Irritable Bowel Syndrome (IBS) is a disorder affecting the intestine's ability to move its contents.  This creates a symptom complex with both upper and lower gastrointestinal symptoms.  Predominant symptoms include variable degrees of abdominal pain, constipation and/or diarrhea, as well as bloating after eating.  The symptoms nearly always occur in the waking state and are usually triggered by stress or the ingestion of food.  This syndrome represents about half of all GI referrals or initial GI complaints in private and institutional care facilities.  Women are affected three times as often as men.

According to the Merck Manual, (16th edition) one of Western medicines most respected and widely used references, no anatomic cause can be found.  Emotional factors, diet, drugs, or hormones may precipitate or aggravate a heightened sensitivity to GI motility.

There are two major groups of clinical types of IBS that are recognized.  In the "spastic colon type" bowel movements are variable.  Most patients have pain that originates in the large intestine with periodic constipation and diarrhea.  Symptoms are commonly triggered by eating.  The key symptoms include a dull ache in the lower abdomen which is either continuous or comes and goes in bouts.  It may be relieved by a bowel movement.  Symptoms are commonly triggered by eating.  Nonspecific symptoms such as bloating, flatulence, nausea, headache, fatigue, depression, anxiety and difficulty in concentration are common.

The second group of IBS patients primarily manifest painless diarrhea, usually urgent precipitous diarrhea that occurs immediately upon rising or, more typically, during or immediately after a meal.  Incontinence may also occur.  Nocturnal diarrhea is unusual.

Enough of the Western, let's talk about the Chinese approach to IBS.

Firstly, IBS is a Western differentiation.  In Chinese (or "Oriental") medicine, we organize the symptoms a little differently.  Fortunately, the symptoms that may seem rather unrelated in Western medicine make up a very simple and typical syndrome in Chinese medicine.

Chinese medical theory talks about the Spleen being the key organ in charge of digestion.  In Western medicine, the spleen has certain functions that don't necessarily agree with the Chinese concept of the organ, that's why it is capitalized when referring to its Chinese functions.  In general, the Chinese Spleen may be defined as both the Spleen and Pancreas in Western medicine, give or take.

When the Spleen isn't working well enough, when it has been weakened by any number of factors, it is like a car's engine that needs a tune-up.  When the car's workings aren't operating efficiently, a number of problems arise, including reduced power and more exhaust smoke for example.

The Spleen's symptoms of reduced functional efficiency include bloating and flatulence, a little bit like a car's engine pinging, knocking or backfiring.  Another key symptom of a Spleen deficiency is diarrhea which is also the key symptom of IBS.  The organ with which the Spleen associates the most is the Stomach.  In the case of any disharmony within the Spleen, the stomach may resond with nausea and vomiting.

When a car's engine is not tuned well, it doesn't burn fuel well.  This can create a greater amount of exhaust fumes and an accumulation of carbon in the exhaust system.  Because a deficiency is diarrhea which is also the key symptom of IBS.  The organ with which the Spleen associates the most is the Stomach.  In the case of any disharmony within the Spleen, the stomach may respond with nausea and vomiting.

When a car's engine is not tuned well, it doesn't burn fuel well.  This can create a greater amount of exhaust fumes and an accumulation of carbon in the exhaust system.  Because a deficient Spleen cannot metabolize the food efficiently, the Spleen will create "Dampness" in the body, the equivalent of excessive exhaust smoke in the car.  When dampness is created in the Spleen it can rise to the head and create headaches that have a sensation of dull fullness in the head.  This is the kind of headache in which one feels as if there is a clamp tightened around the head.  Other manifestations of Damp rising to the head include a foggy inability to concentrate.  Fog is much like Damp, if you think about it.  Given time, damp can accumulate and become more substantial in the Large Intestine.  When this happens, mucus in the stool, another common IBS sign, is the typical symptom.

If the Spleen is not able to adequately obtain nutrition from the  food, the obvious symptom would also include fatigue.  Another problem that comes from the Spleen's inability to assimilate the food's nutrition is that it also creates a deficiency of Blood.  When there isn't enough Blood in the body, specifically enough to nourish the Hearth, anxiety follows.  A deficiency of Blood in Chinese medicine comes close to the Western diagnosis of anemia, there is a certain about of overlap, but also a few symptoms that differ, especially when it comes to Boold's function of nourishing the Chinese concept of the Heart organ which is associated with the maintenance of "peace of mind."

Other symptoms in Irritable Bowel Syndrome can be explained as including one other organ besides the Spleen in Chinese medicine.

Going back to the analogy of the car, the Spleen has what mechanics call "companion parts" that can effect the Spleen if they fall out of balance first.  If you have a dead care battery, it could be one or three things.  The battery could be unable to hold a charge.  Or, the problem manifests in the battery could actually be coming from one of its companion parts such as the voltage regulator or the alternator.  If either of these two components are faulty, the battery won't have enough charge to start your car.

The same thing applies to the Spleen.  When a person is subject to a great deal of emotional stress, the Liver's functions begin to impair the Spleen's functions.  The problem manifests in the Spleen, but is really due to the Liver's problems.

The Liver is the organ in Chinese medical theory most sensitive to emotional stress.  When the Liver is involved, additional symptoms will include dull pain that comes and goes along with alternating constipation and diarrhea.  In this case, it is possible that the underlying cause of the IBS is due to emotional factors affecting the Liver first and the Spleen second.  Though it is also possible that the stress associated with the IBS will create additional emotions effecting the Liver, which further aggravates the condition.  Either is possible.

The other "companion part" scenario involves the Kidneys.  The Kidneys, in Chinese medicine, regulate the Yin and Yang in the body.  Yin could be described as the hydration function of the body, and Yang is much like the metabolic heat.  Some people simply refer to it as the balance between Fire and Water in the body.  If there isn't enough fire, or Yang energy in the body, the Spleen can become cold and its function can become impaired.  When a car's windows are fogged up, we turn on the defroster and the warm air evaporates and blows away the damp condensation.  If there isn't enough Kidney Yang, the Spleen can't warm up to digest the food in the same way that the engine must warm up before the heater will start blowing out hot air to clear up the windshield.

When the Kidney is the root of the problem affecting the Spleen, the early morning diarrhea that is part of the symptomological picture arises.  This is such a typical manifestation of Kidney Yang deficiency in Chinese medicine that they actually have a term for this kind of diarrhea.  They call it "Cock's Crow" Diarrhea.  It gets this name from the fact that early morning diarrhea happens when the Cock is crowing in the morning.  In Chinese medicine the Kidneys are also said to control the lower orifices don't have enough energy to remain closed, and so incontinence occurs.

So, although Western medicine doesn't yet have a good idea as to what and how IBS occurs, Chinese medicine has a very clear and obvious explanation for what is really a very typical symptomalogic picture.

Treatment would call for any number of approaches, depending on the constitution of the patient, the specific symptoms and the underlying cause of the IBS.

If the Spleen alone is involved, acupuncture and herbal treatment would seek to simply tonify (or strengthen) the Spleen's function to make it more efficient, clear and clean the entire digestive tract, and dry the damp within the body.

If the Liver is involved also, the treatment principle would include therapies to sedate and calm the Liver, as well as the patients, which will relieve the abdominal pains and allow for the healing of the Spleen's functions.

In the case of the Kidneys being involved in the IBS, the treatment plan would include tonifying the Kidney Yang to warm the Spleen and make it more efficient as well as tonifying the Kidneys to be able to astringe both the diarrhea and urine in the case of incontinence.

Irritable Bowel Syndrome has been treated effectively for thousands of years through Chinese medicine.  And if the number of enquiries that come to Acupuncuture.com regarding IBS is any indication, TCM will continue to be a source of very welcome relief for those who suffer from Irritable Bowel Syndrome.