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TCVM Approach to Inflammatory Bowel Disease IBD • Group of GI disorders with inflammatory infiltrates in the lamina propria of SI & LI • Damage from tissue cytokines • Caused by • Genetic factors • Environment Feline IBD touch prep IBD • Ulcerative colitis • Crohn’s disease (regional enteritis) • Systemic disease (arthritis, uveitis, liver disease, etc.) Crohn’s disease vs Ulcerative colitis IBD- -Signs • Dogs: • Chronic vomiting, diarrhea, weight loss • Cats • Vomiting followed by diarrhea • Other signs • Flatulence, gas, altered appetite, abdominal pain & mucois stools • Dry hair coat • Thickened loops of bowel on palpation IBD- -Causes • Infectious • (Damp-Heat) • Dietary • (Stomach Heat/Stagnation) • Genetic • (Kidney Jing) Diagnosis usually by biopsy IBD- -Treatment • Anti-infectives • Sulfasalazine (Azulfidine) • Dietary • Diet elimination • Vitamin support (all but high vitamin C) • Western herbals • Bromelain/curcumin • Ginger • Cat’s Claw • Immunosuppressive Mechanism of Action of Azulfadine • Antibacterial activity • Local and systemic immunity-lymphs, IgG • Arachidonic acid metabolism-PG, Thr, leukotrienes • Free radical scavengers (5-ASA) • Inhibit PAF, histamine release (mast cells) TCM Pathology of IBD • Excess • Heat Toxin/Damp Heat • Qi/Blood Stagnation • Deficiency • SP Qi Deficiency • Parvovirus Heat Toxin/Damp Heat • Signs • • • • • Bloody/watery diarrhea (mucoid) with foul smell Acute Heat signs (nose/ears) Vomiting Thristy • Tongue • Deep red yellow coating • Pulse • Superficial/Deep and fast Qi-Blood Stagnation • Signs • • • • Chronic diarrhea with stink smell Abdominal pain Vomiting Loss of appetite • Tongue • Purple or red • Pulse • Wiry Spleen Qi Deficiency • Signs • • • • Chronic diarrhea with undigested material Anorexia Loss of body weight (muscle mass) Exercise intolerance • Tongue • Pale • Pulse • Deep & weak Parvovirus • Signs • Bloody diarrhea with mucous and/or foul odor • Anorexia • Vomiting • Tongue • Red & dry • Pulse • Fast (superficial or deep) TCM Treatment of IBD • Heat Toxin/Damp Heat • Great Saussurea Coptis • Qi/Blood Stagnation • Xiang Lian San • SP Qi Deficiency • Shen Ling Bai Zhu • Parvovirus • Red Back Door Great Saussurea Coptis Saussurea Mu Xiang Move Qi & relieve pain Coptis Huang Lian Clear Damp-Heat in the intestines Evodia Wu Zhu Yu Warm the middle Jiao & stop vomiting