Ulcerative Colitis

A 60 year old female came to the clinic for help with ulcerative colitis, accompanied by diarrhea and blood in the stool. Her primary request was to attempt to reduce her use of medications. She had suffered from ulcerative colitis with diarrhea and blood in the stool for about 10 years. She presented with diarrhea or soft stool, and bowel movements three to four times a day. She also had bleeding with dark or fresh blood in the stool every two to three weeks to a month, for which she often visited the ER in order to stop the bleeding. She reported always feeling fatigued with coldness of the body, poor sleep and abdominal pain, with occasional fullness of the abdomen. She reported feelings of stress and depression. Her condition tended to be worse when there was bleeding or blood in the stool. She had undergone blood tests that showed a sed rate of 63 by modified westergren (Reference Range < or= 30mm/h) on 3/19/2008. She was diagnosed by her western medical doctor as having ulcerative colitis. She had been taking medications for about 10 years, such as Cnolazal, Entocort EC, Rowasa Enema and Azathiorine, none of which can control diarrhea and/or blood in the stool. Examination showed that abdominal pain got worse with hand pressure on the upper and lower abdomen, dry skin that was pale and shallow on the face, and distinct thinness of the body. Her tongue presented a dark color and was dry, with teeth marks on the tongue body, with a thin white tongue coating. Her pulse was weak and deep, and her BP was 120/80mmHP. Her weight was 103 lbs.

By Traditional Chinese Medicine standards, her diagnosis is spleen yang deficiency with Qi unable to control blood in the middle abdomen. The treatment principle is to strengthen the spleen, warm spleen yang, tonify spleen Qi, and stop bleeding. The treatment points included Ren4, 6, 10, 12, SP6, 12, ST36, 25, LI4, DU20. These were applied once a week for acupuncture treatment. The Chinese herbal formula selected for this case is modified from Li Zhong Tang. It is 50g powder of an herb Rx for one week, to be taken orally 3 times a day, 2g per time maximum, with about 2cc warm water. The herbs included Dang Shen, Huang Qi, Gan Jiang, Bai Zhu, Sha Yao, Fu Ling, Da Huang, Ce Bai Ye, San Qi, Mai Ya, Shen Qu and Chen Pi.

The treatment for subsequent visits modified some points of acupuncture protocol and herbs in the herbal formula according to the patient’s progression. After a few sessions of treatment, her condition was improved with regard to the diarrhea and abdominal pain, and the frequency of blood in the stool reduced from 3-4 times a month to 1-2 times a month. The majority of her other symptoms were also improved. After a few weeks of treatment, the blood in the stool stopped, bowel movements occurred once a day, and her weight increased to 108 Ibs.

The patient continued to visit once a week to once every two weeks for acupuncture treatments and to refill her Chinese herbal formula. It was reported that blood tests showed the sed rate of 26 by modified westergren (Reference Range < or= 30mm/h) on 9/19/2008. She started to reduce and eventually stop the use of Western medicines in consult with her Western doctor. Her weight increased to 113 lbs. In subsequent visits her tongue presented a pale red color, moist with a thin white coating, and her pulse was thin.