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Inflammatory bowel disease (IBD) is a chronic recurrent inflammatory disease of the gastrointestinal (GI) tract. Prolonged inflammation results in damage to the GI tract. Types of IBD include Crohn’s disease and ulcerative colitis.

 

Crohn’s disease

Ulcerative colitis

Symptoms 

Characterized by persistent diarrhea, abdominal pain, rectal bleeding/bloody stools, fatigue or weight loss

Affected Location 

Can affect any part of the GI tract (from the mouth to the anus)

Most commonly affects the portion of the small intestine before the large intestine/colon

Large intestine (Colon) and rectum

Damaged areas

Appears as inflamed patches in between healthy areas of intestine walls 

Damaged areas are continuous, usually starting at the rectum and spreading into the colon 

Inflammation

Inflammation may extend through the multiple layers of the walls of the GI tract 

Inflammation is present only in the innermost layer of the lining of the colon

Source: https://www.thesurgeons.sg/services/inflammatory-bowel-disease/

What causes IBD?

Genetics: There is a strong genetic component to IBD. Individuals with a family history of IBD are at a higher risk of developing the condition. Multiple genetic variants have been identified that are associated with an increased susceptibility to IBD. However, having these genetic predispositions does not guarantee that a person will develop IBD.

Immune System Dysfunction: IBD is characterized by an abnormal immune response in the gastrointestinal tract. It is believed that in genetically predisposed individuals, the immune system mistakenly attacks harmless substances (such as food or bacteria) in the gut, leading to chronic inflammation. This dysregulated immune response contributes to the development and progression of IBD.

Microbial Infections: Infections with certain bacteria, viruses, or other microorganisms may trigger or exacerbate inflammation in the gut, particularly in genetically susceptible individuals.

Gut Microbiota: The gut microbiota, consisting of trillions of bacteria and other microorganisms, plays a crucial role in maintaining gut health and regulating the immune system. Alterations in the composition and function of the gut microbiota, known as dysbiosis, have been implicated in the pathogenesis of IBD. Disruptions in the balance between beneficial and harmful gut bacteria may contribute to inflammation in the gut.

Environmental Factors: Environmental factors, such as diet, smoking, hygiene, and geographical location, may play a role in triggering or exacerbating IBD. Changes in lifestyle or environmental exposures have been associated with an increased risk of developing IBD in susceptible individuals.

Epigenetic Factors: Epigenetic modifications, which regulate gene expression without altering the underlying DNA sequence, have been implicated in the development of IBD. Environmental factors can influence epigenetic changes that may predispose individuals to IBD.

It’s important to note that IBD is a heterogeneous condition, and the specific combination of factors contributing to its development may vary among individuals. Additionally, the interplay between genetic susceptibility and environmental factors is complex and not fully understood. Further research is needed to elucidate the precise mechanisms underlying IBD and to develop more effective treatments and preventive strategies.

How Traditional Chinese Medicine (TCM) views IBD?

IBD is often viewed as a manifestation of underlying imbalances in the body’s energy (qi) and the interactions between various organ systems in the TCM perspectives. 

Spleen and Stomach imbalances: The spleen and stomach are essential for the digestion and the transformation of food into qi and blood. Recurrent inflammation in the GI tract can weaken the spleen and stomach qi.  Symptoms of spleen deficiency are fatigue, bloating, prone to diarrhea or abdominal discomfort. 

Liver Qi stagnation: In TCM, the liver is the organ that is in charge of managing our emotions, which is a crucial part of our mental health. Stress, unstable emotion, anxiety or overthinking can lead to liver qi stagnation. This stagnation impedes the flow of qi and blood in the body. Overtime, the congesting qi heats up and causes “fire” in the body (more inflammation in the GI tract). Liver qi stagnation  is commonly associated with IBD flare-ups and can exacerbate inflammation in the GI tract. 

Blood Stasis: Chronic inflammation and tissue damage disrupt the flow of qi and blood. Prolonged blood stasis and inflammation contributes to the development of these structural abnormalities such as formation of ulcers, strictures (narrowing of the intestines) or fistulas in the GI tract. 

TCM approach to treating IBD

Traditional Chinese Medicine (TCM) offers a holistic approach to treating inflammatory bowel disease (IBD) by addressing imbalances in the body’s energy, or qi, and restoring harmony between the body’s systems. Here are some common TCM modalities used in the treatment of IBD:

Herbal Medicine: Chinese herbal medicine uses a combination of herbs to create customized formulas tailored to the individual’s specific pattern of disharmony. Herbal formulas for IBD may include herbs with anti-inflammatory, antispasmodic, and immune-modulating properties. Some commonly used herbs for IBD include 黄芪 astragalus root (Astragalus membranaceus), 黄芩 Chinese skullcap (Scutellaria baicalensis) and 甘草 licorice root (Glycyrrhiza glabra).

Acupuncture: Acupuncture involves the insertion of thin needles into specific points on the body to stimulate energy flow and promote healing. In the treatment of IBD, acupuncture may help reduce inflammation, alleviate pain, regulate bowel function, and strengthen the immune system. It can also help manage stress and improve overall well-being.

Common acupoints used are 

  • GV20 Bai Hui 百会

  • CV12 Zhong Wan 中脘

  • ST36 Zu San Li 足三里

  • LI4 He Gu 合谷

  • LV3 Tai Chong 太冲

  • 董氏奇穴 驷马穴

Mind-Body Practices: Mind-body practices such as meditation, mindfulness, and breathing exercises can help individuals with IBD manage stress, reduce anxiety, and improve coping skills.

It’s important for individuals with IBD who are considering TCM treatment to consult with a qualified TCM practitioner who can provide personalized recommendations based on their specific symptoms, health history, and individual needs. TCM treatment for IBD is often used in conjunction with conventional medical therapies, and close coordination between TCM practitioners and healthcare providers is essential for optimizing patient outcomes.