Chronic and inflammatory diarrhea is a serious and debilitating symptom and is the often the main presenting complaint in a long list of Western medical conditions such as Irritable Bowel Syndrome, diverticulitis, Celiac disease, Crohn's disease, and ulcerative colitis to name but a few. While there are diverse etiologies behind chronic and inflammatory diarrhea, I would like to present a short case study, which will examine ways to integrate nutritional supplements with TCM medicinals in a HIV positive patient who was suffering from chronic severe diarrhea as a result of the use of protease inhibitors and anti-retroviral medication.
The patient was a 39-year-old Caucasian male who had been diagnosed HIV positive for three years and had started protease inhibitors and anti-retroviral medication for the past six months with severe chronic diarrhea resulting. Discontinuing the medication was not an option as the patient's overall response to medication was life changing. However the side effects were life disturbing as he was experiencing 4-6 episodes of heavy diarrhea daily. The patient was currently receiving weekly acupuncture sessions with minimal response, hence his acupuncturist referred him to my clinic to improve clinical outcome.
The patient was following a Spleen friend diet and was avoiding dairy and gluten in an attempt to ameliorate chronic diarrhea. Patient's primary care physician had referred him for a colonoscopy which revealed inflammatory bowel disease with no other signs of concern. The patient was administered doses of steroids, which provided no relief hence the patient had turned to acupuncture.
After 10 sessions of weekly acupuncture the patient had not experienced any relief from diarrhea. The patient's tongue was pale and wet with thick yellow coat and teeth-marks; pulse was rapid and wiry. No other signs were present.
The following TCM medicinals / supplements were administered : Modification of BuZhong Yi Qi Tang, Huang Qi 30 gr, Ren Shen 15 gr, Bai Zhu 15 gr, Yi Yi Ren 15 gr, Bu Gu Zhi 10 gr, Huang Bai 5 gr, Huang Qin 5 gr, Chen Pi 5 gr, Gan Cao 5 gr.
Dose was two cups daily taken concurrently with the following supplements: Glutamine powder, 5 grams daily on an empty stomach; 1,500 mg of Colostrum powder daily on an empty stomach.
After 10 days on aforementioned protocol, the patient was having one episode of diarrhea daily. After 20 days on protocol, the patient was having one solid bowel movement daily and was experiencing diarrhea 2-3 times per week. After one month on protocol, patient was having one solid bowel movement daily and experiencing 1-2 episodes of diarrhea weekly. The patients primary care physician was extremely satisfied with clinical outcomes and requested he continue herbal / supplement protocol.
At this point, the patient's tongue coating was thin and white and tongue body had minimal teeth-marks. For convenience, we switched patient to tablet version of Bu Zhong Yi Qi Tang and continued aforementioned dosing of Glutamine and Colostrum powder daily. At the three-month follow-up, patient was stable and was experiencing solid bowel movements with occasional episodes of diarrhea. Due to the severity of patient's Western medical diagnosis, his primary care physician recommended he stay on herbal/supplement protocol indefinitely and would be monitored with blood work every six months.
The supplements Glutamine and Colostrum were added to TCM formula modification to heavily boost the Spleen Qi , transform Dampness and clear heat. Western research has shown Glutamine and Colostrum to heal the small intestine and assuage chronic intestinal inflammation resulting in a lessening of chronic episodes of diarrhea. When these two supplements are combined with a TCM formula to boost the Spleen and clear Damp Heat, we can see highly effective clinical outcomes resulting in high patient compliance in taking herbal medication/ supplements. Depending on the patient's particular TCM pattern presentation, herbal formulas can be modified accordingly and taken concurrently with Glutamine and Colostrum powders or capsules.
This case also reveals the ease at which herbal medicine and supplements can provide quick clinical response when the patient is compliant with removing common food allergies and a Spleen friendly diet. This point must not be overlooked while no amount of acupuncture and or herbal supplementation can overpower a poor quality diet. Also of concern in cases of chronic inflammatory diarrhea is a good quality probiotic supplement. Probiotics work very effectively taken along with Glutamine and Colostrum and can easily be combined with appropriately administered TCM medicinals.
