BY Craig Williams, LAC, AHG
One of the most common presentations in the clinical setting is digestive complaints. Almost daily I see patients presenting with a wide array of digestive issues ranging from simple issues such as gas or bloating to complex issues such as IBS or chronic food allergies. The other commonality that I encounter in these clinical issues is the respective patients bringing in bags of digestive supplements. This usually includes basic to complex digestive enzymes and probiotics. The troubling aspect of this presentation is that the majority of these patients are referrals from other acupuncturists. Why would practitioners of Chinese medicine, with all the years of training, resort to prescribing basic digestive supplements over effective TCM formulas based on pattern presentation? Therefore, I will discuss two TCM formulas with specific modifications, that I use extensively in cases of digestive disorders. They also more effectively treat a wide array of digestive challenges versus generic digestive supplements. Liu Jun Zi Tang This is one of the most foundational formulas for a wide spectrum of digestive disorders. This formula boosts Spleen Qi, harmonizes the Stomach and transforms Phlegm. The typical tongue presentation for this formula is normal to pale, and swollen with teeth marks. In cases of digestive disorders, heat is often present causing the tongue to be red to scarlet and in these cases, the formula can easily be adapted or combined with another formula to target Spleen Qi Vacuity with heat complications. I often use this formula for patients with a combination of chronic digestive challenges and chronic allergies. Liu Jun Zi Tang is highly effective for resolving chronic low-grade phlegm complications that result in chronic bloating and vague digestive complaints. This can easily be combined with Chai Hu Shu Gan Wan in such cases, which almost always includes Liver Depression Qi Stagnation. In cases of digestive issues with chronic phlegm with the patient complaining of a chronic cough or mucus in the throat, combine Liu Jun Zi Tang with Ban Xia Hou Po Tang. In cases of significant phlegm or damp, use the modified Xiang Sha Liu Jun Zi Tang which adds Mu Xiang and Sha Ren with the foundational formula. This will more effectively clear and transform phlegm and dampness, two issues so common in chronic digestive issues and chronic allergies. One of the most effective formulas to combine with Liu Jun Zi Tang is Jia WeiXiao Yao Wan. This is an extremely powerful formula combination for any digestive disorder with Spleen/Liver disharmony with concomitant heat. These two formulas often resolve long-standing digestive issues which have been ineffectively treated with the band-aid of generic digestive enzymes or probiotics. If the patient has significant issues with loose stools as a main symptom of the respective digestive complaint, combine Liu Jun Zi Tang with Shen Ling Bai Zhu Tang, a highly effective formula combination which often resolves conditions which probiotics seem unable to effectively resolve. Bao He Wan This is perhaps the most important formula in my clinical repertoire when dealing with digestive complaints. I'm constantly shocked at how clinicians seem to ignore this highly effective TCM formula and resort to using generic digestive supplements instead. This formula is essentially a modified Er Chen Tang with the addition of Ban Xia and Fu Ling. This can be used for food stagnation, clears heat, dispels damp, descends the Stomach Qi and promotes digestion. Very few formulas can target so many aspects of the digestive system as well as clear heat. This formula can be highly effective in patent medicines and can be used in a relatively high dose to resolve hard to diagnose or recalcitrant digestive complaints. The tongue presentation is typically a red body with a greasy yellow or white coat, often sticky in consistency. This formula can be combined in with Spleen tonics such as Bu Zhong Yi Qi Tang or Xiao Yao Wan in complex cases of stagnation and heat which often go unresolved when patients are prescribed generic digestive enzymes or probiotics. This formula can be taken with food or on an empty stomach and works fairly quickly to assuage symptoms as well as resolve more complex underlying disease mechanisms. Bao He Wan is a key formula for holiday overeating, as well as for digestive issues which can occur while traveling. This formula can also of course be combined with the aforementioned Liu Jun Zi Tang in cases of complex and hard to treat digestive presentations. One wonders why TCM practitioners would ignore the vast array of TCM formulas which target the patterns behind digestive disorders and blindly prescribe generic digestive enzymes or probiotics. While I have no issue with the use of digestive supplements and do occasionally employ them in the clinical setting, the average patient I see in my clinic has already been self-medicating with digestive enzymes/probiotics with poor to average results. Although they may feel slightly better, once they stop the digestive supplements, the symptoms reappear and the digestive complaints remain essentially unresolved. These are the cases in which TCM can excel, and in which TCM clinicians should employ pattern diagnosis to effectively target the root causes instead of seeking to constantly trim the branch symptoms. I hope this information inspires clinicians to put aside generic supplements and strive to use the rich treasure chest of Chinese medicine to help improve the lives of patients suffering from digestive complaints.
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