Source: Efficacy of Traditional Chinese Medicine of the Management of Constipation: A Systematic review:
In the US One in three patients suffering from constipation seek medical care. Older people are more likely to have constipation than younger population particularly those older people in residential aged care. In medicine there are actually three types of constipation 1) functional 2) de-factory disorders and 3) slow transit constipation. The most common treatments are laxatives, enemas and in serious cases manual removal of faeces. As usual the reports of Chinese herbal medicine (CHM) as effectives treatment for constipation have been mixed. This review looked extensively at available research from international and chinese databases.
Finding from Systematic Research
21 high quality trials from the period 1997 – 2007 were included in this research. 18 trials used chinese herbal medicine (CHM) and 3 used acupuncture. Today’s post will focus on the CHM trials.
Many of the high quality trials reported herbs had beneficial effects on constipation. In trials where herbs were compared to conventional medications herbs was usually higher effectives rates than the conventional medicine in the control groups.
Also, adverse effects of CHM were not common and the conclusion was that using herbs for constipation is both effective and safe.
TCM Diagnosis for constipation
This research concluded there were five patterns relating to constipation. Patterns were diagnosed using traditional diagnostic methods including tongue, pulse, and questioning about other symptoms to determine pattern.
The five patterns were:
Qi-bi (obstruction of qi and or blood)
Re-bi – obstruction of qi and blood caused by heat
QI-Xu – deficiency of Qi
Xue – Xu – deficiency of blood
Leng-bi – ?
You will have to do your own research to find all herbs listed in formulas mentioned below. Here are some herbs and formulas used in the CHM trials included in this study.
Bai Zhu (Rhizoma atractylodis macrocephalae ) – in one trial this was used as a single herb perscription
Runchang Pian (formula includes Da Huang in it)
Tong Bian (formula includes Dang Gui and Da Huang)
Heji – couldn’t find what this was referring to
Mitong – spleen activation and intestine moistening
Tongbian jiaonang – off the shelf capsule formula includes rhubarb (Da Huang root)
Boost Qi formula – to warm yang and nourish blood – few variations of this formula can be purchased in capsules.
According to this study in conventional medicine there are three types of constipation compared with TCM that has five underlying patterns that can cause constipation. This study reminds us that there are many causes to constipation and getting the diagnosis wrong will result in the wrong prescription.
However in conventional medicine there are few interventions and these days most of us would immediately think of going to the chemist and buying laxatives before we would consider going to the doctor or seeking out an alternative gentler remedy. In TCM formulas and single herb prescriptions provide many more options for a patient and the great benefits of formula prescription is that you can treat the symptom of constipation and also the underlying causes.
This is a better outcome for older people in care who are currently reliant on the medical staff’s prescriptions of drugs that address symptoms only and have side effects.
For example, Cisapride , a drug used to speed up motility in the digestive system can have these side effects:
Gastrointestinal side effects are often due the pharmacologic actions of Cisapride. These effects appear to be dose-related, as 20 mg doses are associated with an increased incidence of diarrhea, abdominal pain, and flatulence compared to 10 mg doses.
In a study of 1500 patients, approximately 2.5% discontinued cisapride therapy, usually due to abdominal pain and intolerable diarrhea.
Gastrointestinal side effects have been reported the most frequently. These have included diarrhea or loose stools (14.2%), abdominal cramping (10.2%), nausea (7.6%), flatulence (3.5%), borborygmi (rumbling bowel sounds), and dry mouth. Nervous system side effects have included headache (19.3%), dizziness, somnolence, and fatigue. (This came from drugs.com and for more information o other side effects go to http://www.drugs.com/sfx/cisapride-side-effects.html)
Efficacy of Traditional Chinese Medicine for the Management of Constipation: A Systematic Review. Li-Wei Lin, M.S., R.N., Yuan-Tsung Fu, M.D., Ph.D., Trisha Dunning, Ph.D., R.N.,Anthony Lin Zhang, Ph.D., M.P.H., Tien-Hui Ho, M.S., R.N., Maxine Duke, Ph.D., R.N., and Sing Kai Lo, Ph.D.
Journal of Alternative and Complementary Medicine Col 15. No 12 2009, 1335 – 1346