- 21 September 2023
Harmony in Your Gut
Diarrhea and constipation occur together
Diarrhea and constipation are on opposite ends of the stool spectrum, with one characterized by loose, watery stools and the other by hard, dry stools. Still, constipation and diarrhea occur together in a few cases. One such instance is paradoxical diarrhea.
When stools are not passed out regularly, they accumulate in the rectum, giving rise to a medical condition known as fecal impaction.
Fecal impaction occurs when there’s a large stool mass in the rectum that a person cannot expel because the stool is either too dry or too hard. The rectum enlarges to accommodate the stool, leaving watery excrement around it. And in what seems like an impossible occurrence, watery stool may leak out even with the large stool mass blocking the lower part of the rectum and anal cavity.
This kind of diarrhea is called paradoxical diarrhea or overflow diarrhea. It happens when a soft, watery stool flows over a solid mass of hard stool that is blocking bowel movement. It is usually foul-smelling.
Irritable bowel syndrome is a medical condition that causes diarrhea and constipation to occur alternatingly—almost simultaneously. A type of IBS called IBS-M can cause episodes of diarrhea and constipation, almost occurring at the same time.
Traditional Chinese Medicine Advice for a Healthier Colon
In Traditional Chinese Medicine (TCM), the Large Intestine (LI) or colon has a symbiotic relationship with the Lung channel, representing the Metal element and symbolizing both beginnings and endings.
TCM emphasizes the interconnectedness of the spleen and lung in promoting digestion and bowel movements. The spleen transforms food into energy and transports nutrients, while the lung circulates vital energy (qi) throughout the body. Dysfunction in these organs can lead to constipation.
Spleen deficiency constipation, a TCM concept, involves slow-transmission constipation. Spleen deficiency affects liver qi flow, causing constipation. When the LI is impacted by emotions like sorrow and anxiety; their repression can lead to imbalances and contribute to constipation by hindering LI qi descent.
In Traditional Chinese Medicine (TCM), spleen deficiency constipation is a type of constipation associated with slow-transmission constipation. When the spleen is weak, it can lead to the retrograde flow of liver qi, or disharmony between the liver and spleen, resulting in constipation.
When the large intestine is influenced by emotions like sorrow and anxiety, if these emotions are repressed and accumulate, they can lead to imbalances. This can result in constipation by hindering the descent of large intestine qi. Phlegm can also contribute to constipation due to its sticky and gel-like nature, which easily obstructs the flow of qi and disrupts the descent of the stomach and large intestine.
When phlegm is related to constipation, it is often associated with liver qi stagnation, which is usually caused by qi stagnation weakening the spleen and slowing the distribution of fluids, leading to the congealing of phlegm.
Spleen yin deficiency symptoms include constipation, abdominal discomfort, dry mouth, and heat in hands/feet. Spleen weakness exploited by liver qi can cause diarrhea and abdominal issues, affecting transportation and digestion.
Physical signs of a weak LI encompass colitis, constipation, diarrhea, metabolic sluggishness, sore throat, bloating, low energy, allergies, edema, bad breath, hair thinning/loss, inflammation, and colon cancer.
Several factors can also disrupt the flow of the LI, including dehydration, lack of movement, fast eating, insufficient chewing of food, irregular eating patterns, consumption of acidic and congesting foods like dairy products, sugar, GMO foods, refined foods, excess raw vegetables, cold drinks, yeast, alcohol, and deep-fried foods.
Therefore, according to the principles of TCM, a balanced diet incorporates the following five flavors to improve our gut:
- Sweet: Nourishing and moistening, beneficial for conditions associated with excess dryness like constipation.
- Sour: Drying in nature, promotes contraction in the digestive tract. Can be helpful in small quantities to remove excess fluids, such as with soft stools.
- Hot and Pungent: Warming properties stimulate appetite and enhance circulation of blood and Qi throughout the body.
- Bitter: Cooling effect, helps dry up dampness. Stimulates the gut and supports liver function when sluggish.
- Salty: Lubricates the intestines, aids in removing accumulated wastes.
Diarrhea can also be caused by excess heat in the body; what can be eaten to stop it?
It is commonly believed that an upset stomach resulting in diarrhea can be due to a cold, while constipation can result from excessive heat in the body. These causations seem perfectly reasonable to most people. However, strangely enough, diarrhea can also be associated with excess heat.
According to Traditional Chinese Medicine, chronic diarrhea is often caused by spleen weakness, which is typically manifested as frequent bowel movements that are loose and unformed.
Severe cases may even involve having to rush to the bathroom right after eating or discomfort in the stomach after eating ‘cold’ food. Humans are seen as a whole of Yin and Yang in balance. When one organ’s function declines, the body will compensate with the functionality of another organ.
For instance, when the stomach is cold, if it is due to spleen deficiency and can’t perform its warming function, the body will mobilize the Yang energy of the liver. The more deficient the spleen, the more liver Yang is mobilized. Gradually, the liver becomes stronger, the spleen becomes weaker, and a vicious cycle is created. As a result, some people may exhibit symptoms of both excess liver heat (manifested as a very red ring around the tongue, a bitter taste in the mouth, a quick temper, a propensity for mouth ulcers, or restlessness and excessive dreaming) and diarrhea. This mixed condition of deficiency and excess makes treatment more challenging.
Chief physician Yin Xiukun of the China Academy of Chinese Medical Sciences believes that the principle of “treating the symptoms in acute cases, treating the root in chronic cases” should be followed. As the essence of diarrhea is spleen deficiency, one should avoid eating raw, cold, and greasy food regularly to prevent putting extra burden on the spleen.
Pay attention to keeping your feet and abdomen warm, and eat more food that strengthens the spleen and replenishes Qi, such as lentils, sorghum rice, barley, buckwheat, chestnuts, Euryale seeds, Chinese yam, jujube, carrots, pumpkin, etc.
On the other hand, you should also eat more foods that clear the liver and regulate Qi, such as bitter gourd, mung beans, celery, chrysanthemum, hawthorn, finger citron, etc., while avoiding smoking and alcohol, spicy food, and refraining from staying up late.
If diarrhea is severe, you can make porridge with lotus seeds and Euryale seeds. However, remember that those with chronic illnesses must learn to watch their diet; otherwise, they may experience diminishing returns in terms of health benefits.
From Qi Imbalance to Functional Disorder: The Dual Faces of IBS in Medicine (Differences between TCM and Western Medicine)
Western medicine views IBS primarily as a functional bowel disorder, while TCM sees it as a manifestation of broader imbalances in the body.
Western Medicine | TCM | |
Definition | functional gastrointestinal disorder, meaning there is a recurring set of symptoms without an identifiable anatomical or biochemical cause. | IBS is not identified as a standalone disease in TCM. Instead, the symptoms associated with IBS are seen as manifestations of imbalances in the body’s fundamental substances and organ systems. |
Symptoms | Abdominal pain, bloating, and altered bowel habits (diarrhea, constipation, or alternating between the two) are the primary symptoms. Criteria like the Rome IV criteria are often used to diagnose IBS based on symptom duration and frequency. | Symptoms are seen in the context of the whole body and are used to determine the underlying imbalances. For instance, the nature of the stool, presence of mucus, the sensation of abdominal pain, and even the emotional state of the patient can indicate different patterns of imbalance. Diagnosis: questioning, pulse reading, tongue examination, and other traditional methods. |
Etiology | The exact cause is unknown. It’s believed to involve various factors like gut-brain interaction, infections, inflammation, gut flora alterations, and food sensitivities. | TCM believes IBS can arise from a variety of imbalances, including Liver Qi stagnation, Spleen Qi deficiency, Damp-Heat in the Large Intestine, Cold Invasion, or Yin Deficiency. |
Treatment | Treatment is usually symptom-targeted. It might include dietary modifications (like the low FODMAP diet), probiotics, medications to reduce diarrhea or constipation, antispasmodics, and sometimes psychological therapies. | Treatment is holistic and tailored to the individual’s syndrome differentiation. Approaches can include acupuncture, herbal remedies, dietary modifications, and lifestyle advice. The goal is to restore balance to the body’s Qi, Blood, Yin, and Yang. |
Both perspectives offer valuable insights and approaches. Some patients find combining treatments from both Western and TCM to be especially effective in managing their IBS symptoms.
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