IBS after gallbladder removal

[Guest guest]

Hi Everyone,

 

I am a newly licensed acupuncturist in the San Francisco Bay Area with a

patient I'd like help on.

 

He is a 85 yr old man who got his gallbladder removed 2 years ago due to

stones. Since then he's had Irritable Bowel Syndrome (IBS). His main sx's

are cramping, which can be severe enough to send him to the emergency room,

bloating, lots of gas and constipation. He also has hemorrhoids due to the

constipation. Metamucil used to help with his bowel movement, but now it's

not working anymore. In fact yesterday he had to be rushed to the emergency

room due to the cramping after taking Metamucil. The only thing that helps

with the cramping is applying a heat pad.

 

His tonge was red and slightly peeld/geographic. His pulse is thin and wiry

on the right side and wiry and full/slippery on the left.

 

Although he gets a lot of support from his wife and is very thankful for

her, he is depressed and frustrated that he cannot eat the things he wants

to eat any more. His energy is also not what it used to be. Also, he's not

able to be as physically active as he used to be due to fear of constant

cramping.

 

He avoids dairy, fatty foods, refined sugar, carbonated drinks, canned

foods, raw vegetables, caffeine and alcohol.

 

I've treated him just once, two days ago, with Ren 12, St 25, St 37, LV3 and

Li10. I also gave him Ease Digestion by Golden Flower, which is their

version of Curin Wan. He did not have any problems with Ease Digestion, but

obviously it did not help with the Metamucil attack he had yesterday. I

told him to replace Metamucil with flax seed oil. He's also going to keep a

food diary and record any attacks.

 

His Western doctors don't know what to do with him. In fact, one of them

referred him to me. He's been seen by couple of different

gastroenterologist who have done all the " -scopies " and found nothing. No

irritation or inflammation, except for the hemorroids.

 

I'd appreciate any insight of suggestions. Thanks in advance for your help.

 

Liz Lee

leeliz

[Guest guest]

Dear Liz Lee, I had a patient almost exactly like yours: GB removal, age 83,

diarrhea, gas, cramping, could not eat any more what he wanted to. Very

frustrated about the changes in his health and his aging.

 

Your patient has more constipation and mine had more diarrhea, but same

source (I think): according to your pulse, it seems liver is overacting on

stomach and spleen. I would add LI-4 to your point selection, it being on the

large intestine channel, and also part of the qi-regulating pair LI-4 and

Liv-3. I would also add St-36 because in older people their spleen-stomach qi

is just not what it used to be. I also like LI-11 a lot for these patients. I

know it is clearing, but I think it is also regulating, and so useful for

heat.

 

I reviewed his diet carefully and removed anything that was not bland and

plain. This bothered him, but when his symptoms improved, he saw the logic in

not overburdening his GI tract. Don't overlook the shen aspect: my patient

was very " Type A " and not at all patient. Calming the shen with acupuncture

always helped. He comes once a month for maintenance and is doing well. For

herbs, bland and harmonizing formulas worked best for my patient.

 

At that age, gentle clearing (of whatever needs clearing) and tonification

worked best for me. Good luck. Metamucil is probably too strong. Why not try

Peach Kernel Pills (Tao Ren Wan) or even mild decoctions of Da Huang (I say

MILD: small dosage, longer cooking, a wonderful herb).

 

Julie Chambers

[Guest guest]

Hi Liz

Go to todd's library and read over my IBS case/curly question and go to

treatment 4.That formula is from a translation of Steve Clavey .Because he

gets relief with a heat pad, indicates an underlying cold stagnation, I

would add xiao hui (fennel) and wu zhu yu which helps for pain will also

disperse cold.

hope this helps

 

 

Heiko Lade

Registered Acupuncturist / Chinese Herbalist

2 Jenkins St.

Green Island, Dunedin

New Zealand

Tel: (03) 488 4086, Fax: (03) 488 4012

http://www.lade.com/heiko

Email: heiko

[Guest guest]

Hi Liz

 

> He is a 85 yr old man who got his gallbladder removed 2 years ago due to

> stones. Since then he's had Irritable Bowel Syndrome (IBS). His main sx's

> are cramping, which can be severe enough to send him to the emergency room,

> bloating, lots of gas and constipation. He also has hemorrhoids due to the

> constipation. Metamucil used to help with his bowel movement, but now it's

> not working anymore. In fact yesterday he had to be rushed to the emergency

> room due to the cramping after taking Metamucil. The only thing that helps

> with the cramping is applying a heat pad.

 

> His tonge was red and slightly peeld/geographic. His pulse is thin and wiry

> on the right side and wiry and full/slippery on the left.

 

It may be hard to figure this out, since his GB was removed 2 years ago.

But, if you can get an idea about why he had gall stones in the first place,

you might get a clue as to how the problem has continued to unfold into it's

present condition.

I often think about dampheat when stones are involved. I also think about

dampheat when there are odd and often conflicting signs. Like heat helps his

cramps, but he has a red and slightly peeled tongue. Of course, dampheat

can wreak all kinds of havoc with the digestive system. So, look and see if

that might be part of the problem and then choose your points accordingly.

 

 

>I also gave him Ease Digestion by Golden Flower, which is their

> version of Curin Wan. He did not have any problems with Ease Digestion, but

> obviously it did not help with the Metamucil attack he had yesterday. I

> told him to replace Metamucil with flax seed oil. He's also going to keep a

> food diary and record any attacks.

 

My take on Ease Digestion (curing wan) is that it is more for acute

digestive distress. Usually from bad food or a damp and turbid evil

pathogen of some sort.

 

I'm not sure what formula to recommend as I don't know what 'kind' of

constipation he has. Is it that the stool is dry and hard to pass? Or that

he skips days between bowel movements? Is the problem one of qi deficiency

or qi stagnation? Or, is the problem due to dryness? Once you have a sense

of what the problem is, then it becomes easier to come up with a formula.

>

Good luck and keep us posted!

Michael

 

 

------

Michael Max, Licensed Acupuncturist

michaelmax

http://www.home.earthlink.net/~michaelmax