Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a general term for a group of chronic inflammatory disorders involving the gastrointestinal tract. It can be divided into two major groups, chronic ulcerative colitis (UC) and Crohn's disease (CD). Clinically, these disorders are characterized by recurrent inflammatory involvement of intestinal segments with diverse clinical manifestations and often resulting in a chronic unpredictable course.

The cause of IBD is still unknown. There may be several factors, such as genetic predisposition, infectious agent, and auto-immunity involved in its pathogenesis. The extraintestinal manifestations which may accompany these disorders, such as arthritis or pericholangitis, may suggest auto-immune phenomena and therapeutic agents such as corticosteroids may exert their effects through immunosuppressive and anti-inflammatory mechanisms.

The major clinical symptoms of UC and CD are similar with some distinctions--bloody diarrhea, abdominal pain, often with fever, anemia and weight loss in severe cases. With predominately rectal involvement, constipation rather than diarrhea may be present, and tenesmus may be a major complaint. For CD, it tends attack a younger group of patients, with less frequent bloody stool, more abdominal pain, palpable masses, strictures and fistulas. Extraintestinal symptoms are more common in CD than UC. About 25% of the IBD patients have joint involvement, ranging from arthralgia to acute arthritis with pain and swollen joints. About 15% of patients have skin disorders, rashes, canker sores of the mouth, etc. Abnormal liver functions are common in IBD cases. The long-term inflammation may cause severe complications, such as toxic megacolon, perforation, etc., and increase the probability of incidence of malignancy in the intestine.

Western medical treatments are primarily pharmaceutical and use surgical intervention for "intractable" cases. The aim of the treatments is to control the inflammation. Anti-inflammatory, nutritional replacement, correction of electrolyte and fluid balance and anemia, and stopping diarrhea are the major treatments. Severe acute cases need to be hospitalized. Since these patients need long term use of steroids or non-steroid anti inflammatory drugs (NSAID), such as sulfasalazin, many of them develop complications, such as Cushing'sSyndrome and/or low white blood cells, caused by the side effects of these drugs.

Based on the saying, "different diseases, same treatment", the Chinese medical treatment of CD and UC are basically the same. There are the same disease causes and mechanisms, the same patterns, and the same treatment principles. Chinese anti inflammatory and immune regulatory herbs, such as licorice and extracts of Mucunae Caulis, Sargentodoxae Caulis, and Paederiae Caulis are very effective. In China , these herbs, especially their active ingredients, have been used to replace steroids and NSAID in many clinical conditions.

Anal abscesses, fissures, and fistulas commonly require surgical treatment. However, the administration of internal Chinese medicinals treats the root of these conditions. Thus the conditions are less recalcitrant to surgical treatment and do not relapse easily.

A clear bland diet and lifestyle modifications, including both more physical exercise and more mental-emotional relaxation, are necessary parts of an overall Chinese medical treatment plan for this condition.