If you were going to see your physician for a problem with irritable bowel syndrome, you would certainly expect some questions about the state of your bowels. But Chinese medicine diagnosis will always include questions about bowel function, regardless of the purpose of your visit. You would be surprised how the functioning of the bowels is related to so many other issues with your health.
Chinese medicine diagnosis describes disease in terms of an imbalance in the body of heat and cold, dampness and dryness, yin and yang. By questioning the state of all bodily functions, both physical and emotional, and looking at both the tongue and the pulse, a pattern of disharmony evolves. Everything about the stools can be diagnostic – the size, color, consistency, frequency, odor and even the time of day that a bowel movement occurs.
Let’s talk about constipation. If chronic constipation is accompanied with heat signs, such as a yellow tongue coating and a rapid pulse, the diagnosis might be Heat in the Stomach or Intestine, or Heat in the Yangming channel. This constipation is made worse with a diet of spicy foods and the consumption of alcohol. This patient may also have acne on the face and chest and bad breath or bleeding gums. Chronic heat in the Liver will also cause constipation and may be accompanied by irritability, red eyes, hypertension and headaches. Liver Heat constipation is aggravated by stress and frustration. The stool associated with internal heat in the body is hard and dry and looks like small pellets.
Internal Heat may be combined with Phlegm or Damp in some people whose Spleen functioning has been compromised. Bowel movements associated with this pattern are very sluggish and often feel incomplete. Mucous may be visible in the stool. This type of person may also have abdominal distention and feel lethargic in the afternoon.
Constipation in elderly patients or postpartum women is often due to a deficiency of Blood. There is just not enough lubrication for the stool to pass. There is a Chinese expression “if the river is dry, the boat can’t go”. There could be other dry signs with this diagnosis such as dry skin, eyes and mouth. Blood deficiency is characterized by paleness of the tongue, lips and nails. The pulse is fine and weak. Often these people have trouble falling asleep and are forgetful or feel anxious. New mothers may have a problem with sufficient lactation.
Constipation due to Yin deficiency is due to a more deep seated lack of bodily fluids and may develop with the aging process. If there is Yin deficiency, the tongue would be red and cracked with no coating and the pulse thin and rapid. Other Yin deficient symptoms are night sweats, tinnitus and low back pain.
The elderly or those suffering a chronic illness may also be Qi deficient. Qi, the vital energy of the body, is just not strong enough to push the stool out and often this patient is exhausted just trying. The stool tends to be soft, large and thick. The tongue may look swollen and pale. The pulse is very weak. Patients who are Qi deficient may speak softly and suffer from shortness of breath.
Infrequent or thin stools can accompany a diagnosis of Qi stagnation. Other Qi stagnation symptoms are depression, neck and shoulder tension, frequent sighing, PMS and irregular menstrual cycles. This type of constipation is aggravated by stress, changes in routine or simply a sedentary lifestyle. Exercise and gentle clockwise abdominal massage can be helpful for this pattern.
Diarrhea also has many differentiating patterns. Dampness in the body is often key and evident by a thick tongue coating. Cold Damp would exhibit a thick white tongue coating. The stool would be watery and explosive and may be accompanied with colicky pain and nausea. Cold Damp patterns are aggravated by eating cold or raw foods. Damp Heat would exhibit a thick yellow tongue coating. The bowel movements would be burning and explosive with a foul smell.
Diarrhea that occurs following a meal is an indication of Spleen Qi deficiency. One might also feel tired after eating, tend to worry and have a poor appetite. The tongue may be pale with toothmarks around the edge. Attacks are aggravated by a diet of excess cold or sweet foods or may occur when one is overtired.
Spleen and Kidney Yang deficiency can develop from Spleen Qi deficiency. Patients who are Yang deficient often wake early in the morning with urgent diarrhea. There may even be fecal incontinence. Pressure and warmth applied to the abdomen is comforting to these patients as they tend to be very intolerant to cold. These people often just want to sleep all day.
Alternating constipation and diarrhea is usually explained by chronic Liver Qi stagnation that gradually weakens Spleen Qi. This pattern has a name in Chinese medicine diagnosis – Liver Qi invading the Spleen. This pattern may be diagnosed in Western medicine as IBS or ulcerative colitis. This pattern responds well to a treatment of acupuncture, herbs and stress management.
I strongly believe that treating bowel issues is one area where Western and Chinese medicine can work well together. See your physician and have a colonoscopy to rule out serious issues. And then consider Chinese medicine. Incorporate acupuncture, lifestyle changes and possibly herbal preparations to restore balance in the body. Treatment for each of the patterns above will address not only the problem of constipation or diarrhea, but also the underlying cause. Bowel habits will improve, and so will many of the accompanying symptoms.
About the Author:
Joyce Marley is a licensed acupuncturist that provides acupuncture therapy in New Hartford, NY. She writes Traditional Chinese Medicine (TCM) health articles about acupuncture and Oriental medicine.