Diarrhea Flashcards
Definition of diarrhea (Xie Xie). When to worry?
- Stools are loose and watery and may be more frequent than normal
- If it lasts more than 2 days it could be serious
- Can lead to malnutrition
- Short term and long term
Age and time of year most common?
Summer and Autumn
Under 2 years old
Organ locations for diarrhea?
Spleen
Kidneys
(In adults Liver as well)
Main symptoms of diarrhea
- Abdominal pain
- Bloody stools
- Cramping
- Dehydration (loss of BF)
- Fever
- Incontinence
- Nausea upset stomach
- Swelling
- Urgent need to go
Etiology/Pathogeny
- Spleen constantly deficient
- Easy to get external pathogen invasion
- Breast milk?
- Spleen and Yang Deficiency
- Excess of dampness
Pathogenesis
Spleen malfunction –> Excess damp –> Long term damage Yin and Qi –> Malnutrition
Factors to consider for diarrhea
- Bacterial infection
- Viral infection
- Food intolerances
- Food allergies (immune response)
- Parasites
- Reaction to medicine
- IBD inflammatory
- Functional bowel disorder IBS
- Surgery on ST or GB
Protocol of diagnosis
- Diet or recent common cold
- Frequent stools (more than often) dehydration, fever, vomit, thirst and pain in extreme case
- Stool evaluation for blood or fat
- Blood test to rule out certain diseases
- Imaging tests to rule out structural problems
- Tests to check for food intolerance or allergy
Exam: differentiate from dysentery
Amoebic dysentery: Diarrhea, High fever, Nausea and vomiting, Upset stomach, Weight loss
Bacillary dysentery: Cramps, Diarrhea with blood or mucus, High fever, Nausea and vomiting
Different from regular diarrhea: High fever, vomiting, blood and mucus
Syndrome differentiation categories broad
- Heat Damp
- Wind Cold
- Food Damage
- Spleen Xu
- Yang Xu
- Qi and Yin Damage
- Depletion of Yin and Yang
Diarrhea patterns specific
- Wind Cold Diarrhea
- Damp Heat Diarrhea
- Food Stagnation Diarrhea
- Spleen Deficiency
- Spleen and Kidney Yang Deficiency
- Exhaustion of Yin and Yang
Broad treatment principle for diarrhea?
- Tonify Spleen
- Regulate Spleen transporting and transforming function
- Transform dampness
Wind Cold Diarrhea S/S
S/S:
- Stools, thin and frothy with sl. foul odour
- Abdominal pain
- Aversion to cold
- Borborygmus
- Cough
- Fever
- Nasal discharge
- Tongue: pale with thin white coat
- Pulse: floating and tight
- Finger venules: pale and red
Wind Cold Diarrhea TXP and Formula
TXP:
- Expel wind
- Remove cold
- Eliminate damp
- Regulate MJ
Formula: Huo Xiang Zheng Qi San
Huo Xiang Zheng Qi San (Agastache powder to Rectify) ingredients, functions
- Huo Xiang (Agastache, Pogostemon, Patchouli, Giant Hyssop) Aromatically transform damp, Harmonize MJ, Release exterior
- Zi Su Ye (Perilla leaf) Release exterior, Disperse cold, Move SP/ST Qi
- Fang Feng (Sapashnikoviae) Expel Wind Cold, Relieve diarrhea
- Chen Pi (Tangerine peel) Regulate Qi, Tonify SP, Adjust middle, Dry damp, Transform phlegm
- Ban Xia (Pinellia) Transform phlegm, Dry damp, Descend rebellious Qi, Harmonize ST
- Fu Ling (Poria) Promote urination, Resolve damp, Strengthen SP, Harmonize MJ
- Zhi Gan Cao (fried licorice) Harmonize, Tonify SP and Qi
- Cang Zhu (Atractylode rhizome) Aromatically transform damp, Expel Wind Damp, Tonify SP
- Sheng Jiang (fresh ginger) Release exterior, Warm MJ, Adjust Ying and Wei
- Da Zao
Overall fx:
- Release exterior
- Transform damp
- Regulate Qi
- Harmonize MJ
5 Extra Herbs for W-C Diarrhea
- Bai Zhu (White Atractylodes) Tonify Qi, Strengthen T & T function of Spleen and dry damp
- Gui Zhi (Cinnamon bark) Disperse cold, Warm Yang, Release ext W-C
- Hou Po (Magnolia Bark) Dry dampness, Transform phlegm
- Ma Huang (Ephedra) Release ext, Warm cold, Circulate water
- Xiang Fu (Cyperus) Spread and regulate LR Qi, often used with Zi Su Ye for abdominal discomfort associated with externally contracted disorders
Damp Heat Diarrhea S/S
- urgent frequent bowel mvmt
- bouts of abdominal pain
- crying, dysphoria
- fever
- loss of appetite
- mucous possible
- nausea and vomiting
- thirst w/ desire to drink
- watery, cloudy loose bowels with foul odour
- yellow scanty urine
- Tongue: red with yellow greasy coat
- Pulse: slippery and rapid
- Finger: purple venules
-
Damp Heat Diarrhea TXP
Clear intestines
Relieve heat
Resolve dampness
Stop diarrhea
Damp Heat Diarrhea formula and overall function
Ge Gen Huang Qin Huang Lian Tang
Fx:
* Release exterior
* Clear internal Yangming heat
* Raise Yang to stop diarrhea
Ge Gen Huang Qin Huang Lian Tang ingredients and fx
- Ge Gen (Kudzu root) Release ext, Raise Yang, Neck/upper back muscle relax, Relieve Heat, Generate fluid
- Huang Qin (Scutellaria) Clear Lung heat, Drain Fire, Detoxify, Cool blood
- Huang Lian (Coptis rhizome) Drain Fire, Relieve toxicity, Clear Heart Fire, Drain Stomach Fire
- Zhi Gan Cao Harmonize other herb
5 extra herbs for Damp-Heat diarrhea
- Bai Tou Weng (Pulsatilla root) Herbs that* clear heat and dry damp*: Relieve fire toxin, Clear damp heat, Stop diarrhea
- Hou Po (Magnolia Bark) Dispel dampness, Harmonize Stomach, Regulate Qi
- Huang Bai (Phellodendron) Clear damp-heat from lower jiao, Clean heat, dry damp
- Qin Pi (Ash bark) Clear heat, Dry damp Astringe diarrhea, works well with Bai Tou Weng and Huang Lian
- Ze Xie (Alisma, Water Plantain) Drain dampness, Promote urination, Drain damp heat from LJ
Food Stagnation Diarrhea S/S
- Loose stool with food residue
- Stool with sour rotten egg odour
- Abdominal, epigastric distention/pain
- Belching with sour odour/vomit
- Desire for defecation, relieved after mvmt
- Distention/pain worse with pressure
- Poor appetite
- Restless at night
- Tongue: red with thick greasy coat
- Pulse: slippery and rapid
Food Stagnation Diarrhea TXP
Boost Spleen
Harmonize Stomach
Disperse food stagnation