Diarrhoea
Definition
Western
Diarrhoea refers to the condition of having three or more loose or liquid bowel movements per day. Relatively, it could also refer to an increased number of bowel movements per day compared to the usual number of daily bowel movements. Having loose or liquid stools without the increase in the number of daily bowel movements is defined as relative diarrhoea.
Traditional Chinese Medicine (TCM)
Xiexie (泄泻), or diarrhoea, refers to increased frequency of defaecation, loose stools or stools containing undigested materials or even watery stools. Chronic condition is defined as xie(泄), while an acute and urgent condtion of watery stools is defined as xie(泻).
Classifications or Symptoms Displayed in TCM Context
Respiratory conditons
Loose or liquid stools, poor appetite, stomach pains with growling noise, may also be present with fever, and aversion to cold or headache.
Inflammatory conditions
Stomach pains with urge to defecate, pungent brownish-yellow stools, burning sensation around anus, thirst, yellow urine, red tongue with thick yellow coat, fast pulse.
Indigestion
Stomach pains, stools with strong rotten-egg smell, pain relief upon defaecation, stomach bloatedness, no appetite with thick tongue coat.
Weak Digestive System
Long periods of loose stools, poor appetite, stomach bloatedness after meals, intolerant to spicy and oily foods, fatigue and yellowish skin tone.
Poor absorption
Loose bowel movements at dawn time, stomach grumbles prior to defaecation, and stools may contain undigested materials upon exit.
Stress-related Syndrome
Loose bowel movements with grumbling noises, abdominal pains, frequent gas release, chest tightness, belching, poor appetite, triggered by stress or emotional changes.
Causes
Mal-absorption
Enzyme deficiency, mucosal abnormality or structural defects can lead to the inability to absorb nutrients from the food intake. Enzyme deficiencies include conditions like lactose intolerance and sucrose intolerance.
Infection
Bacteria, parasites and viruses can cause diarrhoea. They enter the body through the oral cavity into the digestive tract. Common viruses that cause diarrhoea include rotavirus, norovirus, adenovirus. Bacterial sources include campylobacter, salmonella, shigella and Escherichia coli. Other causes of infections include bacterial toxins and parasites such as Giardia.
Risk Factors
Lifestyle
Emotional stress, anxiety can result in diarrhoea. Irregular meals or not having adequate amount of rest can lead to weakened digestive and immune system. Good habits such as hand-washing before meals can help to minimise ingestion of bacteria and viruses.
Treatments
Herbs commonly used in prescriptions:
1. Shan Yao –山药
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English/ Common name
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Chinese Yam
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Latin species
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Rhizoma Dioscoreae
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Park of plant used
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Rhizomes
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Action/s
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Found to have anti-inflammatory effects, helps to relieve diarrhoeaand improve digestion [1-5].
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Precaution/s
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No significant side effects.
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2. Yi Yi Ren – 薏苡仁
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English/ Common name
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Coix Seed
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Latin species
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Semen Coicis
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Park of plant used
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Seeds
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Action/s
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Helps to relieve diarrhoea, promote urination to calm swelling, help with digestion and reduce pus [6-7].
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Precaution/s
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Pregnant women should avoid taking this herb.
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3. Shan Ren – 砂仁
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English/ Common name
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Villous Amomrum Fruit
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Latin species
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Fructus Amomi
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Park of plant used
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Fruit
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Action/s
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Found to have anti-inflammatory effects and helps to improve digestion [8-9].
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Precaution/s
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Not suitable for patients with symptoms such as night perspirations, flushed cheeks, warm palms and soles.
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4. Huo Xiang – 藿香 (Huo Xiang)
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English/ Common name
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Wrinkled Gianthyssop
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Latin species
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Agastache rugosa
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Park of plant used
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Leaves and stems
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Action/s
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Helps to arrest diarrhoea [10-12].
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Precaution/s
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No significant side effects.
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5. Sheng Jiang – 生姜
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English/ Common name
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Ginger
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Latin species
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Zingiber officinale Roscoe
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Park of plant used
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Root tubers
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Action/s
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Found to have anti-inflammatory effects, helps to warm the body in attempt to induce perspiration to lower body temperature, improves digestion, arrest vomiting and nauseous [13-15].
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Precaution/s
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Not suitable for patients with symptoms such as night perspirations, flushed cheeks, warm palms and soles.
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While oral medication is effective as it arrives at the site of problems (the colons), other treatments such as acupuncture can help to relieve symptoms.
Test & Diagnosis
Physical Examination
Physical examination of the abdomen for tenderness or masses.
Tests for Possible Infections
Stools are often examined to see what is the nature of diarrhoea, while blood tests check for signs of infections or other abnormalities.
Lifestyle and Home Remedies
It is important to replenish fluids lost during diarrhoea by taking in plenty of water. Avoid cold drinks, alcohol and caffeine as they can worsen the condition. If the condition is due to intolerance of certain food products, simply avoid them during this time. While having diarrhoea, it is also advisable to eat food that is easy to digest.
Chinese Yam + Rice + Ginger + Red dates
a) Cut the Chinese yam into small slices or cubes. Cut the ginger into slices.
b) Put all ingredients in a cooking pot and pour enough water to fill half the pot.
c) Bring to boil for 10 minutes.
d) Simmer for a further 15 minutes to make sure all grains are softened.
e) Remove from heat. Add salt or sugar to taste. Serve warm.
References
1. S.-C. Lee, C.-C. Tsai, J.-C. Chen et al., Effects of “Chinese yam” on hepato-nephrotoxicity of acetaminophen in rats. Acta Pharmacol Sin 23 (2002), p. 503.
2. S.C. Lee, C.C. Tsai, J.C. Chen, C.C. Lin, M.L. Hu and S. Lu, The evaluation of reno- and hepatoprotective effects of huai-shan-yao (Rhizome Dioscoreae), Am. J. Chin. Med. 30 (2002) (4), pp. 609–616.
3. Y.Q. Zhao and A.F. Wang, Pharmacological advances of Chinese yam, Traditional Chinese Medicine Research 13 (2000), pp. 49–51.
4. Y.F. Zuo and D.C. Tang, Science of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine Press, Shanghai, China (2003) pp.301–303.
5. G.H. Nie, K.F. Zhou, X.H. Dong and C. Zhang, Research advances of yam, Chinese Traditional Herbal Drugs 24 (1993), pp. 158–160.
6. D.P. Li, Research advance on ethnopharmacology, pharmacodynamics, pharmacokinetics and clinical therapeutics of Coix seed and its preparation, Kanglaite injection, Asian Journal of Pharmacodynamics and Pharmacokinetics 6 (2006), pp. 83–102.
7. D. Normile, The new face of traditional Chinese medicine, Science 299 (2003), pp. 188–190.
8. J.G. Yu, L. Sun and L.D. Zhou, Studies on the chemical constituents of Fructus Amomi, Chin. J. Chin. Mater. Medica 22 (1997), p. 231-234.
9. Guo DJ, Cheng HL, Chan SW and Yu PH., Antioxidative activities and the total phenolic contents of tonic Chinese medicinal herbs,Inflammopharmacology. 2008 Oct;16 (5):201-7.
10. J.H. Hong, J.H. Choi, S.R. Oh, H.K. Lee, J.H. Park, K.Y. Lee, J.J. Kim, T.S. Jeong and G.T. Oh, Inhibition of cytokine-induced vascular cell adhesion molecule-1 expression; possible mechanism for anti-atherogenic effect of Agastache rugosa, FEBS Letter 495 (2001), pp. 142–147.
11. C.H. Lee, H.N. Kim and Y.E. Kho, Agastinol and Agastenol, Novel Ligans from Agastache rugosa and their evaluation in an apoptosis inhibition assay, Journal of Natural Products 65 (2002), pp. 414–416.
12. Oh SR, Jung KY, Lee HK. In vitro anticomplementary activity of phenylpropanoids from agastache rugosa. Korean Journal of Pharmacognosy. 1996; 27(1):20-5.
13. W.H. Wang and Z.M. Wang, Studies of commonly used traditional medicine-ginger, Journal of China Chinese Medicine 30 (2005). 30 (2005), pp. 1569–1573.
14. L.C. Tapsell, I. Hemphill, L. Cobiac, C.S. Patch, D.R. Sullivan, M. Fenech, S. Roodenrys, J.B. Keogh, P.M. Clifton, P.G. Williams, V.A. Fazio and K.E. Inge, Health benefits of herbs and spices: the past, the present, the future, Med. J. Aust. 185 (Suppl. 4) (2006), pp. S4–S24.
15. M. Afzal, D. Al-Hadidi, M. Menon, J. Pesek and M.S. Dhami, Ginger: an ethnomedical, chemical and pharmacological review, Drug Metab. Drug Interact. 18 (2001), pp. 159–190.
16. R. Grzanna, L. Lindmark and C.G. Frondoza, Ginger – an herbal medicinal product with broad anti-inflammatory actions, J. Med. Food 8 (2005), pp. 125–132.