Irritable bowel syndrome a chinese medicine perspective balfour healing at oasis palisades gas bloating back pain


Irritable Bowel Syndrome (IBS) is an intestinal disorder causing a variety of symptoms which may include cramping, abdominal pain, gas, bloating, and irregular bowels. Some people with IBS have diarrhea with frequent loose stools, while others have constipation causing infrequent bowel movements that are difficult to pass. Still other IBS patients will suffer from alternating diarrhea and constipation. Symptoms are frequently triggered by stress, emotional factors, or the ingestion of food.

IBS is described as a ‘functional’ illness — the small and large intestines aren’t functioning appropriately although there is no structural damage found through diagnostic testing. No anatomic defect can be found in IBS patients, and the cause of the illness is not known. What is known is that there is a link between the onset of symptoms and emotional triggers.

Constipation-predominant (or ‘spastic colon’ type) IBS manifests with pain over at least one area of the colon and periodic constipation. This pain may be continuous or it may come in bouts, and is frequently relieved by moving the bowels. There may be constipation alternating with normal stools or constipation alternating with diarrhea. The stool often contains mucus. Associated symptoms include bloating, gas, nausea and dyspepsia. Eating can commonly trigger these symptoms.

Whereas Western medicine looks closely at a symptom and tries to find an underlying cause, Traditional Chinese Medicine looks at the body as a whole. Each symptom is looked at in relationship to all other presenting symptoms. The goal of the TCM practitioner is to assess the entire constitution of the patient — considering both physiological and psychological aspects.

The practitioner first observes the general characteristics of the patient, then tries to discern a relationship between symptoms in order to establish what is called a “pattern of disharmony”. Treatment is aimed at restoring harmony and bringing the body into balance.

The fundamental TCM theory used to determine the pattern of disharmony is the theory of “Yin and Yang”. Yin and Yang are terms used to describe two polar opposites. Each body part, each organ, and even each symptom in the body can be described in terms of Yin and Yang. Levels of Yin and Yang are constantly changing in the body and there are four possible states of imbalance:

It is rare for one of these states of imbalance to exist by itself. Excesses and deficiencies of Yin and Yang almost always appear in combination. For example, in Irritable Bowel Syndrome the symptom of loose stools shows an excess of yin; but if the patient feels a burning sensation along with the loose stools, this indicates an additional excess of yang.

To look at the body as an integrated whole, one also looks at the theory of the ‘Internal Organs’. The TCM definition of an Internal Organ is very different from the Western concept. In Western medicine, an organ is a material-anatomical structure. In Chinese medicine each Internal Organ encompasses much more. There can be an anatomical structure, but there is also a corresponding emotion, tissue, sensory organ, color and element.

In addition, 12 of the Internal Organs correspond to the 12 main acupuncture meridians (or channels) that run through the body. There is qi (or energy) flowing through each meridian. If an Internal Organ is out of balance, the qi of that organ will be damaged.

IBS patients with a pattern of Spleen qi deficiency will suffer from fatigue and diarrhea which is worse when they are overexerting themselves. This is often accompanied by abdominal pain which may be relieved by exerting pressure over the painful area. Patients may also have gas and bloating. Hemorrhoids are an additional indication of Spleen qi deficiency.

Another important part of treatment is the Chinese herbal formula. In Chinese herbalism, a group of herbs is combined together to specifically address a person’s unique constitution. This is one way in which treatment is very individualized — a master herbalist treats no two patients with the same combination of herbs.

An excess of cold in the Spleen causes severe pain. The patient may be “doubling over” in pain, feeling as if curling up will somehow offer relief. Here the patient cannot tolerate being touched. This pain may be accompanied by constipation.

Yang energy provides warmth to the body and a deficiency of Spleen and Kidney Yang may result in feeling cold or having cold hands and feet. IBS patients with Spleen and Kidney Yang deficiency will have diarrhea first thing in the morning which may contain undigested food particles. Other symptoms include chronic low back pain, low libido, frequent urination, or in severe cases, urinary incontinence.

The Chinese Liver is the organ most affected by stress, aggravation, and anger. The Liver is frequently involved in modern disease, most commonly when its qi becomes stagnant or stuck. There may be depression, moodiness, or simply a feeling of being ‘wound up’. Women may suffer from irregular or painful periods.

Disharmony between the Liver and Spleen causes irritability along with abdominal distension and pain. The IBS symptom of alternating constipation and diarrhea is common in a Liver/Spleen disharmony. Stress, frustration, and anger aggravate the condition.

Xiao Yao Wan is a very commonly used classical formula for Liver/Spleen disharmony, but does need to be modified in most IBS cases. Tong Xie Yao Fang is another classical formula used for Liver/Spleen disharmony and is the best choice when diarrhea is prevalent.

Abdominal pain and diarrhea with a sense of urgency are key symptoms indicating damp-heat in the Large Intestine. The diarrhea is commonly yellow and explosive with a strong odor and a sensation of burning. This heat indicates that there may be a low grade infection, although this type of chronic infection may not show up on lab tests. In addition, there may be a feeling of heaviness of the body and limbs and stuffiness in the chest.

Irritable Bowel Syndrome is clearly a complicated illness in both Western and Chinese medicine. Its many manifestations require very different treatment approaches in Traditional Chinese Medicine. The patterns of disharmony mentioned above may even appear in combination and treatment must be adjusted appropriately. In any severe case of IBS, Chinese medicine treatment will be customized for the individual and classical herbal formulas will be modified for the patient.

An Australian study published in 1998 in the Journal of the American Medical Association lends strong scientific support to treating IBS with Chinese herbs. In this double-blind study, 116 patients with Irritable Bowel Syndrome were divided into three groups. One group was given a standard Chinese herbal preparation, a second group was given customized herbal formulas (individually written for each patient), and a third group was given a placebo. Each patient had regular consultations with both a Chinese herbal-medicine practitioner and a gastroenterologist. Both groups taking the Chinese herbs showed significant improvement over the patients taking the placebo. Positive results were reported by both the patients themselves and the gastroenterologists. Although there was improvement in both groups of patients taking herbs, it is important to note that the positive effects were shown to last longer in the group that was given individualized formulas. Only these patients had maintained improvement on a follow-up consultation 14 weeks after completing the treatment.

This study clearly shows that Chinese herbalism is most effective when each patient is treated not only for their condition, but also for their bodily constitution and other presenting symptoms. According to the principles of Chinese medicine, each patient must be treated as an individual. Optimal results will be obtained with both herbs and acupuncture when specific treatments are customized for each patient.