Indigestion and Acid Reflux (Heartburn)
Irritable bowel syndrome
Inflammatory bowel disease
The digestive system is considered to be most central to, and of most importance in, Chinese medicine. We eat daily and the digestive system turns the food into the “building blocks” of our body and into the energy that keeps everything working in our body. Without an effectively functioning digestive system many systems in our body will struggle to function properly. Symptoms of digestive system disorder can include abdominal pain, diarrhoea, constipation etc or symptoms as a result of other systems suffering due to a malfunctioning digestive system such as low energy, a weak immune system or insomnia.
Generally speaking, in Chinese medicine chronic diarrhoea can arise from three reasons:
1) weakness of the digestive system
2) excess fluids in the system
3) a combination of 1) and 2)
Weakness of the digestive system can arise from overworking, too much stress or over consumption of cold and raw food. Excess fluid in the system usually arises from long-term indulgence of rich food or from weakness of the digestive system. Other reasons are consumption of medications that weaken the digestive system like antibiotics or severe or chronic infection of the gut by bacteria or a virus or a parasite. The treatment of chronic diarrhoea with TCM is fairly simple: we’ll use acupuncture points and herbs to strengthen the function of the digestive system and to drain the excess fluids. Reasonable and manageable diet and lifestyle advice will be given when needed. The results of treating chronic diarrhoea with TCM are very good. In addition to restoring the proper function of the digestive system the patient will feel an overall improvement in his energy and wellbeing.
These days, very commonly, nutritionists and other practitioners will diagnose many different digestive system symptoms as overgrowth of Candida. They then tend to prescribe the Candida diet to starve the Candida and also medication to kill the Candida. The diet is very restrictive and although the treatment is ok it has a major limitation in that the problem which caused the Candida overgrowth to start has not been addressed. Another problem is that some of the sufferers are already quite weak and will struggle to persevere with the diet and the strong medications Candida is a fungus and so thrives in damp and wet environments. Thick pathological fluids (termed Damp in TCM) are a side product of a weak digestion. The accumulation of damp gives the Candida the perfect environment to thrive and overgrow. A treatment of Candida must therefore include drying the dampness by the strengthening of the digestive system function. This can be very effectively achieved with Chinese herbs and acupuncture treatment.
Chronic constipation can be divided into three different types in TCM:
1) Constipation arising from dryness in the digestive system
2) Constipation as a result of reduced motility (movement) of the digestive system
3) Constipation from weakness of the digestive system
Dry digestive system is generally the more common type. In this case the stool will be hard, dry and difficult to pass. The reason for this dryness is a failure of the digestive tract to moisten the stool. This failure can arise as a result of the patient’s constitution, bad diet, stress or the presence of heat in the digestive system. The treatment of this dry type of constipation is with acupuncture points and herbs that restore the ability of the digestive tract to moisten the stool. Good practitioners will also look to find the reason behind the dryness and will address that as well. The results are excellent and long-lasting.
The second type of constipation arises as a result of reduced motility in the digestive tract. This reduction is usually a result of stress. It can be long-term or short-term stress, emotional stress, work stress or any other type of stress. When we are stressed the function of the digestive system can be disturbed in a few different ways due to the disturbance of the flow of blood and energy (QI) through the digestive system. In some people it will result in low motility in the digestive tract and that will lead to constipation. The stools tend to come in small pieces like rabbit droppings. The treatment in these cases will be with acupuncture points and herbs aimed at restoring the movement of the digestive tract. Treatment will also be given to reduce the stress. The results are very good. The third type of constipation arises from a weakness of the digestive tract and the stools tend to be thin and often pale. This type is common in elderly people and in people who are suffering from a chronic condition. The treatment in these cases is aimed at strengthening the person in general and the digestive system in particular. In addition to improvement in the bowel movement the patient will experience improvement in general well-being.
Of course in life we can sometimes see a combination of two or even three of these types of constipation. An accurate diagnosis is essential for an effective treatment.
Important note regarding digestive system symptoms:
When you experiences symptoms, like a change in bowel movements (constipation or diarrhoea) or abdominal pain, that last over three weeks then your GP should be consulted first. This is in order to rule out the small possibility of cancer. After this has been ruled out, and if the symptoms persist, Chinese medicine will be a safer and better treatment for the condition.
Abdominal pain is one of the most common symptoms and can be caused by different factors which can manifest themselves in different ways and in different parts of the abdomen. An accurate diagnosis of the type of problem and the underlying cause of it is essential for an effective treatment. From the point of view of location, pain in the upper part of the abdomen will be caused by problems in the stomach, duodenum or pancreas. Pain in the middle or lower abdomen will originate from problems in the small or large intestine. (Pain in the very low abdomen can sometimes be caused by an organ out of the digestive system like the womb, ovaries or urinary bladder.) Pain in the hypochondria area (side of upper abdomen) is usually caused by problems in the liver or gallbladder.
Pain, in Chinese medicine, always arises from a block in the flow of QI (energy). The question a good practitioner will ask himself is what is causing the QI to be blocked. There can be a few factors that can disturb the flow of QI in the digestive system:
1) Stress: emotional stress or stress from overdoing things and rushing around too much will affect the liver. The liver maintains the smooth flow of QI in the body. A stressed liver will fail to maintain this flow and although this can affect different systems in the body it most commonly affects the digestive system. Abdominal pain originating from a stressed liver can occur in any part of the abdomen. It will be typically be crampy in nature, will often be exacerbated by stress and often will be accompanied by irritability and mood swings.
2) Weak digestive system: weakness in the system can cause an accumulation of fluid or digestive product in the digestive tract. The digestive tract will become overloaded and will struggle to move the food forward. This struggle will cause pain and possibly bloatedness and diarrhoea or constipation and a lack of appetite.
3) Dampness: dampness, as mentioned before, is a fluidy side product of an ineffective digestive system. It can be caused by weakness of the digestive system or by overeating rich or raw cold food. Our digestive system does not function well in a wet environment and so a vicious circle is established: the dampness is weakening the digestive system and a weak digestive system produces more damp and so on. The QI is struggling to move properly in the damp tissues and as a result pain will accrue. Other typical symptoms are bloatedness, heaviness and diarrhoea.
4) Cold digestive system: just like in the case of dampness, cold in the digestive system will often block the movement of the Qi and will cause pain. Cold can develop from eating too much raw cold food or from overuse of certain medication like antibiotics. The pain will be severe and usually worsen at night and be relieved with heat.
From these explanations one can understand why it is so important in Chinese medicine to determine the type of pain and the underlying cause. We are not just treating the pain (as painkillers from a doctor do) we are treating the function of the digestive system using the specific acupuncture points and herbs to treat the specific problem that is in front of us. No two patients will be exactly the same. The aim is to relieve the pain by restoring the function of the digestive system. The results are almost always both positive and long-lasting.
Indigestion and Acid Reflux (heartburn)
I have put these conditions together since they are all related to a malfunction of the stomach. Indigestion refers to an uncomfortable feeling, or even pain, in the stomach (upper part of the abdomen) following a meal. Other symptoms, like bloatedness, belching, fullness, nausea and heartburn, are common. The reason for these symptoms is the inability of the stomach to do its normal function which is to receive the food, start the digestive process and then move the food further down the digestive tract. In Chinese medicine we are looking for the cause of this malfunction of the stomach. This can be different in different cases. A malfunctioning stomach can be too weak, too dry, too damp, too hot or too cold. It can also have disharmony with the liver or the gallbladder. These problems can arise from too much stress, too much rushing around, bad diet or a constitutionally weak digestive system. Often we will see a combination of a few of these. The Chinese Medicine practitioner will have to diagnose exactly what is the situation in each case and the treatment will be focused on correcting these problems and allowing the stomach to resume normal function.
Acid reflux or heartburn refers to the burning, acidy feeling in the upper abdomen or the chest (oesophagus). These symptoms are a result of too much acid in the stomach or of damage in the mucous layer in the stomach that protects it from the acid, or from a malfunction in the sphincter between the oesophagus and the stomach that allows acid from the stomach into the oesophagus. In Chinese Medicine we will usually view it as too much heat in the stomach or weakness of the stomach. As in the case of indigestion, the treatment with Acupuncture and Chinese herbs is very effective in restoring normal stomach function.
Irritable Bowel Syndrome (IBS)
IBS is the most common complaint I see in my clinic. The reason for that is probably the complete failure by Western medicine to understand and treat this condition. The medical definition of IBS is chronic digestive symptoms without any pathological findings in medical tests. Basically this says: we know you are suffering but we don’t really know why, therefore it is IBS. However, in Chinese medicine the attitude is completely different. If the patient has a symptom then that by itself is already telling us that something is wrong even if a doctor can’t see it in a medical test. The symptoms themselves actually tell us what the diagnosis is. The symptoms of IBS can vary widely and can include all the symptoms of the digestive system that we have already discussed: chronic diarrhoea, constipation or both together, abdominal pain, bloatedness and so on. No two IBS cases will be exactly the same. The cause of IBS can often be stress affecting the function of the digestive system but it can also be related to diet, allergies, intolerances to different foods or a constitutionally weak digestive system. In the Chinese medicine clinic we have to get to the bottom of each case. People’s constitutions are different and so is the cause of the condition in the different cases. When we arrive at an accurate diagnosis the treatment is extremely effective.
Inflammatory Bowel Disease (IBD)
The term IBD includes two conditions: crohn’s disease and ulcerative colitis. Both are serious chronic inflammatory conditions of the digestive system. Patients often need to take strong medications to control the symptoms; sometimes surgical intervention is needed. The cause of these conditions is unknown but there is probably a strong autoimmune element to it since the conditions react well to immunosuppressant medications.
Chinese medicine can be a great help to IBD sufferers. Acupuncture and particularly Chinese herbs can be very effective in reducing inflammation and in regulating a misfiring and overactive immune system. Over the years I have helped a few IBD sufferers to reduce their symptoms and increase their quality of life. In most cases they were able to reduce the medications they were taking for the condition and, in some cases, even stop them altogether.
To Sum Up:
I will go as far as to say that restoring the function of a malfunctioning digestive system with Chinese herbs and acupuncture can be the flagship of Chinese medicine treatment. For more technical details about the treatment please refer to the writing about abdominal pain, Candida, diarrhoea and constipation.