Ulcerative Colitis

Abstract

Colitis is a term used to describe inflammation of the colon. Ulcerative colitis is a inflammatory ulcerative disease of the colon and rectum. Infections, poor blood supply, and autoimmune reactions cause colitis. Acupuncture has traditionally been used in treatment for inflammatory bowel disease in China. The objective of this study is to investigate the efficiency of acupuncture and moxibustion in the treatment of ulcerative colitis (UC). This report will identify the causes of colitis and identify how one can find healing through dietary changes, allopathy, acupuncture and herbal prescription. ayuvadic, food therapy, the biomat and the importance of alkaline water will be considered why they should be use as form of treatment.

Anatomy of the Colon

The colon is divided into six parts, the cecum, the ascending colon, the transverse, the sigmoid, the rectum, and the anus. The colon is responsible for collecting and storing waste and pushing undigested food towards the anus for elimination. Food is digested in the stomach, it passes through the small intestine where the nutrients are absorbed into the body for use. The wall of the colon has numerous layers. There is a smooth muscle layer that wraps the outside and is responsible for squeezing the undigested food through the length of the colon. The inner layer, or mucosa, comes into contact with the fluid and allows the absorption of water and electrolytes, which helps to solidify the feces. The mucosal layer is where the colon inflammation occurs and is responsible for the symptoms of colitis. The colon has a blood supply with arteries delivering oxygen rich blood and nutrients to it, and veins that drain carbon dioxide and lactic acid from it. Diseases, viruses or bacteria can cause colitis by decreasing the blood supply causing inflammation of the colon.

The Causes of Colitis

Viruses and bacteria can cause colon infections, several types exists, most are food-borne illnesses. Common bacterial such as Shigella, E Coli, Salmonella and Campylobacter can cause bloody diarrhea and can result in significant dehydration. Parasites such as giardia can cause significant diarrhea. The parasite can enter the body when infected water is swallowed. The source may be from recreational water such as rivers, lakes, and swimming pools. It may also be contaminated from a water well or cistern.

Pseudomembranous colitis is caused by the bacteria Clostridium difficile. Clostridium difficile is seen in patients who have recently been taking antibiotics for an infection. Antibiotic alters the normal bacteria present in the colon and allows an overgrowth of the Clostridium bacteria which produce a toxin that causes diarrhea. This type of diarrhea is usually not bloody.

Ischemic Colitis occurs when the arteries that supply blood to the colon have the potential to become narrow due to atherosclerosis. When these arteries become narrow, the colon may loose its blood supply and become inflamed. The colon can also lose its blood supply for mechanical reasons. A couple of examples include volvulus, where the bowel twists on itself, or an incarcerated hernia, where a portion of the colon gets trapped in an out pouching of the abdominal wall, which prevents blood from flowing to the affected portion. Ischemia or lack of blood supply causes significant pain, fever, and bloody bowel movements. In individuals who are at risk for decreased blood flow to the colon, ischemic colitis can occur if the blood pressure falls. This may occur with dehydration, anemia, or shock.

Ulcerative colitis is thought to be an autoimmune illness in which the body's immune system attacks the colon and causes inflammation. Ulcerative colitis begins in the rectum and may gradually spread throughout the colon. The signs and symptoms include abdominal pain and bloody bowel movements. Crohn's disease may involve any part of the digestive tract from the esophagus and stomach, through to the small and large intestine all the way to the rectum. It often has skip lesions, that is diseased areas are interspersed with healthy areas of tissue. Two diseases that make up Microscopic Colitis are collagenous colitis and lymphocytic colitis. Inflammation is caused when the colon wall becomes engorged with either collagen or lymphocytes. Watery, non-bloody diarrhea is the most common symptom. This illness is seen more frequently in older women. The cause is unknown but an autoimmune potential may exist.

 

Chemical Colitishappens when chemicals are instilled into the colon, inflammation and damage can occur. One of the complications of an enema is inflammation of the mucosal lining of the colon caused by harsh chemicals.

Symptoms of colitis will depend upon the type of colitis that is present, but in general, colitis most often is associated with abdominal pain and diarrhea. Other symptoms of colitis can include blood in the bowel movement may or may not be present. Diarrhea can sometimes cause hemorrhoids, which can bleed. Tenesmus, the constant urge to have a bowel movement may exist. Abdominal pain may come in waves, building to diarrhea, and then waning. There may be constant pain. Fever, chills, and other signs of infection and inflammation may be present depending upon the cause of colitis.

Blood in stools, colon cancer is another important cause of blood in the stool, and this symptom should not be ignored. The time of onset of symptoms, the duration of pain, the frequency of diarrhea, and whether there are any other associated complaints are questions that should be considered upon patient interview. It would also be important to know the lifestyle of an individual with, if an infectious cause is being considered. Recent travel, unusual diet, recent use of antibiotics may be consider as the cause. Medical history is also important to assess the risk factors for peripheral vascular disease or narrowing of the arteries. These include smoking, high blood pressure, high cholesterol, and diabetes. This may give direction to explore the cause for colitis.

Blood testing will help assess the stability of the patient and look for potential issues associated with colitis. Stool samples should be collected for culture, looking for infection as the cause of colitis. If a specific cause of colitis is not apparent, colonoscopy may be considered. Biopsies (small pieces of tissue) may be taken from the lining of the colon and examined by a pathologist.

IV fluids: Intravenous (IV) fluid may be required, especially if the patient cannot drink enough fluids by mouth. For some illnesses like ischemic colitis, in which blood flow to the bowel is already compromised, adequate hydration is a key element in treatment. Electrolyte replacement may be required in some patients who have significant dehydration.

After diagnosis, there are several effective treatments that can be considered. Of the many, North Americans are more familiar with Allopathic treatments. This type of treatment include Aminosalicylates (sulfasalazine, mesalamine), Corticosteroids (prednisone, budesonide), Immunomodulators (eg, azathioprine, 6-mercaptopurine), Antibiotics (eg, metronidazole, ciprofloxacin), Probiotics (Lactobacillus GG, Saccharomyces boulardii) and Biological agents (eg, infliximab) etc...

However these Allopathic treatments do not cure Colitis. They are merely a way of suppressing symptoms.[1] Alternative treatments have been proven to be more effective than taking a pill with associated side effects. We will now take a look at Chinese Medicine Ayurveda and food based healing.

Acupuncture

Spleen is the key organ involved in gastro-intestinal disorders. The Spleen has primary responsibility for "transforming" and "transporting" food essence in the body, and the excretion of waste. The Spleen needs to be moist in order to function well, but if it becomes deficient in Qi, it will become overwhelmed by moisture, and a pathological condition of Dampness (or Damp Heat) can settle into the body. The Stomach, on the other hand, needs to be on the dry side to function well, and when its balance is upset, it can easily overheat, and a painful condition of Stomach Fire can develop. Other organs, especially the Liver, can also contribute to gastro-intestinal distress.

The four most common patterns seen in Chinese Medicine are, Spleen Chi Deficiency, caused by chronic fatigue or chronic illness; Damp Heat Retention, caused by improper diet, environmental factors, or infections; Disharmony of Liver and Spleen, caused by emotional disturbance; and Spleen and Kidney Yang Deficiency, caused by chronic illness or aging. Healing techniques to treat patients with ulcerative colitis such as, Acupuncture, herbal formula and moxibustion. These modalities balance Yin and Yang, harmonize Qi and Blood, nourish the organs, and eliminate Damp Heat.

Point protocols include the following points.

KD4,5, UB23, Liv 11, 2,8 St 25,27, Ren 12.

RN4, Sp9, KD2 UB65, Lu9, UB54/40 LI11, St 36,SP1, SP3.

St 44, SP4, GB41, SP14, KD14, K7, RN9, UB35.

Herbal Formula

Xiao Yao San- For liver Qi stagnation with Liver Blood deficiency. Smooths liver Qi reduces irritation, strengthens Spleen tonifies blood.

Si Shen Wan- for Spleen Kidney Yang Deficiency; Day Break Diarrhea. For patients with poor appetite, chronic diarrhea, undigested food in stool, abdominal low back pain, colitis, Crohn’s disease. Warms and tonifies Spleen and Kidney Yang, astringes the intestines, stops diarrhea. Other herbal formulas include Shu Gan Wan, Chai Hu Shu Gan Wan, Jia Wai Xiao Yao San, Xiang LIan Wan, Zi Sheng Wan, and Xiang Shun Qi Wan.

Moxibustion

Moxibustion has been proven to be effective against certain types of inflammation such as colitis. Moxa is used to warm up cold conditions or tonify deficient conditions. [2] study done at Shanghai Acupuncture and Meridian Institute showed that moxibustion at acupuncture points St 36, Ren 12, and Ren 6 could effectively treat chronic ulcerative colitis. Colon mucus were observed under a microscope, the results showed that chronic mucositis (inflammation of the mucous layer of the intestinal wall) was decreased, neutrophil infiltration in epithelial cells disappeared, and crypt abscess and/or mucous ulceration were eliminated.

Auricular Points that Alleviate UC Symptoms

The large intestine, occiput, Rectum.C Shen Men, Small Intestine, Spleen C, Stomach and Sympathetic Autonomic Point of the ear are areas that should be considered for needling. The large intestine point clears excess heat from the bowel, it is used for constipation, diarrhea, enteritis, dysentery and respiratory diseases. Chad Bailey LA and Qi Gong instructor said, ‘A master of acupuncture treat disease as 98% of diseases emotionally related’. The Occiput region connects directly with the brain and the spinal cord. This point tranquilizes the mind, addresses headache, emotional disorders that can be affected by an infection as an additional point for healing. Rectum C affects the distal portion of the colon, hemorrhoids, hernia, colitis, fissures, fecal incontinence and regulates peristalsis. However medical attention is required if diarrhea, dehydration, fever, significant abdominal pain and blood in the stool exist. [3]

The use of Ayurveda for Ulcerative Colitis

There are two major forms of treatments in Ayurveda for ulcerative colitis, Vasti therapy (enemata) and oral medications. Normally, vasti therapy is administered first and followed by several months of oral medications. Panchakarma Therapies of varying duration are also strongly advised. There is no causative factor greater than Vata in the manifestation of diseases in the peripheral tissues, viscera of the thorax and abdomen, marma (vital points), upper region of the body, travelling throughout the entire body and those effecting individual parts.

Vasti (enema therapy) is regarded by all the ancient vaidyas as the most important panchakarma procedure. The reason in part is that vasti promotes the elimination of excess Vata dosha from the body, and Vata dosha is the root of the majority of diseases, which afflicts mankind. It is the moving force in the physiology, which governs the formation, interaction, spread, and elimination of all biological substances and waste products. It is also the force that propels the other disease out of their normal seats and shrotas into the peripheral tissues. Being the principal treatment of this most influential of biological energies, Vasti Karma is of paramount importance in any regimen of panchakarma Therapies. Two types of vastis are always used: anuvasana (oil-based) and niruha (decoction-based). They are given for a period of either eight or sixteen days in alternating order. [4]

The following specific foods are generally recommended in Ayurveda for patients of ulcerative colitis. Old basmati rice for three months, barley, saffron, coriander, cumin, fennel, navy beans, kidney beans, green lentils, cow's milk and butter, goat's milk and butter, almonds, water chestnut, pomegranate, banana, mango, limes, and kiwi fruit. Foods to be reduced or avoided are all leftovers, spicy foods, white sugar, wheat, pasta, red grapes, vinegar, mustard, salty and acidic foods.

Food Based Healing Protocol

The most recurrent gastric ulcer reported in 1994 were caused by H. Pylori bacteria. H pylori bacteria weakens the protective mucous coating of the stomach and duodenum which allows acid to get through to the sensitive lining. The bacteria and stomach acid irritate the lining causing sores or ulcers. UMF is a phytochemical that comes from nectar of the Manuka flower, honey made from the Manuka help people with ulcers and other bacterial infections. Mastic Gum kill H. Pylori. The following are recommended food choices while fighting UC.

In a blender mix fruit and veggie smoothie made with bananas, blueberries, Cabbages is the mighty stomach healer, high in anino acid glutamine and enough water to get it going. Bowl of porridge made with white rice (2 cups of water for 1 cup of rice), a small handful of raisins (cooked for at least 5 minutes), and a sprinkle of cinnamon and 1 teaspoon of raw or unpasteurized honey. Green smoothie made with 2-3 peaches, 2 tablespoons of blueberries or blackberries, 2 big handfuls of spinach, and enough water to blend everything together.

Steamed sweet potato, avocado, and one or two soft boiled eggs. Steamed zucchini, avocado, and a potato-based soup. Please see our archive of healthy soup recipes for several potato-based soup ideas. White rice (1.5 cups of water for 1 cup of rice), steamed cabbage, and hummus. Quinoa (2 cups of water for 1 cup of quinoa), avocado, and steamed butternut or acorn squash. I recommend taking one teaspoon of cod liver oil per 50 pounds of body weight right before or with dinner. White rice (1.5 cups of water for 1 cup of rice) with chickpeas and avocado, dressed with extra virgin olive oil and fresh lemon juice, to taste. Avocado-orange salad with raw or steamed wild salmon. Quinoa (2 cups of water for 1 cup of quinoa) with mashed garlic sweet potatoes and avocado. Steamed zucchini, steamed carrots, steamed red beets, and sardines.[5]

In addition to food based healing, it is important to note the amount of toxins that accumulate in the body preventing adequate absorption of nutrients while undergoing a complete healing regime. It would be wised to consider using other tools for healing such as hydrotherapy, the use of a Biomat. Biomat technology is a combination of far infrared rays that produce negative ions effect through amethyst crystals delivering heat while stimulate the regeneration of damages cells in the body. It helps improve antioxidant levels, leaves the body and mind relaxed. The Biomat is efficient in body detoxification and immune system resilience. I would send patients home with free bottles of high alkaline drinking water. Alkaline water restores balanced and improved immune function and resistant to acidic environment. Ionized water neutralizes the build up of acidity in the body and restores the pH balance to an ideal range between 7.35 and 7.45. It encourage detoxification and plaque breakup that clog our systems that prevent nutrients from being absorbed, so that the body can process the nutrients it needs for better heath. Often patients dealing with colitis will be need to frequently dehydrate. Alkaline water molecules are reduced in size, more complete cellular absorption and rehydrates more efficiently.

 

Autointoxication is the result from being poisoned by one’s own waste, incomplete elimination of waste matter from the intestines turns parts of the body in to an area of accumulated toxins. Clear fluid/liquid diet allows the colon to rest, since the fluid is absorbed in the stomach and none is passed into the colon to be processed as stool.

 

Hydrotherapy is an effective colon cleaning therapy that eliminates large amount of waste that has been trap for several years. It removes toxic waste, tones hydrates and rejuvenates the colon muscle. Colonic irrigation help restore the colon’s natural shape, stimulates the reflex points that connect the colon with other parts of the body. 70-80 percent of the immune tissue resides in the intestines. Cleaning the colon from immune suppressive toxic wastes will improve nutritional absorption, and any other health programs will become more effective.

 

Hydration: Adequate hydration an individual can lose a significant amount of fluid with each diarrheal bowel movement.

 

Conclusion

Considering a more alternative route will lead to a long lasting recovery. However the decision is life changing and will require developing better eating habits. I would encourage a patient to consider a detox in addition to following an Alternative Medicine Therapy plan before considering the Allopathic route. All methods should be considered with guidance. I would recommend a protocol that would start with a Detox, followed by food based healing and juicing. Juicing will improve the digestive tract health and eliminate toxins and provide nutrition to the cells that have been damage. However Many colitis patients are underweight and would not be able to sustain a juice therapy fast of several days.

What juices are best for juice therapy? Carrot and apple juice are the top choices. During the liquid juice therapy fast, two types of herbal tea – slippery elm and comfrey – may be consumed. Both teas should be taken warm. I would also recommend regularly eat foods that are rich in omega-3 fatty acids. Ulcerative colitis is strongly associated with immune system dysfunction. An adequate blood level of Vitamin D is necessary to optimally support a healthy immune system. Vitamin D can be obtained from healthy exposure to the sun. It can also be obtained from healthy food sources such as wild salmon, organic eggs, a high quality source of cod liver oil, and sardines. Minimize intake of sugar and refined carbohydrates. Most importantly, give careful consideration to chronic emotional stressors.

Simultaneously, then introduce the Chinese Medicine for emotional and physical health for the long term or until symptoms have completely subsided.

 

 

 

 

 

 

 

References

Medicine, Wei Liu TCMD, Gastrointestinal Disorders in Chinese www.tcmpage.com/hypgastrotinest.html

 

National Institute of Ayurvedic Medicine, www.niam.com

 

Auriculo HD Application, Miridia Technology

 

Conquering Any Disease The Ultimate High Phytochemical Food Healing System, Jeff Primack.

 

www.altmeds.com/juice-therapy/articles/juice-therapy-to-treat-ulcerative-colitis

 


[1] Colitis Alternative Treatment, www.Curezone.com

[2]Medicine, Wei Liu TCMD, Gastrointestinal Disorders in Chinese www.tcmpage.com/hypgastrotinest.html

[3] Auriculo HD Version 2 Miridia Technology

[4] National Institute of Ayurvedic Medicine, www.niam.com

[5] Dr. Ben Kim, Ulcerative Colitis Diet Plan, www.drbenkim.com/articles-ulcerative-colitis-diet.htm