Alternative Medicine That Works For Regular Folks

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Chronic Diarrhea
By Brian B. Carter, MSci, LAc

Brian is the founder of the Pulse of Oriental Medicine. He teaches at the Pacific College of Oriental Medicine and maintains a private acupuncture and herbal practice in San Diego, California, and is the author of Powerful Body, Peaceful Mind: How to Heal Yourself with Foods, Herbs, and Acupressure.

Dehydration (fluid and electrolyte imbalance) is one effect of chronic diarrhea. In this Q&A we discuss dehydration symptoms, the cause of diarrhea, diarrhea treatments, a special diarrhea diet, and ways to stop diarrhea. Oriental Medicine patterns and are discussed and herbal formulas are mentioned.


Question: I'm suffering of chronic diarrhea since Nov. 2001 and lost 40 pounds in that period. I was twice in hospital here in Panama, but also have being for check-ups at MD Anderson Cancer Center

in Houston, TX. and in the Methodist Hospital in that city. The test done do not reveal cancer, parasites or bacteria. Do you have any advice to heal me? I would appreciate it indeed.

Best regards, R.

Dear R,

I find that often people write me with a little information, and when I ask for more, they never write back. The fact is that doctors need a lot of information to make a good diagnosis, and that treatment cannot begin before that happens. I would love to help you, and more information would help me help you. What happened in November? Did you travel somewhere new? Eat a new food? Experience some short or long-term emotional trauma (e.g. death in the family, ending of a relationship, work stress)?

OM and Diarrhea
Next, we can talk about the way that Oriental Medicine diagnoses diarrhea. The OM disease 'Xie Xie' (pronounced shay-shay) is differentiated from 'Li Ji' (often translated as 'dysentery' although not exactly what biomedicine calls dysentery) in that Li Ji includes the symptoms of
straining to evacuate (tenesmus), and diarrhea that contains pus and blood. Assuming you are talking just about diarrhea increased frequency and/or amount of stool), we can go ahead. Otherwise, we need to talk about Li Ji.

In Xie Xie/Diarrhea, there are 6 patterns or subtypes. We figure out which one the patient has based on their symptoms and signs (pulse and tongue). Since we are doing this via the internet, it's impossible for me to take your pulse or see your tongue, so let's talk about the unique symptoms of each pattern.

Table of the 6 patterns and Diarrhea Treatments
(note that herbs in the name of the formula are NOT the only herbs in the formula)

Pattern Unique Symptoms Herbal Formula
1. External Attack of Cold & Dampness Watery stool, intestinal rumbling, fever, aversion to cold, stuffy nose, headache, no thirst, general aches and pains Agastache Qi-Rectifying Powder (Huo Xiang Zheng Qi San)
2. External Attack of Damp-Heat Urgent BM or difficult defecation, yellow pasty smelly stool, burning anus, irritability, thirst, dark scanty urine Pueraria, Scutellaria and Coptis Decoction (Ge gen huang qin huang lian tang)
3. Retention of Food in Stomach and Intestines Intestinal rumbling, stools with foul rotten egg odor, abdominal pain better after BM, fullness, belching foul gas, acid regurgitation, loss of appetite Harmony Preserving Pill (Bao he wan)
4. Disharmony of Liver and Spleen Brought on by depression anger or anxiety, no relief of pain with BM, Distention and congestion in chest and hypochondrium, belching, poor appetite Pain and Diarrhea Formula (Tong xie yao feng)
5. Spleen and Stomach vacuity Loose stool, more BM's with oily and greasy foods, loss of appetite, fullness and discomfort after eating, lack of vitality, fatigue Ginseng, Poria, Atractylodes Powder (Shen Ling Bai Zhu san)
6. Kidney and Spleen Yang Vacuity Diarrhea just before dawn, abdominal coldness and pain and rumbling before bowel movements, physical feeling of cold, cold extremities, sore weak lower back and knees Four Super-powers Pill (Si shen wan)

Comments on the Patterns
Compare your symptoms with the chart. Since you've had the diarrhea for 5 months, it is not likely that it is one of the external attack patterns. The last 4 patterns are more commonly responsible for chronic diarrhea. The food stagnation pattern could correlate to a number of things in biomedicine, including insufficient ST acids or pancreatic enzymes. The Liver/Stomach pattern might be called 'IBS' by a physician. I wouldn't be surprised if it were a cold-pattern diarrhea, because those are the ones that often baffle biomedicine. Cold-pattern diarrhea is not bacterial, and antibiotics could actually make it worse.

See an OM Practitioner
I don't intend this to be a diagnose-yourself resource, but more of a vista on Oriental Medicine. If you are interested in herbal treatment, I suggest that you see an OM practitioner. To find one, you will have to consult your local phonebook - I don't know of any online resource that will help you find an acupuncturist in Panama (yet - but if you find something let me know!).

Diarrhea Diet
In the meantime, you can certainly modify your diet. While you have diarrhea, avoid dairy, greasy, high-fiber, and sweet foods. If there is any improvement, add bland foods such as bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat.

Make sure to replace fluids and electrolytes that are lost due in the diarrhea. This means more than drinking water- physicians often provide an oral electrolyte rehydration fluid.

Danger Signals and Dehydration Symptoms
Other than the chronic nature of the diarrhea, there are danger signals such as severe pain in the abdomen or rectum, fever of 102 degrees Fahrenheit or higher, blood in your stool or have black, tarry stools, and dehydration symptoms (thirst, less urination, dry skin, fatigue, light-headedness, and dark-colored urine). Because the diarrhea is chronic, you should already be under medical care (outpatient), but keep an eye out for these other signals too.

Diagnoses (Biomedical)
Chronic diarrhea is usually related to irritable bowel syndrome, celiac disease or inflammatory bowel disease. Your physician should rule out the last two, and consider the first one. Other than viral, bacterial, and parasitic causes, your physician should also consider food intolerances and reaction to medications (even antacids).

All the Best!

Brian Carter

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