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Digestive Disorders

Digestive disorders are common afflictions that, according to a 2009 NIH study, affects 60-70 million Americans (1). There are 13.5 million hospitalizations, and over 230,000 digestive disorder-related deaths annually (2). These numbers have been climbing as Americans’ dietary habits and food supply have deteriorated over the last few decades.  The most common digestive disorders include constipation, diarrhea, gallstones, acid reflux, hernia, gastritis, irritable bowel syndrome, and hemorrhoids. 

Oriental Medicine’s View on the Digestive System

The digestive system is universally understood as a key player in extracting nutrients and energy from food and drink.  In Oriental medicine, the two main organs involved with digestion are the Spleen and the Stomach, which are said to receive, and then process food into qi and Blood that nourishes our bodies and minds.  It should be noted that the ancient Chinese understanding of the Spleen also includes the functions of the pancreas.  If there is an imbalance in the Spleen or Stomach, then a variety of associated problems—ranging from pain, to chronic fatigue, to insomnia—can arise.  Oriental medicine has successfully treated digestive disorders for thousands of years. Treatise on Spleen and Stomach, written in the 13th century, was the first known text to emphasize the centrality of a healthy digestive system, and the ideas found therein are still frequently used in contemporary practice.

Oriental Medicine Treatment Strategies

lotus pond One of Oriental medicine’s foundational principles emphasizes that every individual is unique.  Even if two people present with similar complaints, the cause of illness for one person almost certainly differs from that of the other.  Therefore every person’s course of treatment must be individually-tailored to suit his/her particular needs.  Digestive disorders usually respond best to a combination of three types of therapies:

Acupuncture is the insertion of sterile, thin needles into specific sites on the body.  Selecting appropriate acupuncture points regulates proper qi or energy flow, which encourages one’s body to bring itself back into balance.  When treating digestive disorders, acupuncture can help strengthen the Spleen and Stomach, regulate metabolism, and is especially useful in curbing GI-related acute pain.

Chinese Herbal Medicine (CHM) is a science and art supported by at least 2,000 years of empirical practice.  Practitioners have always prescribed herbs to aid in digestion, promote nutrient absorption, and adjust appetites. 

Nutrition is an essential component of good general health, and it is an especially important aspect for those with digestive disorders. Understanding a person’s dietary habits and nutritional needs provides the framework for implementing specific, effective dietary changes. The suggested changes usually involve introducing nutritious and delicious foods into the diet rather than depriving one of particular cravings. Often, simple dietary changes make a profound difference within one week.
*Increasingly, we are finding our patients to have food allergies and intolerances that affect their digestion and overall health. Learn more about food allergies/intolerances.   

Western Medicine’s Approach

The Western Medicine treatment of digestive disorders frequently employs medications such as antacids, proton pump inhibitors, antibiotics, and steroids, which often carry undesirable side effects. For example, the Harvard Medical School Family Health Guide advises that proton pump inhibitors decrease the user’s stomach acid levels, which could lead to increased susceptibility to bacterial infections in the colon, pneumonia, and long-term use interferes with calcium and vitamin B12 absorption (3).

What Does the Research Say?

A large body of work is building up around the topic of Oriental Medicine and digestive disorders.  One of the studies that gained wide recognition early on was a 1998 article that appeared in the Journal of the American Medical Association.  In this randomized, double-blind, placebo-controlled trial concerning irritable bowel syndrome (IBS), it was found that both standardized and individually-tailored Chinese herbal formulas significantly improved the bowel symptoms and global quality of life experienced by IBS sufferers in the short term.  However, at the 14-week follow-up, only those subjects who took the individually-tailored herbal formulas had sustained improvement (4). 

An aspect of acupuncture that makes it so versatile is its ability to have a homeostatic effect on the body.  For example, whether one has an overactive or underactive digestive system (i.e. diarrhea vs. constipation), acupuncture can help to regulate the disorder, and bring the system back into balance.  This effect was studied by Xu, et al. In 2006, who found that the stimulation of acupuncture points traditionally used to treat digestive symptoms accelerated gastric emptying in patients with delayed bowel responses, and relieved dyspepsia in subjects with normal gastric emptying (5).

One of the most promising fields for the use of acupuncture is in the field of functional gastric disorders.  “Functional disorder” refers to any condition in which the function, or normal operation, of the body is disrupted, but at the same time, exams show no identifiable anatomical or structural abnormalities.  In these cases, Western medicine has much difficulty finding the appropriate treatment modalities.  Because Oriental medicine views the person as a whole, the treatment approach of a “functional disorder” is no different from other disorders. 

Clinical research is recognizing that acupuncture may be useful in functional disorders “because it has been shown to alter acid secretion, GI motility, and visceral pain” (6).  As such, acupuncture is showing promise in the treatment of gastroesophageal reflux disease (GERD), functional dyspepsia (FD), irritable bowel syndrome (IBS), postoperative nausea/vomiting, and even visceral hypersensitivity (6).

References

1. National Institutes of Health, U.S. Department of Health and Human Services. Opportunities and Challenges in Digestive Diseases Research: Recommendations of the National Commission on Digestive Diseases. Bethesda, MD: National Institutes of Health; 2009. NIH Publication 08–6514.

2. Cherry DK, Hing E, Woodwell DA, Rechsteiner EA. National Ambulatory Medical Survey: 2006 Summary. Hyattsville, MD: National Center for Health Statistics; 2008:(3).

3. http://www.health.harvard.edu/fhg/updates/do-ppis-have-long-term-side-effects.shtml

4. Bensoussan et al. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial.  JAMA. 1998 Nov 11;280(18):1585-9.

5. Xu, et al. Electroacupuncture accelerates solid gastric emptying and improves dyspeptic symptoms in patients with functional dyspepsia.  Dig Dis Sci. 2006 Dec;51(12):2154-9.

6. Takahashi, T. Acupuncture for functional gastrointestinal disorders.  J Gastroenterol. 2006 May;41(5):408-17.

Other relevant studies:

Ohman L, Simren M. Pathogenesis of IBS:  role of inflammation, immunity and neuroimmune interactions:  Nat Rev Gastroenterol Hepatol. 2010 Mar:7(3):163-73.  Epub 2010 Jan 26

Lydiard RB. Irritable bowel syndrome, anxiety, and depression:  What are the links?  J Clin Psychiatry. 2001;62 Suppl 8:38-45; discussion 46-7

O’Mahony SM, et al. Early life stress alters behavior, immunity, and microbiota in rats:  implications for Irritable Bowel Syndrome and psychiatric illnesses:  Biol Psychiatry. 2009 Feb 1;65(3):263-7. Epub 2008 Aug 23

Kwan CL, et al. Abnormal forebrain activity in functional bowel disorder patients with chronic pain:  Neurology 2005 Oct 25;65(8):1268-77

Tache Y, et al. Brain regulation of gastric acid secretion by neurogastrointestinal peptides:  Peptides. 1981;suppl 2:51-5

Savidge TC, et al. Enteric glia regulate intestinal barrier function and inflammation via release of S-nitrosoglutathione:  Gastroenterology. 2007 Apr;132(4):1344-58. Epub 2007 Feb 1

Geissler A, et al. Focal white-matter lesions in patients with inflammatory bowel disease:  Lancet 345: 897-898;1995

Wade PR, Cowen T. Neurodegeneration:  a key factor in the ageing gut:  Neurogastroenterol Motil. 2004 Apr;16 Suppl 1:19-23

Photo © Dagmar Ehling