Question: 13 weeks pregnant and Da Cheng Qi Tang

[Guest guest]

Hello!

 

 

 

I would be most thankful for any advice on the following:

 

 

 

A patient, 13 weeks pregnant, with severe constipation since the first week

of the pregnancy. She has been treated several times at western hospital for

acute severe cramping due to not defecation for several weeks. MDs have

tried the strongest laxatives, but nothing works.

 

 

 

I initially diagnosed her with Yang Ming type constipation, but since she

was at that time already 5 weeks into her pregnancy, I was reluctant to use

Da Cheng Qi Tang or any other Cheng Qi Tang. By modifying Zeng Ye Tang and

using that, she was able to start defecation again. However, the last

several weeks she has had a very severe nausea the whole day and night, and

therefore not been able to drink any herbs, and the constipation has

returned, including severe cramping.

 

 

 

I prescribed Da Cheng Qi Tang for one day, and she manage to force this

done. The result was that she went to the bathroom and defecated more then

she has done since the start of this problem.

 

 

 

Since she now is 13 weeks pregnant I do not want to use these herbs again

orally, but thinking about using an enema bag instead..

 

 

 

What are your thoughts and experience on this strategy? Would the use of Da

Cheng Qi tang (or something like it) through an enema bag, lessen the impact

on the fetus? How much of the decoction would actually be absorbed by the

body when administered this way?

 

 

 

BR

 

Carl Wallmark

 

 

 

 

 

 

 

 

[Guest guest]

Hi Carl,

 

I always begin with dietary therapy in pregnancy constipation... have

you tried recommending foods that promote bowel movements (as well as

foods to avoid)?

 

~Cindy

Cynthia J. Splies, L.Ac.

www.acupuncturebycindy.com

[Guest guest]

Hi Carl,

 

Thanks for sharing.

If she can't eat, is she blood deficient also?

Is her constipation from blood deficiency, yang deficiency (functionally),

and/or dryness?

Is there qi stagnation, food stagnation, excess heat?

 

The moist laxatives are not contraindicated during pregnancy.. *huo ma ren,

yu li ren*

The purgatives and harsh expellants are contraindicated.

 

Other herbs that can help with constipation that are not contraindicated

during pregnancy are:

*bai zi ren

dang gui

honey

he shou wu

rou cong rong

black sesame seeds (hei zhi ma)

xing ren *(tao ren is contraindicated)

 

Getting back to *luo han guo*, this also can be used during pregnancy for

constipation

and a teacher of mine recommends it especially 2nd and 3rd trimesters when

there can be dry throat also.

 

Mayway carries *Cong rong bu shen wan*, which warms KD yang, nourishes yin

and blood,

secures jing and moistens the bowels:

*Rou cong rong, shu di huang, tu si zi, wu wei zi*

 

Tu si zi is beneficial during pregnancy, as well as dang gui and honey for

constipation.

*Zi su ye *and *sha ren *can help regulate qi circulation in the middle

jiao.

 

*Cod liver oil and flax seed oil* could both help nourish the yin and

lubricate the stools.

Both are high in Essential Fatty acids

 

Other: *drinking more water.. qi gong... apples (fiber) ... acidophilus*

to replace friendly bacteria lost with laxatives.

 

What about Curing pills?

Even though it has tian hua fen in it, the abortifacient aspect of it is

deactivated by exposure to heat, light and moisture.

 

What has been the group's experience with this?

 

K.

 

 

 

[Guest guest]

Hi Carl,

I think u r right being cautious to use Da Cheng Qi Tang initially

and u should stick to this tract of thought for the following

reasons.

 

1) I believe the chief sign here is 'severe cramping' (I assume it

is gastro-intestinal, abdominal); constipation is secondary, so is

the nausea. Therefore, u should focus upon the treatment of etiology

(the root) and the constipation (the tip) will be resolved later.

 

2) Be cautious using precipitation

 

" the last several weeks she has had a very severe nausea "

 

According to Jin Gui Yao Lue (the Sypnosis of Golden Chamber), chpt

17 of vomiting disease,

 

¯f¤H±ý¦RªÌ¡A¤£¥i¤U¤§¡C(¤»)

( 6 ) When the patient has the urge to eject, use no precipitation.

The statement discusses the prevention of erroneous precipitation.

Due to rebellious stomach Qi, the patient has the urge to

eject. ...........If there are no signs indicating the use of

ejection, the treatment methods are¡¥counterflow-downbearing and

vomiting-checking¡¦ so ejection will be healed. Do not easily use

precipitation or the stomach Qi is damaged.

 

3)Be cautious using Da Cheng Qi Tang

It is a strong formula. We cannot justify its usage (incomplete data

provided here, such as pulse, tongue, form of stools) However, extra

caution is needed when treating pregnant patient.

 

Hope that helps.

 

SUNG, Yuk-ming PhD (Chengdu)

[Guest guest]

Carl,

 

How did you or your patient apply the enema?

 

Why zeng ye tang?

 

Thanks.

 

 

 

On Tue, Feb 26, 2008 at 11:42 AM, Carl <carlhenryk.wallmark

wrote:

 

> Hi Sung

>

> Thanks for your answer! By using Zeng Ye Tang via an enema (rectal),

> during

> these days since I sent out this question, her bowels has started again

> and

> she feels a lot better.

>

> I am however very thankful for yours and Cynthia reply!

>

> Carl Wallmark

>

> _____

>

> Från: <%40>

>

[ <%40>\

]

> För sxm2649

> Skickat: den 26 februari 2008 18:11

> Till: <%40>

>

> Ämne: Re: Question: 13 weeks pregnant and Da Cheng Qi Tang

>

> Hi Carl,

> I think u r right being cautious to use Da Cheng Qi Tang initially

> and u should stick to this tract of thought for the following

> reasons.

>

> 1) I believe the chief sign here is 'severe cramping' (I assume it

> is gastro-intestinal, abdominal); constipation is secondary, so is

> the nausea. Therefore, u should focus upon the treatment of etiology

> (the root) and the constipation (the tip) will be resolved later.

>

> 2) Be cautious using precipitation

>

> " the last several weeks she has had a very severe nausea "

>

> According to Jin Gui Yao Lue (the Sypnosis of Golden Chamber), chpt

> 17 of vomiting disease,

>

> ¯f¤H±ý¦RªÌ¡A¤£¥i¤U¤§¡C(¤»)

> ( 6 ) When the patient has the urge to eject, use no precipitation.

> The statement discusses the prevention of erroneous precipitation.

> Due to rebellious stomach Qi, the patient has the urge to

> eject. ...........If there are no signs indicating the use of

> ejection, the treatment methods are'counterflow-downbearing and

> vomiting-checking' so ejection will be healed. Do not easily use

> precipitation or the stomach Qi is damaged.

>

> 3)Be cautious using Da Cheng Qi Tang

> It is a strong formula. We cannot justify its usage (incomplete data

> provided here, such as pulse, tongue, form of stools) However, extra

> caution is needed when treating pregnant patient.

>

> Hope that helps.

>

> SUNG, Yuk-ming PhD (Chengdu)

>

>