Irritable bowel syndrome (IBS) is the second largest reason people miss work, and the most common gastrointestinal disorder. Common symptoms include abdominal cramping, nausea, intestinal gas, diarrhea, constipation and alternating stools. It is important to note that no structural abnormalities are present. Below are some recent case studies seen in our clinic.
Case One
Helen, a 50-year old minister, had chronic constipation, bloating and intestinal gas. She was underweight. As this problem had persisted her whole life, her GI specialist recommended surgery. Despite eating plenty of fruits and daily exercise, Helen was unable to go to the bathroom more than twice per week and often required an enema.
At the point she consulted me she was talking vitamin C; bioflavoids; an eye supplement with bilberry and lutein; a bone building supplement; ipriflavone; alphalipoic acid; curcumin; CoQ-10; milk thistle; digestive enzymes; ginkgo; bacterial cultures; colostrom, an adrenal supplement; reishi, an herbal cleanser; aloe vera; black cohosh; vitex; dandelion; red clover; American ginseng; a fish protein supplement; maitake mushroom; iron; HCL; homeopathic lycopodium; seaweed tablets; blue-green algae; chorella; spirulina; flaxseed oil; and borage oil. Helen's pulse was weak in the first and third positions and wiry in the middle position. Her tongue was normal color, dry, and flabby.
Initially, I recommended 1-2 tablets of a formula consisting of aquilaria root (chen xiang), white atractylodes rhizome (bai zhu), szechuan pepper fruit (chuan hua jiao), melia fruit (chuan lian zi), codonopsis root (dang shen), torreya seeds (fei zi), poria (fu ling), rubia (fu pen zi), licorice root (gan cao), dried ginger (gan jiang), myrobalan fruit (he zi), omphalia fruiting body (lei wan), dry aloe leaf juice concentrate (lu hui), saussurea root (mu xiang), nutmeg seed (rou dou kou), quisqualis seed (shi jun zi), pomegranate husk (shi liu pi), mume fruit (wu mei), stinking elm fruit (wu yi) and bitter orange fruit (zhi shi) TID. I also recommended she stop all supplements except for the aloe vera and flax oil, which have laxative effects. In addition, I recommended 400 milligrams of magnesium aspartate daily.
After two weeks there was little change, so I suggested she try chewing the aquilaria root formula. I also recommended 1-2 tablets of a formula consisting of angelica dahurica root (bai zhi), peppermint (bo he), gray atractylodes rhizome (cang zhu), aspergillus niger, halloystium resin (chi shi zhi), poria (fu ling), pueraria root (ge gen), rice sprout (gu ya), magnolia officinalis bark (hou po), agastache (huo xiang), red citrus peel (ju hong), chrysanthemum flower (ju hua), aspergillus oryzae, saussurea root (mu xiang), horseradish root, massa formenta (shen qu), trichosanthis root (tian hua fen) and coix seed (yi yi ren) with meals and as needed to reduce bloating and gas. I also suggested increasing the magnesium aspartate to 800mg per day, and I recommend a tea consisting of oryza sprout (gu ya), cistanche (rou cong rong), flax (huo ma ren), immature citrus (qing pi), red peony (chi shao), white peony (bai shao), magnolia bark (hou po), cardamon (sha ren) and aurantium (zhi shi).
As Helen was a vegetarian, I urged her to try to eat fish when possible, and to go for two weeks without any soy products. This new regime was very successful, and after two weeks, she was able to have bowel movements without an enema. She had much less intestinal gas and bloating. After one month, we cut down the herbal tea to half a cup per day. Eventually she rarely needed the tea. She continued taking both formulas as needed.
Discussion: Helen's case was unusual in that she was talking an extreme number of supplements, which I believed was compromising her absorption. I therefore suggested she go off everything, which helped her body get back into balance. Some supplements such as the algae, chorella and spirulina could have actually contributed to her indigestion; colostrom can cause constipation. Instead of taking seaweed tablets, I encouraged her to take seaweed as a food. Helen seemed to get added benefit to chewing the aquilaria formula, which has laxative effects, and a number of qi moving herbs. The tea was designed to moisten her stools and move qi. Magnesium has laxative effects and helps reduce muscle contractions.
Case Two
Marjorie was a 57-year-old housewife with a life-long history of IBS. Her main symptoms included diarrhea and severe pain, which sometimes resulted in hospitalization. She also complained of panic attacks, feeling cold, and headaches. Her pulse was slightly wiry, her tongue dry.
Initially we recommended three tablets of a formula composed of gray and white atractylodes rhizome (cang zhu and bai zhu), bupleurum root (chai hu), poria (fu ling), dried ginger (gan jiang), astragalus root (huang qi), lotus seed (lian zi), euryale seed (qian shi), white ginseng root (ren shen), nutmeg seed (rou dou kou), dioscorea root (shan yao), massa formenta (shen qu), cimicifugea rhizome (sheng ma) and honey-fried licorice root (zhi gan cao) TID with ginger or cinnamon tea, increased to 3 QID after one week. After two weeks, Marjorie reported feeling warmer and more energetic, and had a reduction in diarrhea. She complained of neck pain, hip pain and poor sleep. Her pulse was unchanged and her tongue was darker.
At this point, we added two tablets QID of a formula made up of white peony root (bai shao), pinellia rhizome (ban xia), bupleurum root (chai hu), licorice root (gan cao), dried ginger (gan jiang), pueraria root (ge gen), cinnamon twig (gui zhi), scutellaria root (huang qin) and white ginseng root (ren shen). After a month all symptoms were ninety percent improved. Marjorie went off of the second formula but continued with three tablets TID of the first formula. As she had more energy, Marjorie began to take classes at a nearby college and started to exercise and garden more.
Discussion: The first formula was selected because it contains strong herbs to tonify the spleen and stop diarrhea. A lifetime of worry and diarrhea weakened her spleen, so we felt that this was an appropriate long-term formula. The second formula was recommended for the short term to help invigorate liver qi and at the same time tonify the spleen, release shoulder neck tension and relax her nervous system.
Case Three
Steve, a contractor, was recently diagnosed with IBS. His main symptoms were gas, bloating and cramping. A friend had suggested acidophilus, which had not helped. Steve's pulse was wiry, and his tongue had a yellow coating. We suggested to Steve that he reduce coffee and drinking alcohol. He was not open to other dietary changes, as he was single and didn't cook.
We recommended two tablets QID of a formula of white peony root (bai shao), aged tangerine peel (chen pi), aquilaria root (chen xiang), licorice root (gan cao), magnolia officinalis bark (hou po), tree peony root (mu dan pi), saussurea root (mu xiang), green tangerine peel (qing pi), nutmeg seed (rou dou kou), amomum fruit (sha ren), sandlewood (tan xiang), cyperus rhizome (xiang fu), corydalis rhizome (yan hu suo), curcuma-tumeric (yu jin) and ripe bitter orange (zhi ke/zhi qiao), plus two tablets QID of a formula consisting of angelica dahurica root (bai zhi), peppermint (bo he), gray atractylodes rhizome (cang zhu), halloystium resin (chi shi zhi), poria (fu ling), pueraria root (ge gen), rice sprout (gu ya), magnolia officinalis bark (hou po), agastache (huo xiang), red citrus peel (ju hong), chrysanthemum flower (ju hua), saussurea root (mu xiang), massa formenta (shen qu), trichosanthis root (tian hua fen) and coix seed (yi yi ren). We also recommended peppermint or chamomile tea to be brought in a thermos to work. Within two weeks, all of Steve's symptoms had almost totally resolved. He remained on the herbs another month, then felt he did not need herbs.
Discussion: Steve was very active and responded quickly to the herbs. No doubt reducing coffee and alcohol helped his digestion. The first formula invigorates qi; the second reduces dampness and food stagnation.
Case Four
Daisy was a 44-year-old executive who complained of chronic constipation for at least 20 years. She had tried numerous therapies, including acupuncture, nutritional counseling and NAET. Each therapy a slight improvement; however, she was only able to go to the bathroom completely after having senna tea, which she reluctantly took once or twice per week. Daisy insisted she got plenty of exercise and ate plenty of fruits and vegetables; she ate prunes daily. Her pulse was thin and slow, and her tongue was dry.
Figuring her constipation was due to deficiency of qi and blood ,I recommended two tablets TID of a formula consisting of white peony root (bai shao), white atractylodes rhizome (bai zhu), ligusticum wallichi root (chuan xiong), jujube (da zao), angelicae sinensis (dang guia), codonopsis root (dang shen), poria (fu ling), dried ginger (gan jiang), militia root and vine (ji xue teng), cooked rehmannia root (shu di huang) and honey-fried licorice root (zhi gan cao), and two tablets TID of the aquilaria formula mentioned in case one. I also recommended 1-3 tablespoons of freshly ground flax seeds to be taken with oatmeal in the mourning. She was counseled to slowly reduce the senna tea, but not to go off it cold turkey.
Two weeks later, Daisy returned. She was very happy, as she was starting to have more regular bowel movements. Daisy remained a client for several months. During this time, we gradually increased the white peony root formula and reduced the aquilaria formula; she was weaned off the senna.
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