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HIV Drug related Diarhea

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Dear Group,

 

Slightly less than 10% of my practice is HIV+ and most of them are using the current drug cocktail. They seek me out, in large part, to help deal with the drug side effects to improve the quality of life while hoping to remain on the drugs in order to survive. Over the years the symptom that I have had the greatest difficulty resolving in some patients is diarhea. In the last 6 months I believe that I may have come up with an idea which seems to bear out clinically and I wanted to share it. Hopefully by disseminating this info I can (a) determine whether a larger group pf patients continue to demonstrate success and (b) help more people.

 

Of course the critical piece in treating diarhea remains differentiating the TCM pattern the patient has and how the drug has either created that pattern or taken advantage of existing weaknesses. But that part always has been easy on paper. Even as other symptoms improve, some patients have found no or little relief in their diarhea. I had come to assume that this is similar to a situation in which we treat a person with lactose intolerance for their GI problems but he continues to drink milk every day. Since the patients can't stop taking the drugs they will continue to have this toxic reaction.

 

I began to notice a thread about 6 months ago, when I kept hearing most of these patients complain that their diarhea was always worse after a greasy meal. Now most of these patients already had formulae in place to treat dampness and SP deficiency, so I was already working that angle. Suddenly something I had read about shan zha (craetegus) being used for meat and greasy food related GI problems popped into my mind. As we all know shan zha is an herb used for food stagnation/blood stagn. However it is rarely is seen in formulae for diarhea other than the food stagn. type. As an experiment I added a substantial amount (the granular equivalent of 9g/day) to one man's formula. He rapidly found relief over 1-2 weeks. As a result I have been making this a mainstay of all of my drug side effect diarhea cases with no failures yet. Results do vary slightly from several miracles to mostly "greatly improved". Still it may be worth trying with your own patients.

 

I would appreciate hearing comments on this idea, as well as other people's experiences with this herbal addition, should they decide to try it out.

 

Mark Reese

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