Her doctor had given up, Marsha said. The names of some of the tests she’d been through over the last few years were not easy to pronounce, and I could tell she had some practice at it — she’d been through a sigmoidoscopy, colonoscopy, magnetic resonance imaging and a Helicobacter pylori antigen test.
Despite the normal test results, Marsha continued to have burning pains in her upper abdominal area after each time she ate anything. “I can’t eat an apple slice without feeling discomfort,” she said. “When I try to go out to dinner with my friends, it’s no fun. I have a bowl of white rice and a little cup of chicken soup, and then a cup of peppermint tea while they feast on aloo gobi or kung pao chicken.”
Marsha’s doctor had ordered every standard test, and they all came up negative. “Then I went to a naturopathic physician who ordered exotic tests like optimized parasite recovery, pancreatic elastase 1 and short-chain fatty acids and butyrate,” she said. Still all normal. “Then I went to a psychiatrist and tried an antidepressant.”
I had to marvel at Marsha’s persistence. She told me she had improved somewhat over time, while taking lots of different supplements and undergoing other treatments. She felt better overall, but still had the same fundamental lack of digestive strength.
Making a Diagnosis
When faced with such a challenging set of symptoms and health history, I depend on the time-honored skills of Traditional Chinese Medicine (TCM). Most TCM practitioners will pay more attention to their patient than to the numbers on a laboratory test. I do look at the tests, but as we all know, just because the numbers are normal doesn’t mean an imbalance doesn’t exist. A potential imbalance could be in the beginning stages but still produce symptoms.
I asked Marsha to move over by the window so I could take a careful look at her tongue and feel her pulse (important diagnostic tools in TCM). Her tongue was revealing. It had many crisscrossing lines in the middle, showing the chronic nature of her underlying condition. The coating was thicker than normal, greasy and slightly grayish-yellow — signs of food stagnation and perhaps a little inflammation in the lower bowel area.
Her pulse was “tight,” which means the usual regularly rolling pulse was very short and came up to hit my fingers quickly, and quickly faded away. The vessel felt like it was stiffer than normal.
She told me her bowel movements were often loose and frequent. Loose bowels usually indicate some weakness of the digestive organs, qi deficiency, chronic inflammation or a colon flora imbalance. The digestive tract is a complex place, and symptoms are notoriously hard to interpret. Generalized pain, bloating, gas and a feeling of uncomfortable pressure might all fall under the heading of dyspepsia, but what exactly could be the problem?
Marsha’s diet contained a lot of fresh food, but was very limited in scope. She ate the foods she had determined were the easiest to digest and caused her the least discomfort. She walked daily and was never constipated. Her job was not particularly stressful, and her relationship was fine.
With all these clues, making a diagnosis was not easy. Sometimes I find it helpful to make my best guess and then try one or two herbal formulas for 10 days to two weeks to see the response. This becomes part of the diagnosis. For example, if the diagnosis is “heat,” and the herbs given are designed to clear heat but the patient gets worse, then perhaps heat is not the problem at all.
I asked Marsha a few more questions related to digestive weakness. Marsha had bouts of fatigue, especially in the morning. She also had frequent colds in the winter. In TCM, the digestive system (or spleen) is the main organ system that produces daily energy, which also translates into immune power. Both seemed to have some weakness.
All this questioning and the exam laid the groundwork for putting together an herbal program to help reduce the symptoms in the short-term, as well as help correct the deeper problem at its base.
Herbal Program for Digestion
I put together an herbal program to help reduce symptoms and help correct the deeper problem at its base. For Marsha’s initial herbal program, I wanted to try several things at once to see if we could reduce her symptoms, which I hoped would help encourage her to take several months of a fairly intensive herbal program. I figured it would take three to six months to really start getting to the root of the problem, based on her history.
To activate immunity and promote digestive vitality, I recommended the classic TCM formula Bu Zhong Yi Qi Tang, with which I’ve had excellent results over the years. This formula is commonly sold in herb shops and health-food stores. The herbs in the formula include astragalus (Astragalus membranaceus), Asian ginseng (Panax ginseng) and dong quai (Angelica sinensis).
I also wanted to stimulate Marsha’s digestive enzymes, reduce heat and perhaps retard H. pylori — I wasn’t convinced she didn’t have a problem with these fairly common bacteria, even though her test had been negative. I recommended goldenseal (Hydrastis canadensis) and the Chinese herb shan zha (Crataegus cuneata), also known as Chinese hawthorn fruit. Goldenseal contains the yellow alkaloid berberine, which retards H. pylori growth, acts as a mild immune stimulant, increases digestive secretions and has a mild, cooling nature when not used to excess.
Chinese hawthorn fruit is a wonderful digestive aid that contains natural digestive enzymes. It can be purchased whole to make into a tea or in powdered extract form (from Plum Flower brand) to make an instant tea or put into capsules. Hawthorn fruit is one of the most important Chinese herbs to remove food stagnation.
If you experience similar symptoms, try hawthorn extract and goldenseal capsules (2 capsules twice daily before meals) for up to four to six weeks. If symptoms persist, see your practitioner.
Slow but Satisfying Results
Marsha began to feel better right away. She came back into the clinic in an excellent mood and said many nice things about her program. Then, as it often happens, two weeks later we were back to square one. Sometimes, the enthusiasm of a new program can act to reduce symptoms, but after another week, they return.
I was convinced that it was going to take several weeks to really determine the program’s effectiveness for her. I encouraged her to continue the herbs, since she didn’t feel any worse than when we started.
Marsha also agreed to massage her belly with a little sweet almond oil mixed with ginger essential oil (1 ounce almond oil to 10 drops ginger oil). She began to work in about a 1/2 teaspoon of the oil in a clockwise fashion, taking five to 10 minutes to find and work out any especially tender spots. This helps release tension from the abdominal area and can help reduce symptoms if performed regularly.
Marsha began to feel some relief after eating in about three weeks. This time, the results began to show signs of holding. After six weeks, she began to eat a few foods like well-cooked beans and lentil soup, one of her favorite foods, which she hadn’t been able to eat in at least a year. Two months later she was still slowly improving, and we modified the formula, adding some carminative herbs such as fennel seed (Foeniculum vulgare) and peppermint (Mentha piperita) tea, because instead of pressure she was experiencing more expelled gas. The increased gas was not accompanied by much pain or discomfort, so I took it as a sign that the energy was finally starting to move.
Christopher Hobbs’ case studies are gleaned from his 30 years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the correspondence course Foundations of Herbalism; www.foundationsofherbalism.com.
“Case Studies” is not intended to replace the advice of your health-care provider.