Traditional Chinese Medicine's Role in Diarrhea Management

Regarding Traditional Chinese Medicine and Diarrhea

Hello Doctor, last Monday I visited a gastroenterologist due to pain in my upper left abdomen (pain after eating, feeling hungry at midnight).
After eating, I experienced pain in my lower left abdomen, which subsided after using the restroom.
By Thursday, the pain had shifted to my lower abdomen on both sides, specifically in the pelvic area, so I decided to consult a traditional Chinese medicine practitioner who diagnosed me with pelvic inflammation.
Below is the herbal prescription I received: Banxia Xiexin Decoction 6g, Guizhi Fuling Wan 6g, Chuan Dongzi 1.5g, Yanhusuo 1.5g, and Xiangfu 1.5g.
After taking the herbal medicine on Thursday and Friday, my bowel movements were normal; the first part was harder, and the latter part was softer.
However, after drinking milk on Friday night, I experienced abdominal pain on Saturday morning after breakfast, leading to a small bowel movement.
After my second meal on Saturday, my abdomen hurt again, and my stool became mushy like sweet potato puree.
Although my bowel movements on Sunday were normal, the first part was normal while the latter part was loose and mushy.
Today, my stool is also mushy like sweet potato puree.
1.
Does this herbal formula cause diarrhea?
2.
Additionally, after taking the herbal medicine, I have been experiencing pain around the pelvic edges, the right lower back, and under the left rib cage, particularly in the right lower back.
After exercising on Friday, I felt very sore, similar to menstrual cramps.
Is this normal?
3.
Could this be triggered by the milk?
4.
Would you recommend that I return to see a gastroenterologist?
Please address these four questions.
Thank you.

Xunwenren, 20~29 year old female. Ask Date: 2022/06/20

Dr. Gao Peiyi reply Traditional Chinese Medicine

1.
Will this herbal formula cause diarrhea? No, it may actually lead to harder stools.

2.
After taking it, I feel pain around the pelvic rim, the lower edge of the right rib cage, and in the lower abdomen, especially in the right lower back.
After exercising on Friday, it feels very sore, similar to menstrual cramps.
Is this normal? It's not normal, but it is unrelated to the medication; it indicates that the underlying condition has not been addressed.
There may still be several diagnoses that need to be differentiated.
Pelvic inflammation is characterized by chronic pain lasting for several months or more, and other issues must be ruled out for a proper diagnosis.
A consultation with a gynecologist is necessary for confirmation.
3.
Is this caused by milk? It’s possible.
A certain proportion of Asians have lactose intolerance, which can lead to diarrhea or a heavy feeling in the abdomen after consuming milk.
You may want to observe your symptoms for a while.
4.
Will the doctor suggest that I see a gastroenterologist? The bowel symptoms may be influenced by emotions, foodborne illness, or intestinal allergies; self-monitoring is advised.
If upper abdominal pain (pain after eating, hunger at night) occurs frequently (more than twice a week for three consecutive months), it should be taken seriously.
If so, it is recommended to see a gastroenterologist to rule out ulcers.
The description of lower abdominal pain (pain around the pelvic rim, the lower edge of the right rib cage, and especially in the right lower back after exercising on Friday, feeling very sore like menstrual cramps) may suggest acute pain, and it would be advisable to consult a gynecologist for at least an ultrasound examination to rule out certain conditions.

Reply Date: 2022/06/20

More Info

Understanding the role of Traditional Chinese Medicine (TCM) in managing diarrhea involves a comprehensive approach that considers the underlying causes, the specific herbal formulations used, and the patient's overall health condition. In your case, you've been experiencing abdominal pain and changes in bowel movements after starting a TCM regimen, which raises several important questions.

1. Does the TCM formula cause diarrhea?
The herbal formula you mentioned, which includes Banxia (半夏), Guizhi (桂枝), and other herbs, is traditionally used to harmonize the stomach and alleviate gastrointestinal discomfort. However, individual responses to herbal treatments can vary significantly. Some ingredients in TCM can have a laxative effect, especially if they are meant to clear heat or dampness from the body. The presence of Banxia, for example, is often used to address phlegm and digestive issues, but it can also lead to softer stools in some individuals. If you are experiencing a significant change in your bowel habits, it may be worth discussing with your TCM practitioner to determine if the formula needs adjustment.

2. Is the pain in your lower abdomen and back normal?
The pain you describe in the pelvic area and lower back could be related to several factors, including the underlying condition that led you to seek treatment, the effects of the herbal formula, or even physical activity. TCM often views pain as a result of stagnation or imbalance in the body's energy (Qi). If the herbs are working to move Qi and blood, it might lead to temporary discomfort as your body adjusts. However, persistent or worsening pain should not be ignored. It is advisable to monitor the pain and consult with your TCM practitioner or a healthcare provider if it continues or intensifies.

3. Could milk be the cause of your symptoms?
Dairy products, including milk, can be difficult for some individuals to digest, especially if they have a sensitivity or intolerance to lactose. If you consumed milk and then experienced abdominal pain and changes in stool consistency, it is possible that the milk could be contributing to your symptoms. It might be beneficial to eliminate dairy from your diet temporarily to see if your symptoms improve. Keeping a food diary can help identify any correlations between your diet and gastrointestinal symptoms.

4. Should you return to the gastroenterologist?
Given your ongoing symptoms, including abdominal pain and changes in bowel habits, it would be prudent to follow up with your gastroenterologist. They can conduct a thorough evaluation to rule out any underlying gastrointestinal conditions that may require medical intervention. Additionally, they can provide insights into how your current TCM treatment may be interacting with your digestive health. It’s essential to have a collaborative approach between your TCM practitioner and your gastroenterologist to ensure that all aspects of your health are being addressed.

In summary, while TCM can be effective in managing gastrointestinal issues, it is crucial to monitor your body's responses to herbal treatments. If you experience significant changes in your symptoms, including diarrhea or abdominal pain, consulting with both your TCM practitioner and a gastroenterologist can provide a comprehensive understanding of your health and guide appropriate adjustments to your treatment plan.

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