The term inflammatory bowel (IBD) refers mainly to two idiopathic diseases of the gastrointestinal system that are char-acterized by acute and chronic inflammation: ulcerative colitis and Crohn's disease. Ulcerative colitis is characterized by in-flammatory changes involving the colonic mucosa and submu-cosa in a continuous fashion, starting at the rectum and ex-tending proximally. Depending on the extent of the disease, ul-cerative colitis can be divided into proctitis (rectum only), proctosigmoiditis, left-sided colitis (extending to the splenic flexure), or universal colitis (pancolitis). Such classification is important for therapeutic and prognostic reasons. Crohn's dis-ease, on the other hand, can involve any segment of the gas-trointestinal system, usually in a discontinuous fashion (skip lesions), and the inflammation is frequently transmural.
Diagnosis in Traditional Chinese Medicine
Here, we only focus on ulcerative colitis, not inflammato-ry bowel disease.
In traditional Chinese medicine, ulcerative colitis is cate-gorized as "xie xie", "chi bai li ", etc.
1. The chief clinical symptoms include diarrhea and ab-dominal pain. Diarrhea varies in severity. In severe cases it may occur dozens of times a day, accompanied with loose stool, mucous stool or bloody purulent stool and tenesmus. Diarrhea is often persistent or recurrent and resistant to treatment. In most cases, abdominal pain is localized in the left, middle or lower abdomen, pronounced before defecation and relieved after it. The patients may have fever, anorexia, nausea, loss of weight, anemia, edema, etc. Some patients may have erythe. ma nodosum, arthritis, joint pain and other abenteric manifes. tations.
2. Ulcerative colitis can be divided into chronic recurrent type, chronic persistent type and fulminant type. The first one is more frequent, while the last one, though less frequent, is in critical condition and its prognosis is poor.
3. Laboratory examination: Routine stool test usually re-veals nonspecific changes. Bacterial culture finds no pathogen. Barium enema shows colon spasm and deformity, disordered mucosal folds. In severe case, rigid or dented colon wall, colon stenosis or ulcers can be found. X-ray examination is most helpful in detecting the extent and scope of the disease, but runs a risk in acute phase.
Differentiation and Treatment of Common Syndromes in Traditional Chinese Medicine
1. Downward Flow of Damp-heat(frequently found at the onset or in the duration of the attack) :
Clinical manifestations: Fever, abdominal pain, diarrhea, burning sensation in the anus, or tenesmus, bloody, purulent and mucous stool, red tongue with yellow, thick and greasy fur, and slippery rapid pulse.
Therapeutic method: Clearing away pathogenic heat and dampness.
Recipe: Decoction of Pueraria, Scutellaria and Coptis with additional ingredients.
Ingredients:
Radix Puerariae 10g
Radix Scutellariae 10g
Rhizoma Coptidis 30g
Flos Lonicerae 15g
Radix Pulsatillae 10g
Semen Plantaginis 15g
(wrapped in a piece of cloth before it is decocted)
Radix Aucklandiae 10g
Fructus Aurantii 10g
Administration: All the above drugs are to be decocted in water for oral administration.
