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TCVM Approach to Inflammatory Bowel Disease
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IBD Group of GI disorders with inflammatory infiltrates in the lamina propria of SI & LI Damage from tissue cytokines Caused by Genetic factors Environment Feline IBD touch prep
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IBD Ulcerative colitis Crohn’s disease (regional enteritis)
Systemic disease (arthritis, uveitis, liver disease, etc.)
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Crohn’s disease vs Ulcerative colitis
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IBD- -Signs Dogs: Cats Other signs
Chronic vomiting, diarrhea, weight loss Cats Vomiting followed by diarrhea Other signs Flatulence, gas, altered appetite, abdominal pain & mucois stools Dry hair coat Thickened loops of bowel on palpation
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IBD- -Causes Infectious Dietary Genetic (Damp-Heat)
(Stomach Heat/Stagnation) Genetic (Kidney Jing) Diagnosis usually by biopsy
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IBD- -Treatment Anti-infectives Dietary Immunosuppressive
Sulfasalazine (Azulfidine) Dietary Diet elimination Vitamin support (all but high vitamin C) Western herbals Bromelain/curcumin Ginger Cat’s Claw Immunosuppressive
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Mechanism of Action of Azulfadine
Antibacterial activity Local and systemic immunity-lymphs, IgG Arachidonic acid metabolism-PG, Thr, leukotrienes Free radical scavengers (5-ASA) Inhibit PAF, histamine release (mast cells)
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TCM Pathology of IBD Excess Deficiency Parvovirus Heat Toxin/Damp Heat
Qi/Blood Stagnation Deficiency SP Qi Deficiency Parvovirus
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Heat Toxin/Damp Heat Signs Tongue Pulse
Bloody/watery diarrhea (mucoid) with foul smell Acute Heat signs (nose/ears) Vomiting Thristy Tongue Deep red yellow coating Pulse Superficial/Deep and fast
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Qi-Blood Stagnation Signs Tongue Pulse
Chronic diarrhea with stink smell Abdominal pain Vomiting Loss of appetite Tongue Purple or red Pulse Wiry
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Spleen Qi Deficiency Signs Tongue Pulse
Chronic diarrhea with undigested material Anorexia Loss of body weight (muscle mass) Exercise intolerance Tongue Pale Pulse Deep & weak
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Parvovirus Signs Tongue Pulse
Bloody diarrhea with mucous and/or foul odor Anorexia Vomiting Tongue Red & dry Pulse Fast (superficial or deep)
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TCM Treatment of IBD Heat Toxin/Damp Heat Qi/Blood Stagnation
Great Saussurea Coptis Qi/Blood Stagnation Xiang Lian San SP Qi Deficiency Shen Ling Bai Zhu Parvovirus Red Back Door
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Great Saussurea Coptis
Saussurea Mu Xiang Move Qi & relieve pain Coptis Huang Lian Clear Damp-Heat in the intestines Evodia Wu Zhu Yu Warm the middle Jiao & stop vomiting
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