Persistent Lower Abdominal Pain: A Case Study in Traditional Chinese Medicine

Persistent pain in the lower abdominal bladder area?

Hello Dr.
Yan! I would like to ask you a question.
At the beginning of September, I suspected I had a urinary tract infection.
All tests from Western medicine were normal, with no pathogenic bacteria found, but I still experienced symptoms of a urinary tract infection (burning and pain during urination, etc.).
Therefore, I sought treatment from a traditional Chinese medicine (TCM) practitioner (this TCM practitioner does not accept health insurance, did not disclose the prescription to me, and the medication was quite expensive...
but the doctor is licensed).
The herbal medicine was quite bitter, and I suspect it was a type of bitter cold herb.
I was instructed to take it after every meal without interruption.
During the course of the medication, I was advised to avoid alcohol, spicy foods, seafood, white radish, water spinach, etc.
Additionally, during the period I took the Chinese medicine, my urine had a slightly brownish color, which I believe was related to the medication.
The TCM practitioner listened to my symptoms and took my pulse, suggesting that I might have a Chlamydia infection (however, I had previously tested negative for Chlamydia DNA through Western medicine).
Since the TCM practitioner suggested this, I took the Chinese medicine for two courses (a total of one month) with some skepticism.
The frightening part is that I did experience gradual improvement during the treatment, but after finishing the medication a month later, starting this past Monday, I began to experience severe pain in my lower abdomen near the bladder, accompanied by burning, stabbing, itching, and a feeling of fullness...
(the pain was almost unbearable, and I found relief only by lying down or leaning on a table).
(Doctor, this is quite strange because the pain subsided shortly after taking the Chinese medicine, but it returned once I stopped taking it).
Therefore, I turned back to Western medicine for help...
I want to ask the TCM practitioner if they suggested that since it was effective, I should continue treatment.
However, I am afraid to return to that TCM practitioner, fearing further harm to my body...
and the lack of health insurance makes the medication expensive.
I wonder if Dr.
Yan could give me some advice? Can prolonged use of Chinese medicine lead to bladder damage? I am still in pain and can only take Western pain relievers and smooth muscle relaxants for relief...
The course of this condition has been long and recurrent, causing me much distress...
I really don't know what to do...
Thank you for your response, Dr.
Yan.
Helpless Jie adds: I have not engaged in any risky sexual behavior.
The Western medical diagnosis is chronic prostatitis...
I just haven't undergone cystoscopy and urodynamics yet.
I have also discussed with Western urologists and infectious disease specialists whether it could be "interstitial cystitis," but they do not believe so...

jie, 20~29 year old female. Ask Date: 2012/12/18

Dr. Yan Sumei reply Traditional Chinese Medicine

Hello! From your statement, I can sense your worries and helplessness.
Traditional Chinese medicine (TCM) can help improve your condition but may not completely eliminate it, while Western medicine is effective but has not yet provided a definitive diagnosis.
You may be concerned about whether prolonged use of TCM could harm your bladder.
I would like to give you a clear answer, but it is indeed challenging to respond without knowing the specifics of the prescription from the TCM practitioner.
You may consider evaluating which treatment (TCM or Western medicine) is more effective in alleviating your suffering, or seek a more experienced physician for further clarification.
This is my response to you.
I hope you find it satisfactory.
Wishing you all the best! Sincerely, Yen Su-Mei, Department of Traditional Chinese Medicine, Nantou Hospital.

Reply Date: 2012/12/18

More Info

Dear Jie,
Thank you for sharing your experience and concerns regarding your persistent lower abdominal pain and the treatments you have undergone. It sounds like you have been through a challenging journey with both Western and Traditional Chinese Medicine (TCM). Let's break down your situation and explore some insights that may help you navigate your next steps.

Firstly, it's important to recognize that persistent lower abdominal pain can stem from various causes, including urinary tract infections (UTIs), interstitial cystitis, chronic prostatitis, or even gastrointestinal issues. In your case, the initial symptoms of a UTI were not confirmed by Western medical tests, which can be frustrating. However, TCM often approaches such symptoms from a different perspective, focusing on the balance of bodily systems and the flow of Qi (energy) and blood.

The TCM practitioner you consulted suggested a possible Chlamydia infection based on your symptoms, despite negative test results from Western medicine. This highlights a fundamental difference in diagnostic approaches. TCM relies heavily on symptom patterns and pulse diagnosis, which can sometimes lead to different interpretations of the same condition. While you experienced relief during the course of TCM treatment, the return of symptoms after discontinuation raises important questions about the underlying issue.

Regarding your concerns about the long-term use of Chinese herbal medicine, it is generally considered safe when prescribed by a qualified practitioner. However, the effects can vary based on the specific herbs used and individual patient factors. Some herbs may have diuretic properties or affect kidney function, so it's crucial to communicate openly with your TCM practitioner about any side effects or concerns you experience during treatment.

Given that your symptoms have returned with intensity, it may be wise to consider a multi-faceted approach. Here are some recommendations:
1. Consult a Specialist: Since your Western doctors suspect chronic prostatitis, it might be beneficial to follow through with further diagnostic tests, such as cystoscopy or urodynamics, to rule out conditions like interstitial cystitis or other bladder issues. These tests can provide more clarity on your condition.

2. Evaluate TCM Treatment: If you found some relief with TCM, it may be worth seeking a second opinion from another licensed TCM practitioner. Different practitioners may have varying approaches and herbal formulas that could be more effective for your specific symptoms.

3. Integrative Approach: Consider an integrative approach that combines both Western and TCM treatments. This could involve continuing with Western medicine for symptom management while exploring TCM for underlying issues. Always inform both practitioners about the treatments you are receiving to avoid potential interactions.

4. Lifestyle and Dietary Adjustments: Pay attention to your diet and lifestyle. Certain foods and stress can exacerbate bladder and abdominal symptoms. Keeping a symptom diary may help identify triggers and patterns.

5. Pain Management: While you are currently using Western medications for pain relief, discuss with your healthcare provider about the best long-term pain management strategies that align with your overall treatment plan.

6. Mental Health Support: Chronic pain can take a toll on mental health. If you find yourself feeling overwhelmed, consider speaking with a mental health professional who can provide coping strategies and support.

In conclusion, navigating chronic pain and treatment options can be complex and frustrating. It’s essential to advocate for your health by seeking comprehensive care that addresses both the symptoms and the underlying causes. Remember, you are not alone in this journey, and there are resources available to help you find relief and regain your quality of life.

Best wishes for your health and healing,
Doctor Q&A Teams

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