navel pain....worms?

November 22, 2004

I wanted to see if anyone has any ideas about treating this

patient...or perhaps where to look to find out:

I have a patient with constant tightness/pain around his navel. It

is not terribly painful, but he doesn't like any pressure on it and

has been this way for years. It doesn't come and go. He also has

pain above the navel which is different---pressure feels good there.

On p. 313 of " The Treatment of Pain with Chinese Herbs and

Acupuncture " , Sun Peilin said that pain around the navel is usually

caused by ascariasis (worms), but he does not go on to describe a way

to treat it.

What do you think? Do you think that is the likely diagnosis, and if

so, are Chinese herbs an effective strategy to treat it? Any ideas

about how I should treat it?

His navel has a very unusual shape to it----it looks like the kind of

navel that I heard described as being from prolapse with deficiency,

but I really don't think that's the case with him. It seems to me

that the navel area has an excess that is pulling down the qi from

the epigastric area which is therefore deficient. This theory sounds

consistent with worms to me. He is in his 30's and has always been

very athletic, but has been having a very hard time lately due to a

divorce (but the navel problem started long before that), so there is

depression. He has a deep central crack to his tongue, and at times

has a thick coating and at other times as virtually no coating.

Pulses can be wiry but often aren't as strong as I would expect. He

does think its possible that the navel pain started back when he had

pneumonia years ago....and thinks that his health has never been the

same since then. However, he is not certain of this.

He has traveled a fair amount in his life, so its possible he could

have gotten worms in his travels.

Thanks so much for any ideas you can share,

Laura

November 23, 2004

Hi all, I'm just trying to keep this current to see if anyone knows

whether I should assume navel pain is due to worms as Sun Peilin's

book indicates, or whether it can be something else. Thanks!

Laura

, " heylaurag "

<heylaurag@h...> wrote:

>

> I wanted to see if anyone has any ideas about treating this

> patient...or perhaps where to look to find out:

>

> I have a patient with constant tightness/pain around his navel. It

> is not terribly painful, but he doesn't like any pressure on it and

> has been this way for years. It doesn't come and go. He also has

> pain above the navel which is different---pressure feels good

there.

> On p. 313 of " The Treatment of Pain with Chinese Herbs and

> Acupuncture " , Sun Peilin said that pain around the navel is usually

> caused by ascariasis (worms), but he does not go on to describe a

way

> to treat it.

>

> What do you think? Do you think that is the likely diagnosis, and

if

> so, are Chinese herbs an effective strategy to treat it? Any ideas

> about how I should treat it?

>

> His navel has a very unusual shape to it----it looks like the kind

of

> navel that I heard described as being from prolapse with

deficiency,

> but I really don't think that's the case with him. It seems to me

> that the navel area has an excess that is pulling down the qi from

> the epigastric area which is therefore deficient. This theory

sounds

> consistent with worms to me. He is in his 30's and has always been

> very athletic, but has been having a very hard time lately due to a

> divorce (but the navel problem started long before that), so there

is

> depression. He has a deep central crack to his tongue, and at

times

> has a thick coating and at other times as virtually no coating.

> Pulses can be wiry but often aren't as strong as I would expect.

He

> does think its possible that the navel pain started back when he

had

> pneumonia years ago....and thinks that his health has never been

the

> same since then. However, he is not certain of this.

>

> He has traveled a fair amount in his life, so its possible he could

> have gotten worms in his travels.

>

> Thanks so much for any ideas you can share,

>

> Laura

November 24, 2004

Parasitic infestations can often mimic many other TCM patterns - Liver, Spleen,

Intestines, Qi-Stagnation, Dampness, etc., so it can be difficult to determine

with certainty. Moreover, there is a high false negative rate on typical stool

cultures for parasites, so these results are highly unreliable unless done with

greater than usual attention to detail.

I will often give the obvious herbal formulas tailored to the total pattern

configuration, and if after a few weeks the expected improvements fail to occur,

then I'll reassess - considering more exotic things like parasites, heavy

metals, environmental factors, and often taking additional time to do a more

complete health history to see if I've missed something.

Check out the definition of the JueYin Parasites pattern:

Symptoms:

·SYST: chronic; fatigue-lethargy; upper

body feels hot; lower body feels cold;

extremities feel cold.

·INTAK: thirst, burning; appetite, lack of.

·OUTFL: vomiting up of roundworms.

·PAIN: burning pain; of esophagus;

palpitations.

·SLEEP: irregular, disturbed.

·BEHAV: agitated or restless.

Signs:

·TTIS: purplish; purplish in irregular

patches; spots, red, and vesicles near tip.

·TCOAT: variable.

·PULS: variable, tendency to bowstring.

Often, there may be only hints of the above (only a few symptoms in the list),

mixed together with other patterns such as Spleen Qi Deficiency, Spleen

Dampness, Qi Stagnation, etc.

Other clues:

small whitish-clear vesicles on the tongue surface and in sublingual

area.

small whitish patches of skin along spine

intermittent pains in ileocecal valve area - another location where

parasites often tend to hang out in addition to periumbilical area.

examine stools, or ask client to repeatedly inspect, for eggs in stools

(+-1mm diam, whitish), or visible worms, or for sloughed off sections of

tapeworm, etc.

If the pain and distention are persistent, and the guan pulses on either L or R

are deep, slippery, and resistant, like a hard rubber ball, then this might be

consistent with some type of abdominal tumor (Congealed Phlegm).

I usually spend at least 2 hours doing an initial case history. It is difficult

to make any conclusions with certainty based on only a few symptoms in such

cases.

For formula ideas, see Bensky's formula book - there are a range of formulas to

suit different pattern manifestions - here you'll probably want the

Qi-regulating and moving formulas that include herbs like S. Arecae (bin lang).

---Roger Wicke, PhD, TCM Clinical Herbalist