Inflammatory Bowel Disease is a general term for chronic inflammation of the Bowels. There are 2 main types:

• Ulcerative Colitis: inflammation of the Bowel with sores and ulcers.
• Crohn’s Disease: is marked with a chronic inflammation in the digestive tract, usually involving deeper layers of the mucosa. It typically affects the small intestine but can involve the large intestine or upper gastrointestinal tract.

The primary symptoms include abdominal disocomfort or pain, diarrhea with or without blood or mucus, weight loss, indigestion, loss of appetite and fatigue. It can range from mild, almost asymptomatic to a severe and even life-threateneing disease.

Causes according to modern mediicne are uncertain. However, it is probably an autoimmune disease in most cases and there is also gene mutations associated with IBD meaning that it is more common in people with a family history of the disease.

Traditional Medicine

In Traditional medicine it is generally classed as a type of Diarrhea, and remediies used for Diarrhea and Dysentery in the past are generally those most useful for IBD.

In most chronic cases there is a clear aspect of Spleen (Digestive) deficiency/ Qi deficiency, or Yang Deficiency. This is manifested by the fatigue, poor appetite and digestion, the digestive sensitivity seen in most cases, and the general weakness and loss of weight. Pulse and tongue will also generally indicate deficiency. Yang deficiency will include signs of coldness.

Differential diagnosis according to Traditional Medicine:

• Heat/Bile: burning stool and rectum, diarrhea with foul-smelling stool, red face and face, irritable, red tongue with yellow coat, big pulse
• Phlegm/Damp: diarrhea with is watery, no burning, generally not as foul smelling, feels cold, pale face, weak and slow pulse
• Wind/Qi stagnation: rumbling and bloating in the abdomen, explosive diarrhea, nervous disposition, worse with stress, cramping abdominal pain, tight pulse
• Spleen deficiency: fatigue, weakness, pale face, poor appetite, indigestion, loose bowels, pale face, low and weak pulse

Other pathologies that can also be related are Kidney weakness, Yang deficiency, Dishharmony between the Liver and Spleen, Damp-Heat etc.

Treatment:

Choice of formula will be related to differential diagnosis. However, astringent medicines will play an important role as long as they are combined with appropriate other medicines, according to the individual; for example, medicines to clear Heat, or medicines to clear Phlegm and Damp, for example.

In general, the majority of cases require Spleen/Digestive tonics. In an acute flare-up or period of aggravation of symptoms, medicines are used to directly treat the acute condition. But in the majority of cases, a long continuation of symptoms would require use of strengthening medicines along with astringents and other necessary medicines according to the individual. After symptoms have been controlled, an extended course of Spleen/Digestion and Qi strengthening medicines should be used to prevent relapse. Xiang Sha Liu Jun Zi Tang and Bu Zhong Yi Qi Tang are 2 very useful formulas from TCM for this purpose.

It is worth mentioning that Triphala-based medicines can be very good in such chronic digestive diseases. This is because Triphala is primarily used as a digestive regulator; it harmonises the 3 main energies of digestion in the Ayurvedic system. It is both mildly astringent, but also cleansing, and so is viewed as separating the good from the bad. It has also demonstrated anti-inflammatory effects as well as being viewed as a health tonic, able to restore strength and vitality. It is also very safe and well-tolerated. Triphera Minor (Triphera Phoenonis, Triphera Minus) of Mesue is one such formula, used for chronic Leakage including Diarrhea. It is based on Triphala and also contains Frankincense and Cyperus rotundus, another important anti-inflammatory medicine. Electuary of Micleta (Nicholas)
is likewise a useful Myrobalan-based formula.

One last important point is the involvement of Blood stasis in most chronic inflammatory processes. The end result of chronic inflammation may involve excess cellular debris in the area starving local tissues of good blood supply. In addition, the chronic inflammatory process itself leads to fibrosis which is also associated with Blood Stasis, from a traditional point of view. So many cases will benefit from the addition of Blood-moving medicines, with 2 of the most important, well researched Blood-moving anti-inflammatory medicines being Frankincense (Olibanum) and Turmeric.

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Special Formula

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Research:

1. A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease
2. Herbal and plant therapy in patients with inflammatory bowel disease
3. Efficacy of Rose Oil Soft Capsules on Clinical Outcomes in Ulcerative Colitis: A Pilot Randomized, Double-Blinded, Placebo-Controlled Clinical Trial