Practical Applications

 

Gastrointestinal Disorders

              

The gut does not operate as a stomach, small and large bowel – it acts as a whole system and incorporates the liver, gallbladder and pancreas. The gut is neurologically controlled by the parasympathetic nervous system, mainly the vagus nerve and the extensive enteric nervous system and therefore has a very integrated relationship with the central nervous system and the emotional midbrain. Many patients are so-called ‘gut manifesters’ and will always manifest gut symptoms when stressed. One sees these belly achers in school children, the colicky babies and the infants with jaundice.

The Gastrointestinal System, Allostasis and the Allostatic Load

Of all the bodily systems, the gut is the most affected by the allostatic response to stress. Firstly, as all the sympathetic acute response switches are turned on, the parasympathetic nervous system, which incorporates the entire gut and its associated organs of liver, gallbladder, pancreas and spleen are inhibited and the vagus nerve is turned off. Secondly, having such a well-developed nervous, immune and endocrine system – the three legs of the allostatic response – the gut cannot help but be involved in the whole stress/allostatic response. In general, the entire activity of the gut is either toned down or turned off, and this includes nutrient absorption, immune responses, maintenance and repair, and interaction with the brain. These gut responses are mediated by the hypothalamus and midbrain with a very significant input from the emotions. Different emotions can be seen to have a definite physiological effect on bowel mucosa when monitored in real time as seen in the following table.

Table 1 Effects of different emotions on the gastrointestinal tract

Fright and depression	Anger and resentment
Pallor of mucosa	Hyperaemia of mucosa
Reduced acid secretion	Accelerated acid secretion
Reduced gastric motor activity	Increased motor activity

Chronic activation of the acute stress response leads to chronic down regulation of the entire gut physiology with the consequent disturbance of nutrition and the immune system as mentioned above.

Figure 1. demonstrates the brain-gut interactions mediated through the central and enteric nervous systems.

Integral Protocols in GI Treatment

Although the gut is a continuous physiological and anatomical organ, it has commonly been separated into its anatomically recognizable organs for assessment and treatment. Its associated embryological entodermal connected organs are also not given any credence by Western medicine in its function and pathophysiology. Traditional Chinese Medicine recognizes the relationship between then Liver, Pancreas, Spleen and the hollow tube that comprises the oropharynx, esophagus, stomach, duodenum, ileum, cecum, colon and rectum. Many of the symptoms ascribed to portions of the bowel actually take their origin from the Liver and the Spleen and should be treated at that root level.

The Chinese herbal combinations labeled as GI in the InteMedica portfolio are designed to take into consideration both the root causes and the acute presenting manifestations. This is also true of the Homeopathic combination formulas which address patient’s individualized symptoms from both a general and specific point of view. The bowel flora has a marked influence on the physiology and immune activity of the bowel as a whole, and will be discussed.

Symptoms and Treatment

From a purely practical point of view, it is easier to address specific symptoms and their associated dysfunctional organs following the anatomical movement of food down the gut. Therefore, we can start at the esophagus and end at the rectum. In general, the stomach and the colon are the two parts of the bowel that produce the most symptoms, whilst the small bowel, although not that symptomatic, is probably more important in terms of the immune system and neuroendocrine activity.

InteMedica Integral™ Gastrointestinal System Formulas

InteMedica has evolved a system of rebalancing the allostatic dysregulation and the allostatic load for the gut that addresses the core issues surrounding gut dysfunction, and combines the best of Homeopathic formulas, nutritional support and Chinese herbal combinations.

Guidelines on Using the InteMedica Gastrointestinal Health System

You should begin by using the InteStatto assess the contribution of the Liver or Spleen to the pathogenesis of the symptoms. The InteStat will indicate TCM herbal formulas as well as Homeopathic formulas to be used as an Integral Protocol™. Disturbances of the Liver and Spleen cause non-ulcer dyspepsia, GERD, irritable bowel syndrome, constipation and diarrhea.

All Homeopathic formulas may be taken at the same time and dissolved under the tongue for an additional effect. You do not have to decrease your dosage with multiple formulas.

Chinese Herbal formulas may be taken together, but if you are using more than one formula at the same time, decrease the dosage. For example: if you are taking GI-IND and GI-EMB then reduce the dose from 3 capsules 3x/day for each, to 3 capsules 2x/day of each, or 2 capsules 3x/day of each.

There are 4 components to the average Chinese herbal combination. They are named in order of importance:

The Emperor: 1-2 herbs that give the herbal combination its basic characteristic actions. They may not be the greatest percentage of the formula, just the most important clinical herbal directive; they act as leader of the script.

The Minister: Up to 5 herbs in number. Their job is to help the Emperor herbs in their activities. They enhance, augment or broaden the effect of the Emperor.

Assistant: Between 7 to 10 herbs to counteract any side effects of the first two combinations and to further customize the blend to the patient’s picture. They will modify the energy of the formula closer to neutral. They can also address secondary symptoms.

Servant: Enables the mixture to increase circulation, to be harmonious, well absorbed and tolerated by the patient. The servants may be used as a dispensing agent or to give flavor or texture. It is usually Liquorice - Gan Cao.

QUICK GUIDE TO FORMULAS

GI	Nausea/Indigestion (HX)
GI-IND	Indigestion, non-ulcer dyspepsia (TCM)
GI	Stomach (Heartburn) (HX)
GI-HRB	Heartburn, Gastroesophageal Reflux Disease (TCM)
GI-EMB	Emotional bowel dysfunction (TCM)
GI	Diarrhea (HX)
GI-DHR	Diarrhea (TCM)
GI	Constipation (HX)
GI-CON	Constipation (TCM)
GI-YST	Large intestine dysbiosis and yeast overgrowth (TCM)
GI-ENZ	Digestive enzymes (TN)
GI-DTX	Gastrointestinal detox (TN)
GI-ATB	Gastrointestinal antibiotic support (TN)

General and Functional Bowel Symptoms

Symptoms of nausea, discomfort and spasm can be felt and experienced at any level of the gut, so these formulas may be used together with any other specific formula. These formulas include:

1. GI Nausea/Indigestion – a complex Homeopathic formula addressing the vagal nerve, liver and stomach inputs and reactions that cause nausea, vomiting, dyspepsia and upper abdominal discomfort.

Homeopathic	Potency	Homeopathic Action
Anacardium orientale	6X	Nausea after eating
Antimonium crudum	6X	Fullness, discomfort
Argentum nitricum	6X	Belching and epigastric pain
Chelidonium majus	6X	Liver and Gallbladder complaints
Cinchona officinalis	6X	Flatulence, Gallbladder colic
Arsenicum album	12X	Burning pain and vomiting
Carbo vegetabilis	12X	Eructions, fullness
Ipecacuanha	12X	Nausea, vomiting
Lycopodium	12X	Flatulent colic, constipation
Nux vomica	12X	Nausea, pain, pressure
Robinia pseudoacacia	12X	Acidity and acrid belching

2.  GI-IND – a complex Chinese herbal formula that addresses increased allostatic load in stomach, spleen and pancreatic function. This disturbance is seen as patterns of poor appetite, tiredness, a feeling of fullness, distention and pain in the epigastrium, poor digestion, and loose stools.

TCM Name	English Name	Action
Dang Shen	Codonopsis Root	Increases stomach energy
Bai Zhu	Bai-Zhu Atractylodes Rhizome	Increases stomach energy
Shan Yao	Chinese Yam Rhizome	Stimulates vagal activity
Ban Xia	Pinellia Rhizome	Increases Sympathetic Nervous System
Fu Ling	Poria Sclerotium	Diuretic action
Huang Qi	Astragalus Root	Increases stomach energy
Tai Zi Shen	Pseudostellaria Root Tuber	Stimulates vagal activity
Da Fu Pi	Betelnut Palm Pericarp	Stimulates digestion
Zhi Ke	Bitter Orange Nearly Mature Fruit	Increase peristalsis
Sha Ren	Chinese Amomum Fruit	Stimulates digestion
Huo Xiang	Chinese Giant Hyssop Aboveground Parts	Antibacterial and viral
Mu Xiang	Costus Root	Regulates stomach energy
Bai Bian Dou	Dolichos Seeds	Stimulates vagal activity
Shen Qu	Medicated Leaven (Massa fermentata)	Increases digestion
Zi Su Ye	Perilla Leaf	Modulates vagal activity
Chen Pi	Tangerine Dried Rind of Mature Fruit	Regulates stomach energy
Zhi Gan Cao	Chinese Licorice Cured Root	Harmonizes formula

3. PM Spasm/Pain – a complex Homeopathic formula used for smooth muscle and skeletal muscle spasm and pain. This formula can be used for integral treatment of irritable bowel or esophageal spasm.

Homeopathic	Potency	Homeopathic Action
Aconitum napellus	4X	Acute sudden pain
Bryonia alba	4X	Pain worse for movement
Colocynthis	4X	Spasm, pain and colic
Atropinum sulphuricum	6X	Smooth muscle spasm, pain
Cuprum sulphuricum	6X	Muscle cramps
Magnesium phosphoricum	6X	Muscle cramps and radiation

4. GI Stomach – a complex Homeopathic formula that addresses all stomach pain and discomfort.

Homeopathic	Potency	Homeopathic Action
Robinia pseudoacacia	4X, 8X	Hyperacidity, ulcers
Anacardium orientale	6X	Gastric pain, better for eating
Antimonium crudum	6X, 12X	Gastric pain and fullness
Argentum nitricum	6X, 12X	Epigastric belching, inflammation
Arsenicum album	6X, 12X, 30X	Burning gastric pain and vomiting
Chamomilla	6X, 12X, 30X	Nervous hypersensitivity
Chelidonium majus	6X, 12X, 30X	Liver and Gallbladder complaints
Kali Carbonicum	6X, 12X, 30X	Anxiety with flatulence, nausea
Lycopodium	6X, 12X, 30X	Stomach discomfort, flatulence
Nux Vomica	6X, 12X, 30X	Nervous irritability, constriction
Phosphorus	12X	Sourness, belching, post op

5. GI-HRB - a complex Chinese herbal formula that addresses the allostatic load associated with heartburn, GERD and stomach pain in general.

TCM Name	English Name	Action
Chai Hu	Bupleurum Root	Decreases liver inflammation
Yan Hu Suo	Corydalis Yanhusuo Tuber	Decreases stomach pain
Zhi Ke	Bitter Orange Nearly Mature Fruit	Increases stomach energy
Huang Lian	Coptis Rhizome	Decreases burning pain
Mu Dan Pi	Tree Peony Root Bark	Soothes burning sensation
Yu Jin	Turmeric Root Tuber	Anti-inflammatory
Wu Zhu Yu	Evodia Unripe Fruit	Energizes and soothing
Chuan Xiong	Ligusticum Wallichii Rhizome	Increases circulation
Chen Pi	Tangerine Dried Rind of Mature Fruit	Energizes stomach
Sha Ren	Chinese Amomum Fruit	Energizes
Zhi Gan Cao	Chinese Licorice Cured Root	Harmonizes formula

6. GI-EMB - a complex Chinese herbal formula that addresses the allostatic load associated with emotional issues that are expressed as bowel symptoms of pain, spasm and either diarrhea, constipation or alternation of both symptoms.

TCM Name	English Name	Action
Chai Hu	Bupleurum Root	Anti-inflammatory
Bai Shao Yao	Chinese Peony Root without Bark	Anti-inflammatory
Chuan Xiong	Ligusticum Wallichii Rhizome	Increases circulation
Zhi Ke	Bitter Orange Nearly Mature Fruit	Energizes gut
Fu Ling	Poria Sclerotium	Diuretic
Dan Shen	Chinese Salvia Root and Rhizome	Increases circulation
Yan Hu Suo	Corydalis Yanhusuo Tuber	Analgesic
Suan Zao Ren	Jujube Seeds	Anxiolytic
Tai Zi Shen	Pseudostellaria Root Tuber	Energizes gut
Chen Pi	Tangerine Dried Rind of Mature Fruit	Energizes gut
Zhi Gan Cao	Chinese Licorice Cured Root	Harmonizes formula

7. GI  Diarrhea – a complex Homeopathic formula that addresses loose stools and diarrhea caused by irritable bowel, dietary indiscretion, food poisoning or viral invasion.

Homeopathic	Potency	Homeopathic Action
Cinchona officinalis	3X	Painless diarrhea, worse at night
Aloe socotrina	4X	Involuntary excretion, sore anus
Chamomilla	4X	Green stools with colic and irritability
Colocynthis	6X	Violent diarrhea and spasms, bend double
Gambogia morella	6X	Sudden spontaneous diarrhea
Oleander	6X	Stool emitted with passing flatus
Podophyllum peltatum	6X	Diarrhea and teething
Veratrum album	6X	Diarrhea and vomiting with collapse
Ferrum phosphoricum	8X	Watery diarrhea with inflammation
Mercurius corrosivus	8X	Diarrhea with incessant tenesmus
Campylobacter jejuni	12C, 30C	Homeopathic bacterial nosode
Clostridium difficile	12C, 30C	Homeopathic bacterial nosode
E. coli	12C, 30C	Homeopathic bacterial nosode
Norwalk virus	12C, 30C	Homeopathic viral nosode
Rotavirus	12C, 30C	Homeopathic viral nosode
Salmonella enteriditis	12C, 30C	Homeopathic bacterial nosode

8. GI-DHR - a complex Chinese herbal formula that addresses the allostatic load associated with the production of loose stools and diarrhea caused by irritable bowel, dietary indiscretion, food poisoning or viral invasion.

TCM Name	English Name	Action
Huo Xiang	Chinese Giant Hyssop Aboveground Parts	Antibacterial and viral
Bai Bian Dou	Dolichos Seed	Antidiarrheal
Bai Zhi	Fragrant Angelica Root	Anti-inflammatory
Gan Jiang	Ginger Dried Rhizome	Increases circulation
Fu Ling	Poria Sclerotium	Drying agent
Bai Zhu	Bai-Zhu Atractylodes Rhizome	Drying agent
Huang Qin	Chinese Skullcap Root	Antibacterial
Jie Geng	Platycodon Root	Antispasmodic
Chen Pi	Tangerine Dried Rind of Mature Fruit	Antiemetic
Zi Su Ye	Perilla Leaf	Anti-inflammatory
Lian Zi	Sacred Lotus Seed	Antidiarrheal
Yi Yi Ren	Job’s Tears Seed	Diuretic
Zhi Gan Cao	Chinese Licorice Cured Root	Harmonizes formula
Da Zao	Jujube Fruit	Energizes the gut
Sha Ren	Chinese Amomum Fruit	Stimulates digestion

9. GI Constipation - complex Homeopathic formula that addresses hard and dry stools, infrequent bowel movements and severe constipation.

Homeopathic	Potency	Homeopathic Action
Alumina	6X, 12X	Straining, painful urging, hard dry stool
Bryonia	6X, 12X	Dry hard stool as if burnt
Graphites	6X, 12X	Constipation with mucus
Lycopodium	6X, 12X	Hard stool, small and incomplete
Nux Vomica	6X, 12X	Constipation with ineffectual urging
Silicea	6X, 12X	Constipation, stool slips back
Opium	12X, 30X	No desire, hard round black balls of stool
Plumbum	12X, 30X	Dry stools with urging and spasm

10. GI-CON - a complex Chinese herbal formula that addresses the allostatic load associated with the production of hard and dry stools, infrequent bowel movements and severe constipation.

TCM Name	English Name	Action
Sheng Di Huang	Rehmannia Unprocessed Root Tuber	Moistens the stool
Da Huang	Chinese Rhubarb Root and Rhizome	Cathartic laxative
Zhi Shi	Bitter Orange Young Fruit	Increases peristalsis
Dang Gui	Dong Quai Root	Improves circulation
Hu Ma Ren	Flax Seed (Linum usitatissimum)	Gives bulk to stool
Yu Li Ren	Japanese Bush Cherry Seed	Moistens and purges
Tao Ren	Peach Seed	Moistens and expels
Jue Ming Zi	Sickle-pod Senna Seed	Increases peristalsis
Xing Ren	Apricot Seed	Moistens and purges
Mu Xiang	Costus Root	Energizes bowel
He Shou Wu	Fo-Ti Dried Root Tuber	Moistens and purges
Sha Ren	Chinese Amomum Fruit	Energizes bowel

11. GI-YST – a complex Chinese herbal and nutritional mix designed to address the allostatic load caused by yeast overgrowth in the large bowel.

TCM Name	English Name	Action
	FOS (Fructo Oligosaccharides)
	L-Glutamine
Fu Ling	Poria Sclerotium	Drying agent
Bai Zhu	Bai-Zhu Atractylodes Rhizome	Drying agent
Dang Shen	Codonopsis Root	Antidiarrheal
Che Qian Zi	Asian Plantain Seed	Anti-inflammatory
Chai Hu	Bupleurum Root	Anti-inflammatory
Shan Yao	Chinese Yam Rhizome	Stabilizes digestion
Yi Yi Ren	Job’s Tears Seed	Diuretic
Huang Bai	Phellodendron Bark	Anti-inflammatory
Ban Xia	Pinellia Rhizome	Modulates the lower bowel
Bai Tao Weng	Chinese Pulsatilla Root	Antibacterial
	Grape Seed Extract
Gan Jiang	Ginger Dried Rhizome	Soothes and adjusts gut
	Lactospore®
Bu Gu Zhi	Psoralea Fruit	Antidiarrheal
Gan Cao	Chinese Licorice Root and Rhizome	Harmonizes formula
	Saccharomyces Boulardii

                                                 

12. GI-ENZ – a complex nutritional formula of digestive enzymes made from non-animal sources that cover the full pH and activity spectrum of gastric and duodenal digestion.

NUTRITIONAL	AMOUNT IN 3 CAPSULES
Choline (from Choline bitartrate)	100 mg
Protease (Aspergillus orycae)	40,000 HUT
Bromelain (from Pineapple)	70 mg
Alpha Galactosidase  (Aspergillus niger)	50 mg
Phytase (Aspergillus niger)	50 PTU
Lipase (Rhizopus oryzae)	2,400 LU
Lactase (Aspergillus oryzae)	139 ALU
Papain (from Papaya)	60,000 USP
Amylase (Aspergillus oryzae)	35 SKB
Cellulase (Trichodema longibrachiatum)	15 CU

13. GI-DTX – A complex nutritional formula addressing the movement of toxins in bile excreted by the liver into the upper bowel. It prevents the enterohepatic recirculation of toxins back to the liver from the bowel, by absorbing and binding the toxins in the bowel and facilitating their excretion through the bowel by providing a gentle laxative action and ensuring a balance of good bowel flora in the lower intestines.

NUTRITIONAL	AMOUNT IN 3 CAPSULES
Vitamin C (as Ascorbic Acid)	100 mg
Selenium (as AA complex)	10 mcg
Bentonite	200 mg
NutraFlora® FOS (as Fructo oligosaccharides)	100 mg
Lactospore® Lactobacillus (6 billion active per gram)	70 mg
Apple Pectin	67.5 mg
Beet Juice Powder	67.5 mg
Oat fiber	67.5 mg
Rice Bran Flour	67.5 mg
Gum, Guar	60 mg
Alpha Lipoic Acid (Thioctic acid)	50 mg
Marshmallow Root Powder (Althaea officinalis)	50 mg
Bromelain Enzyme (from Pineapple)	20 mg
Papain (from Papaya)	20 mg

14. GI-ATB - a complex nutritional mix designed to address the allostatic load caused by antibiotic use with bowel dysbiosis and yeast overgrowth in the large bowel.

NUTRITIONAL	AMOUNT IN 3 CAPSULES
(Fos) Fructo Oligosaccharides	500 mg
L-Glutamine	400 mg
Saccharomyces boulardhii	250 mg
Garlic, Deodorized (Allium sativum)	50 mg
Grapefruit Seed Extract (Citrus paradasi)	50 mg
Pau D'Arco Bark Powder (Tabebuia impetiginosa)	50 mg
Bifidobacterium brevis (300 billion cfu/gram)	10 mg