Chrohn's disease-case question/Flaws book

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Dear members

 

I have just seeing a new patient with Chrohn's disease. The details are

below.

 

My questions are: the 1st herbs caused the stools to go green/black. Is this

the blood stasis coming out, is this a positive sign, or was I was worsening

the condition. There is quite obviously a mass in lower R quadrant and I was

wondering about da huang mu dan pi tang as suggested by flaws in his book.

Has anyone ever tried the purge approach in treating Chrohn's, I am mindfull

if wrong D/D da huang mu dan tang might cause more severe diarrhea. How many

packets/days would people suggest to purge because I am concerned in

damaging zheng qi. Any thoughts welcome.

 

Heiko Lade (NZ)

 

Female age 22

 

15/08/06

 

Chrohn's disease diagnosed 4 years ago aged 18, sudden appearance literally

over night, then diarrhea up to 10 times per day, pus (white) in stools,

pain, bleeding

 

Initial Tx Steroids, anti inflammatory, anti suppressant drugs, antibiotics

 

If stop drugs, symptoms return within 5 weeks, tried about 2 years ago

 

When Chrohn's plays up --> tired

 

Lost 7 kg in last 6 weeks

 

Medications: current- salazapyrin, metronidazole, azumun

 

Self Tx: vit C, mineral Ca etc, rice bran oil, evening primrose,

primadophillus, fish oil

 

Family: grandmum- diverticulitis, grandfather- cancer

 

Childhood- mumps, German measles, age 10 glandular fever

 

Operations- toncills age 2 ( lots of antibiotics Tx) , r knee cartilage 10

years

 

Emotions: bit irritable sx with cycle

 

6 excesses: dislike cold

 

Past stress: aged 15 moved Gisborne-->Christchurch, dislike cold, lost

friends, (Gisborne hot climate, Christchurch Cold)

 

Other signs: nocturia 1x night, light sleeper, sx 1 x month pain on ribs

breast line which lasts for 10 minutes -->lost of breath, hard to breath,

has been for a few years

 

Headache- if does not eat,

 

Diet: stopped wheat, sugar, alcohol, pork. General past history of diet and

as teenager leading up to Chrohn's was OK , bit of junk food sx

 

Menstrual: pill aged 16-22, (pre aged 16 cycle last 5-7 days mild to heavy,)

now sx mild clotting, sx beginning at cycle, PMT, cramps , irritable

 

Palpation: Lower right quadrant- especially kidney channel area, slight lump

mass feeling

 

Pulse: slippery, lung full, Spleen thin,

 

Tongue: Blood stasis underneath-veins, greasy yellow at back

 

D/D: damp heat on top of cold damp/blood stasis

 

There was a history of lots of antibiotics age 0-2 which I suspected caused

a cold damp scenario.

 

 

 

Herbs- huang bai 9, cang zhu 3, ban xia6, ge gen 9, zhu ru 9, chai hu3, yu

jin 9, bai shao9, gui zhi9, ji xue teng9, hong hua3, zhe bei mu3, gan cao 3,

fu ling 9 2 packets (dosages in grams) [i added some qi regulators even

though not a lot of qi stasis signs, and added bai shao and gui zhi to

harmonise ying and wei]

 

 

 

Tx 2: had a bad headache for 1 day during course of drinking herbs, last few

days bleeding on anus but not dripping as in past, stool colour dark green

to black (not had this before)

 

P: seemed rough now not slippery, flooding T: veins underneath still blood

stasis

 

 

 

Ze xie 9, huang bai 6, jin yin hua9, ji xue teng 12, mu dan pi 9, hong hua

6, yi yi ren 15, huai hua 9, fu ling 15, cang zhu 6, hua shi 9, ge gen 12