Digestive system 3 Flashcards
What are abdominal masses?
- In TCM are Zheng Jia Ji Ju
- This is a collective term for both physical (palpable) masses and transitory swellings in the abdominal cavity
What is Zheng and Ji?
- Zheng and Ji are solid masses associated with palpable structural pathology of affected tissues such as tumours, cysts, fibroids, abscesses, and inflammatory lesions.
What are the four different patterns of masses?
Blood masses, phlegm masses, heat masses and cold or deficiency masses
Where are Zheng and Ji found?
- Zhang Jia masses are usually found in the lower abdomen and are generally associated with reproductive structures
What does Zheng / ji involve?
- Zheng / Ji: signifies palpable masses with pain at a fixed location is a disorder of blood level and yin organs
What does Ju involve?
- Ju: involves insubstantial masses with distending pain that migrates from site to site and the insubstantial mass appears intermittently and unpredictable – is a disorder of the Qi level and Yang organs
What are abdominal masses from a biomedicine perspective?
- Abdominal masses are relevant to the palpable structural changes such as cirrhosis, tumours (benign & cancers), cysts, fibroma etc.
- It’s important to identify any red flags associated with masses and refer patients to the relevant medical professionals for further investigation, clear diagnosis and early intervention.
What are some red flags of abdominal masses?
RED FLAGS
* For patients who present with chronic abdominal pain / distension, irregular bowels, or typical bowel changes of colon cancers etc. with palpable masses, but not yet clearly diagnosed by medical team, refer patients to the medical professionals for further investigation for clear diagnosis
What do the classics say about abdominal masses?
- Qi stagnation and blood stasis from Phlegm blockage and/or toxics from long term injuries of improper diet, emotions, righteous qi deficiency and heat or cold accumulation are the key aetiology and pathogenesis
- Strengthening the righteous Qi and eliminating the phlegm-blood-heat/cold blockage are basic treatment principles.
What is jaundice in TCM?
- Huang Dan
- The yellow discolouration of the sclera, skin and mucus membrane as a result of increased concentration of bilirubin in the body fluid
- Mainly involves the Zang-Fu: Spleen, Liver and GB dysfunction causing dampness-heat or dampness-cold accumulation in the Liver and GB
What is jaundice from a biomedicine perspective?
Biomedicine perspective:
* Is a symptom that can be seen in many diseases.
* Is a clinical manifestation hyperbilirubinemia. Characterised by the yellowish staining of the skin, mucus membrane and sclera.
* Related to Liver, pancreas, GB or some blood disorders.
What are the red flags of jaundice?
- Acute bright jaundice may be seen in some contagious diseases like acute hepatitis A which may require acute referral to specialist medical teams and reporting to the public health department
What are the outcome measures for jaundice?
OUTCOME MEASURES
* TCM symptom checklist
* Patient reported outcome measures (PROMs)
* Pain numeric rating scale (NRS)
* GI symptom rating scale (GSRS)
What do the classics say about jaundice?
- Huangdi Neijing emphasises dampness and the Spleen dysfunction that play key roles in the aetiology and pathogenesis of jaundice and damp-heat is related to Yang Huang (bright jaundice)
- Emphasises the importance of promoting urination to drain dampness to treat jaundice.
- Herbs like Yin Chen and many herbal formulas were formulated to drain dampness and regulate the Spleen for jaundice treatment.
- Xue Zheng Lun (treatise on blood disorders) considers jaundice is a result from Blood stagnation which is due to heat or heat toxins in the blood and emphasises the need for detoxification and invigorating the blood.
- Jaundice is caused by bile flowing erroneously into the blood. Due to accumulation of heat in the Liver, leading to swelling of the bile ducts.
What is a Ji Mass?
course and is more serious or critical health issues
* Developed from Ju mass, worse than Ju masses
