Medicine (WM) and Chinese Medicine (CM- and including Acupuncture and Chinese herbal medicine). This particular area may demonstrate more vividly the difference between the two approaches. Whilst WM tends to concentrate on the biological and chemical changes occurring in the disease process, CM is more concerned with the functional changes and what has led to them. The same applies to the approach regarding the treatment: WM focusing on trying to reverse, stop, or at least slow down these chemical and biological pathological changes, whilst CM focuses more on restoring the impaired functions of the organs by treating the underlying cause as well as the symptoms themselves. I will try and demonstrate that with an example: the different approach is particularly apparent with the most common G.I. condition i.e. Irritable Bowel Syndrome (IBS). It has no known chemical or biological changes associated with it. It is purely a functional problem and therefore a complete mystery to WM. For CM, however, it is the complete opposite. Since the symptoms are abundant we have a lot to work with to analyse, understand and treat the condition. On the other hand, in the case of IBD (Inflammatory Bowel Disease) like Crohn’s Disease the Doctors can see clear inflammatory changes and Autoimmune involvement and they therefore have more to offer in the way of treatment than in the case of IBS.
I am going to discuss in a bit more detail the most common of GI conditions: IBS, IBD, chronic constipation, diarrhoea, diverticulitis and stomach related conditions.
Let’s start from the beginning. The GI tract starts with the mouth. The most common mouth complaints are mouth ulcers/sores and inflamed gums. In both these conditions the treatment with WM is limited to soothing and pain reduction. CM, however, understands that both are a result of excess heat mainly in the stomach. The treatment, therefore, with Acupuncture and Chinese herbs, is aimed at reducing the stomach heat. The results are excellent and, since we treated the source, also longstanding.
Next is the Oesophagus. Primary oesophagus problems are fairly rare. Oesophagus problems are more commonly a result of stomach acid damaging the oesophageal lining, producing pain known as heartburn. We’ll discuss it with stomach acid problems.
Let us continue our journey down the digestive system. After the oesophagus is the stomach. The stomach function is to receive the food we eat, start the digestive process and gradually move it downwards to the duodenum. Stomach problems can generally be divided into acid related problems and stomach dysfunction problems. Acid problems are usually due to the stomach fluid being too acidic or due to the protective layer of the stomach walls being very weak or damaged. Another common problem occurs when the sphincter between the stomach and the oesophagus is malfunctioning allowing stomach acid to travel upwards causing heartburn. The symptoms of hyperacidity problems are usually a burning type of pain around the stomach area, sometimes radiating to the back; sometimes after
food but can also come before food (hunger pain). The symptoms of a malfunctioning stomach are more common after food and include bloating, fullness, extending or swollen stomach and pain. Other possible symptoms are low appetite, nausea and sickness. These two types of stomach problems can sometimes be combined. The WM treatment for stomach acid related problems is with antacid medications. There are different levels of those: from alkaline buffers like Gaviscon or Rennies which simply reduce the level of acidity of the stomach fluids, to drugs like Omeprazole which completely stop the production of acid. From the point of view of fast symptom relief these medicines are, in most cases, remarkably effective. When Omeprazole came on the scene about 25 years ago (I was a young doctor then, working in a hospital) doctors were reluctant to prescribe it. The worry was about the impact of no acid production on the stomach. The rationale was that the acid production must be there for a reason and that if it was eliminated it may cause some long term problems. At the time, Omeprazole was prescribed for the most severe acid related problems which had not responded to other treatment. However, over the years, the doctors became more and more relaxed about prescribing it. It is now one of the most commonly used medicines and these days it is used for almost any stomach niggle. Recent studies into the long term effects of taking Omeprazole have found out, not surprisingly I have to say, that depriving the stomach of its natural way of working in an acidic environment has its price: from a problem in vitamin absorption which can lead to Osteoporosis and other problems and to increase cases of Oesophageal cancer. Yet again’ we find out that attempts to interfere with the natural working of the body have a long term negative consequence. So, treatment of acid problems with WM: good on the symptoms but worries about the long term use of the drugs. It is probably worth mentioning that WM almost eliminated the problems of stomach and duodenal ulcers. This very painful condition which used to be fairly common when I was a young doctor has almost disappeared now since the discovery that it is caused by a bacteria. Adding a course of antibiotics to the antacids made the treatment of these conditions very effective.
The Chinese medicine treatment of stomach over-acidity is aimed at reducing the hyper acidity state and at improving the stomach function. This treatment is often successful. It has no side effects and tends to last for the long term. However, in the case where Heartburn symptoms are a result of a Hiatus Hernia then CM can be less effective since we are talking about a structural problem. I still recommend to try and treat any stomach acid problems with Chinese herbs and Acupuncture first, but in some cases we’ll have to resort to acid blockers or, in some bad cases, to an operation to repair the Hiatus Hernia.
The other type of stomach problems can generally be described as indigestion. It often includes symptoms like bloating, swelling of the stomach and epigastric pain. In some cases low appetite and/or sickness are present as well. WM will place these symptoms under the IBS diagnosis. The only WM treatment available for this condition is Mebeverine. It works on the nerve system. Although its mechanism of work is unknown it is thought to relax the digestive system muscles. Its effectiveness is controversial as a few studies failed to show anything above a placebo effect.
Chinese medicine treatment for these types of stomach complaints is highly effective. According to Chinese medicine these symptoms can arise due to one of three reasons:
a) a weakness of the stomach
b) accumulation of thick fluids in the digestive system (called dampness in CM)
c) stress, distorting the normal workings of the stomach
Combinations of two or three of those is not uncommon. The treatment of these with Acupuncture and Chinese herbs is very efficient. The aim is to restore the function of the stomach and therefore, when it’s done, we can stop the treatment without the risk of the symptoms returning.
I am going to skip Pancreal and Duodenum conditions which are fairly uncommon. We’ll briefly go through Gallbladder as I have a few more important conditions to cover in today’s post. So, the main problems with the Gallbladder are Gallbladder stones and Gallbladder infection (Cholecystitis). Cholecystitis is treated with antibiotics which are fairly effective for the Acute phase. The problem is, however, that the infection can turn into chronic inflammation of the Gallbladder wall. The treatment offered here is usually an operation to remove the Gallbladder. CM can treat Chronic Cholecystitis effectively without the need for an operation. Gallbladder stones are a much more common condition. They are more common in woman, over forty years old and overweight. CM is very effective in clearing gallbladder stones as long as they are 1cm or less in size. Bigger than this and we will struggle to dissolve them.
Next we are going to examine the treatment of IBD (Inflammatory Bowel Diseases). There are two conditions included in this category: Ulcerative Colitis (UC) and Crohn’s Disease (CD). Both are chronic inflammation in the digestive system but are different in some aspects, most importantly in their location. Whilst U.C. is limited to the large intestine, CD can accrue in any part of the GI tract. This difference has an implication re the treatment. Both conditions are probably Autoimmune in nature.
The Western medicine treatment of both is generally with Immunosuppressant drugs. These medications suppress the activity of the Immune system and , by doing that, stop the Immune system from attacking the GI tract. Immunosuppressant drugs can be successful in reducing the inflammation and therefore the symptoms, and yet these are strong medications which are likely to have long term serious side effects like an increase in the likelihood of cancer (through repressing the normal work of our immune system). Another problem is that these meds are for life’ as often the case, they do not treat the root of the problem and therefore have to be taken continuously. In cases where the meds are not working, or have stopped working, the Doctors will resort to an operation to remove the affected segment of the GI. In the case of UC this will be a cure. Removal of the large colon means that the disease can’t come back. It will however leave the patient with chronic diarrhoea in a good case, or a colostomy bag in a bad one. When it comes to CD the situation is more complicated. Removal of the diseased area will only provide a temporary relief from the symptoms. The disease will flare up again in a different part of the Digestive tract. One of the things that shocks me most, is the willingness of the Doctors in this country to operate on a CD patient to remove the inflamed section. It is a temporary solution and will almost certainly eventually bring them to an early grave since there is only so much of the Digestive tract you can take out before it becomes incompatible with life. Sometimes there is no choice and an operation is needed but it should only be done as a last choice!
Chinese medicine treatment of IBD is quite effective although in some cases it needs to be given together with WM treatment, at least at the beginning of the treatment and until clear improvement has been achieved. These conditions are chronic and severe and therefore the treatment may take time. Acupuncture and Chinese herbs are needed and it is strongly recommended to go to an experienced Practitioner. If you can find the Practitioner and commit to possibly long term treatment then it is worth going for CM treatment for Crohn’s and/or UC. It will make you healthier and it may save your life. The few difficult cases that don’t react to CM treatment can be then treated with WM.
We are going to go down in the severity of the conditions and talk about chronic diarrhoea and chronic constipation . These can be very upsetting but, unlike IBD, there is no inflammation involved and they are extremely unlikely to kill you. I thought it important to discuss these fairly common conditions because, as amazing as it sounds, WM does not have the first idea as to what causes these two conditions and therefore the treatment offered is very poor! In CM however these conditions are the bread and butter of Digestive System malfunction. CM recognises a few clear patterns of diarrhoea and constipation. For example, constipation can be caused by dryness in the gut: the stools will be very dry and hard to pass. It can also be caused by Qi deficiency (lack of energy in the gut to move the stool forward). The stools in this case will be very thin. Constipation can also be caused by GI stagnation (problems with the smooth flow of energy in the colon); in this case the stools will be like small pebbles (rabbit droppings). Understanding the different patterns and the underlying causes allows Acupuncture and Chinese herbs to provide effective and longstanding treatment.
We are left with Diverticulitis, anal conditions and IBS and this post is already too long so I will discuss these in the next one!
To summarise the Great WM /CM GI comparison so far: which is more effective?
Mouth conditions-CM all day
Stomach and Oesophageal related problems-WM for symptoms, CM for long-term help
Indigestion and other stomach malfunctions-definitely CM
Gallbladder conditions-Cholecystitis: WM for acute, CM for chronic
Gallbladder stones-CM for stones 1cm and smaller, WM for larger stones
IBD (Crohn’s Disease and Ulcerative Colitis)- CM except the difficult ones; often a combination of CM and WM will yield the best results
Next time IBS, Diverticulitis and anal conditions.
Looking forward for that!
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