Thoughts on a Crohn's disease patient

[Guest guest]

Hi everyone,

 

I'm looking for any thoughts, ideas, etc. on a Crohn's disease patient I am

currently seeing. I would especially appreciate input from those of you who

may have had a similar case.

 

This patient is 23 years old. She was diagnosed three years ago and has

since had her entire large intestine removed.

 

She began seeing me about three weeks ago. Her chief complaint was pain and

bleeding from the still intact rectum. She will have episodes of cramping

and pain where she will bleed large quantities of blood including many

clots. She has to wear a pad at night since she will ooze blood throughout

her sleep.

 

She denies any stress-related aspect to the disorder. Her mother suffers

from crohn's disease as well but not to the extent that she does.

 

In addition to the rectal bleeding, she experiences pretty severe alopecia.

The doctors can't really figure out the link between them and recommend an

additional surgery to remove the rectum. She wants to avoid this.

 

Her tongue is pale purple with a slightly red tip. no coat, wet.

 

Her pulse is weak (most recently rapid as well), spleen position

wiry/floating, liver- weak and deep - 3rd position left is weak, 1st

position right a little slippery.

 

I attributed the rapid pulse, the most recent time she visited, to extreme

loss of blood since she had had some severe episodes in the days before

seeing me.

 

I had diagnosed her initially with Blood stagnation in the rectum with Blood

deficiency/Qi deficiency and Kidney essence deficiency.

 

The first treatment I did UB 57, UB32 in addition to UB23, 25, 17, K3, Sp6,

etc.

She had no sensation in the lower lumbar/sacral region, no ashi points.

 

I also did moxa at Sp1.

 

She improved dramatically after the first treatment - no more bleeding,

improved energy, no episodes, and the discharge from the rectum became

greyish/pink - the color doctors had told her to expect. And this is after

she had tried every type of massage, all that western medicine had to offer

and a nutritionist to no avail.

 

She relapsed this past week - granted she went running, which I think

aggrevated it, but I wondered if anyone had any additional advice. I

would've liked to do a colon cleanse/liver cleanse but I can't imagine how

helpful that will be if the cleansing herbs can't pass through her rectum,

since it isn't attached to anything anymore. I have her on MycoForte - a

medicinal mushroom formula, and she's been doing excellently on it.

 

She's relatively weak from this prolonged illness- Any good recommendations

for herbal formulas? Is it wise to put her on a blood moving formula at this

point in time? With the extent of bleeding, I didn't want to risk it,

preferring to strengthen her first and attributing a good proportion of the

bleeding to the Qi deficiency.

 

Comments are appreciated.

 

Best,

Nadia

[Guest guest]

Patients are often allergic to certain foods - see

 

Breaking the Vicious Cycle: Intestinal Health Through Diet by _Elaine Gloria

Gottschall_

(http://www.amazon.com/s/002-0602586-5294430?ie=UTF8 & index=books & rank=-relevance\

,+availability,-daterank & field-author-exact=Elaine%20Gloria%20Go

ttschall)

 

This is a famous book and many people have become asymptomatic following

this diet.

 

 

 

[Guest guest]

Hi Nadia

 

> ... She's relatively weak from this prolonged illness- Any good

> recommendations for herbal formulas? Is it wise to put her on a blood

> moving formula at this point in time? With the extent of bleeding, I

> didn't want to risk it, preferring to strengthen her first and

> attributing a good proportion of the bleeding to the Qi deficiency.

> Comments are appreciated. Best, Nadia

 

I am no expert on Chron's but your patient's awful history prompts a

response.

 

Acupuncture & herbs to Nourish Qi & Blood would seem right. Maybe

consider haemostat herbs like Sanqi for the blood loss.

 

You miight teach patient indirect moxa for points like CV06, LI04, ST36,

SP06, BL25, SP10 and BL17

 

See Dr. Chen's articles on Crohn's at:

http://www.acupuncturetoday.com/archives2000/nov/11chen.html

and

http://www.acupuncturetoday.com/archives2001/jan/01chen.html

 

Unfortunately, he has no comments on the severe and unusual signs

that you describe.

 

Apart from TCM, I would suggest high-dose supplements with bioplexed

Zn and Se ( http://www.alltech.com/Contact/divisioncontact.cfm#item2 )

and folic acid (by injection, if necessary).

 

Best regards,

 

[Guest guest]

Please follow the program in Breaking the Vicious

Cycle: Intestinal Health Through Diet by _Elaine

Gottschall.

.. I would also suspect any mushroom product as your

patient is, most likely, allergic to several, if not

many foods , especially dairy.... environmental

factors, etc...

She should be tested for allergies to these substances

and environmental factors (soap shampoo, etc...) and

if not possible, she should follow a simple plan of

the elimination diet and a slow re-introduction of

single foods back into her meals to test her

reactions, followed by elimination from her diet if

allergenic. Naet can be useful and/but is costly.

 

Tien Qi or San Qi is a must, if she can tolerate it

should be raw (not steamed), and taken several times a

day, begin slowly and build up to higher dose,

depending on the product. I would look for American

manufacture as it is imperative to keep the quality

and purity at its utmost. In severe discharges of

blood, consider yunan paiyao acutely to stop the

bleeding.

 

Your primary goals, regardless of the root diagnosis,

are to stop the bleeding, and to tonify Qi and Blood.

Moxa is extremely beneficial. Cleanses of any kind

are not indicated as they cause turmoil and tax the

system. You must tonify first then regulate the Qi.

Your patient can not improve without the bleeding

stopped and without the Qi strengthened and Blood

nourished. Besides the constant bleeding, your

patient's body has borne the assult of cutting and

more cutting and removing, antibiotics and immune

suppressing drugs... the typical western cure is to

remove the intestines... voila, cured. Acidophilus is

available dairy free, and should be taken, or home

made yogurt according to the instructions in Elain

Gottschall.

 

Every thing given to this patient to take should be

checked for compatibility, or it may be an allergen

and trigger continual decline.

 

There was a company, long ago, that made a liquid

buteric acid that could be retained as an enema. It

was extremely helpful, But they couldn't profit from

it, so they dropped the product. Capsules can be

gotten and emptied into water and an retention enema

taken for up to 30 minutes, luke warm. I assume the

Small Intestine is still present, and the acidophilus

and buteric acid serve to feed the beneficial flora of

the mucosal lining which suppresses the pathogenic

organisms.

She may very likely also have candida, and that should

be addressed. Dietary changes and the inclusion of

acidophilus etc... will help eliminate the yeast.

 

Treatments should be 2 or more times per week, work

something out with the patient, or else progress will

be very slow or not. As it is, this patient has to

modify her life-style for the rest of her life, and

should continue with treatments for the duration as

well.

Finally, herbal formulas with stop bleeding herbs can

be added other herbs that address the specific

diagnosis in the lower jiao, and the tea can be used

as a retention enema. The enema should begin with a

fairly dilute tea, as it can be irritating. Severe

bleeding can also be addressed with a yunnan paiyao

powder enema. The buteric acid and herbal enemas

should be small in volumn, and luke warm, to address

the bleeding at the rectum. Please use filtered

water, not tap water. The color of the blood tells

you where the lesions are, I am assuming the blood is

red and the lesions are close to the rectum.

 

Finally, your patient should be counselled on the

importance of proper exercise. Running is not

appropriate, nor is weight lifting or any typical

strenuous american exercise or sport. Yoga or Tai Qi,

Qi gong, (and meditation, self-hypnosis) are more

suited.

:Later you can treatLiver overacting on everything,

and the congenital Kidney deficiency, since it runs in

the family. Also consider Liver Wind!!!! Each time

she bleeds, cramps, reacts to allergens or emotion,

Liver Wind is stirred and she bleeds. It works, but

takes a long long time. Don't forget to supplement and

nourish Qi and Blood.

Every acupuncturist should have a copy of Breaking the

Vicious Cycle!!

Good Luck,

[Guest guest]

Dear Nadia,

 

A couple of thoughts. First, I would agree with Marty to consider food

sensitivity and possible allergy. The chronic bleeding could very well be the

result of continuing source of inflammation from her diet. A very simple way to

determine if there are provocative foods causing or contributing to this

potential scenario would be to do the Coca pulse test. Check out the CHA

archives for details, write to me privately or call me and I'll be glad to

explain it to you. Second, what you describe as her initial increase in energy

is very similar to the response I had after the first treatment with a cancer

patient I am treating. She too felt so good after her initial treatment that

she decided to go on a long hike. When I saw her 4 days later, her pulses were

weak, particular lung, and thready, choppy and a little rapid. My feeling is

that in both cases, there is severe blood and yin xu as well as spleen qi xu

with damp accumulation causing blood stasis. By gently

treating the root of the problem, I have seen wonderful results. I alternated

front and back points: first treatment after her hike, I tonified lu 7, and k6,

sp 6, st 36, and reduced sp9. Period. (I didn't want to deplete her qi any

more than it already was), second treatment I tonfied back shu points

(particularly ub 13, 17,18, 20, 21, 23 and 25), and so on. As far as herbs go,

#1 you've got to stop the rectal bleeding, starting with a combination of like

Huai Hua san and si wu tang,adding Bai Ji or Di Yu which are very effective in

stopping rectal bleeding, or San Qi as Phil suggested, modifying it with herbs

to tonify qi. BTW, I think that a very important ingredient to considering

adding would be E Jiao. The beauty of E Jiao is that it not only to tonify

Jing, which most probably is exhausted ( I don't think that it is just

coincidence that alopecia has concurrently presented for that reason.) , but it

also stops bleeding.

 

Anyway, just some thoughts. Great to hear that your practicing and hopefully

busy and making a good living!

 

All the best,

 

Yehuda

 

 

< wrote:

Hi Nadia

 

> ... She's relatively weak from this prolonged illness- Any good

> recommendations for herbal formulas? Is it wise to put her on a blood

> moving formula at this point in time? With the extent of bleeding, I

> didn't want to risk it, preferring to strengthen her first and

> attributing a good proportion of the bleeding to the Qi deficiency.

> Comments are appreciated. Best, Nadia

 

I am no expert on Chron's but your patient's awful history prompts a

response.

 

Acupuncture & herbs to Nourish Qi & Blood would seem right. Maybe

consider haemostat herbs like Sanqi for the blood loss.

 

You miight teach patient indirect moxa for points like CV06, LI04, ST36,

SP06, BL25, SP10 and BL17

 

See Dr. Chen's articles on Crohn's at:

http://www.acupuncturetoday.com/archives2000/nov/11chen.html

and

http://www.acupuncturetoday.com/archives2001/jan/01chen.html

 

Unfortunately, he has no comments on the severe and unusual signs

that you describe.

 

Apart from TCM, I would suggest high-dose supplements with bioplexed

Zn and Se ( http://www.alltech.com/Contact/divisioncontact.cfm#item2 )

and folic acid (by injection, if necessary).

 

Best regards,

 

 

 

 

 

 

 

 

Everyone is raving about the all-new Mail Beta.