TCVM Approach to Inflammatory Bowel Disease

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TCVM Approach to Inflammatory Bowel Disease
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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
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IBD

• Ulcerative colitis
• Crohns disease (regional enteritis)
• Systemic disease (arthritis, uveitis, liver
  disease, etc.)

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Crohns disease vs Ulcerative colitis
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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

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IBD- -Causes

• Infectious
• (Damp-Heat)
• Dietary
• (Stomach Heat/Stagnation)
• Genetic
• (Kidney Jing)

Diagnosis usually by biopsy
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IBD- -Treatment

• Anti-infectives
• Sulfasalazine (Azulfidine)
• Dietary
• Diet elimination
• Vitamin support (all but high vitamin C)
• Western herbals
• Bromelain/curcumin
• Ginger
• Cats Claw
• Immunosuppressive

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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)

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TCM Pathology of IBD

• Excess
• Heat Toxin/Damp Heat
• Qi/Blood Stagnation
• Deficiency
• SP Qi Deficiency
• Parvovirus

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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

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Qi-Blood Stagnation

• Signs
• Chronic diarrhea with stink smell
• Abdominal pain
• Vomiting
• Loss of appetite
• Tongue
• Purple or red
• Pulse
• Wiry

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Spleen Qi Deficiency

• Signs
• Chronic diarrhea with undigested material
• Anorexia
• Loss of body weight (muscle mass)
• Exercise intolerance
• Tongue
• Pale
• Pulse
• Deep weak

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Parvovirus

• Signs
• Bloody diarrhea with mucous and/or foul odor
• Anorexia
• Vomiting
• Tongue
• Red dry
• Pulse
• Fast (superficial or deep)

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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

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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