Introduction
Acute and chronic enteritis refers to acute or chronic inflammation of intestinal wall mucus due to various factors. The usual manifestations are abdominal pain, frequent defecation, loose stool or watery stool. This disease is similar to the conception of diarrhea in TCM.
Acute enteritis is usually caused by bacteria, virus, fungus and chemical toxin in improper foods or intestinal parasites. The most commonly seen are viral enteritis and bacterial food poisoning. The clinical symptoms are acute diarrhea, abdominal pain and vomiting, accompanied by aversion to cold and fever, etc. The major causes of acute enteritis are exogenous pathogenic factors and improper foods that lead to dysfunction of the spleen in transformation and transportation due to encumbrance by dampness.
Chronic enteritis refers to a series of symptoms of intestinal chronic inflammation due to various factors, pertaining to chronic inflammation of intestinal mucus and disturbance of intestinal absorption due to non-specific bacterial infection. The clinical symptoms are abdominal pain, diarrhea, abdominal distension, borborygmus, loose stool or stool with mucus and pusblood, or alternation of diarrhea and constipation, slow progression of pathological conditions, recurrence and difficulty to heal.
Chronic enteritis is usually caused by lingering diarrhea due to exogenous factors, improper diet and overstrain that lead to hypofunction of the spleen and stomach; or by mental upsets, failure of the liver to disperse and convey as well as invasion of liver qi into the spleen. Prolonged diarrhea will lead to involvement of the kidney in spleen disease and insufficiency of kidney yang, consequently resulting in failure in transportation and transformation.
Syndrome Differentiation
1. Acute Enteritis
Cold-dampness type: Abdominal pain, borborygmus, watery stool without odor, heaviness of head and body, or accompanied by aversion to cold, fever, white and greasy tongue fur as well as soft and slow pulse.
Damp-heat type: Abdominal pain, diarrhea, urgent diarrhea with brown color or with pus-blood and foul odor, burning sensation in the anus, fever, thirst, scanty and brown urine, or accompanied by vomiting and nausea, red tongue with yellow and greasy fur as well as slippery and rapid pulse.
Dyspepsia type: Diarrhea with the odor of putrid egg, alleviation of abdominal pain after diarrhea, undigested food in diarrhea, fullness and oppression in the chest and epigastrium, beltching and acid regurgitation, greasy tongue fur and slippery pulse.
2. Chronic Enteritis
Liver depression subjugating the spleen: Occurrence of diarrhea with abdominal pain following psychological stimulation or nervousness, alleviation of pain after diarrhea, frequent flatus, accompanied by distension and oppression in the chest and rib-side, belching and poor appetite, light-red tongue with white fur and taut pulse.
Hypofunction of the spleen and stomach: Loose stool, or occasional loose stool and diarrhea with undigested food, frequent defecation after slight intake of greasy food, no appetite, spiritual lassitude, light-colored tongue with white fur, soft, slow and weak pulse.
Decline of kidney yang: Morning diarrhea, dull abdominal pain, diarrhea right after borborygmus, relief of pain after diarrhea, cold body and limbs, aching and weakness of loins and knees, light-colored tongue with white fur, deep, thin and weak pulse.
Treatment
1. Body Acupuncture
Prescription:
Acute enteritis: Shangjuxu (ST 37), Xiajuxu (ST 39), Liangmen (ST 21), Tianshu (ST 25) and Yinlingquan (SP 9).
Chronic enteritis: Zhongwan (CV 12), Guanyuan (CV 4), Tianshu (ST 25) and Zusanli (ST 36).
Modification: In acute enteritis, for cold-dampness type, Shenque (CV 8) and Sanyinjiao (SP 6) are added; for damp-heat type, Quchi (LI 11), Dazhui (GV 14) and Neiting (ST 44) are added; for fever, Hegu (LI 4) and Quchi (LI 11 ) are added; for dyspepsia, Zhongwan (CV 12) and Gongsun (SP 4) are added. In chronic enteritis, for liver depression subjugating the spleen, Zhangmen (LR 13) and Taichong (LR 3) are added; for hypofunction of the spleen and stomach, Pishu (BL 20) and Weishu (BL 21) are added; for decline of fire in mingmen (gate of life), Mingmen (GV 4) and Shenshu (BL 23) are added; for prolonged diarrhea and prolapse of rectum, Baihui (GV 20) is added.
Performance: For acute diarrhea, filiform needles and reducing techniques are used. For chronic diarrhea, Zhangmen (LR 13) and Taichong (LR 3) are needled with mild reducing and reinforcing techniques or reducing technique, the rest acupoints are needled with reinforcing techniques. For predominance of cold and asthenia of qi and yang, the needling is followed by moxibustion and cupping.
2. Ear Acupnuctur
Prescription: Large Intestine (CO7), Small Intestine (CO6), Spleen (CO13), Stomach (CO4), Liver (CO12), Abdomen (AH8), Sympathetic Nerve (AH6a), Triple Energizer (CO17) and Ear Shenmen (TF4).
Performance: Each time 3 - 5 acupoints are selected and needled with routine procedure. For acute enteritis, strong stimulation in needling is required, once or twice a day; for chronic enteritis, moderate stimulation in needling is required, once a day or once every other day; or Wangbuliuxingzi (Semen Vaccariae) is used for ear pressure.