Acupuncture and Digestion
When I was a young bride of 21, my then-husband Tom (not his real name) developed pain in the right lower region of his abdomen. When the pain got severe, we went to the emergency room, where he was admitted with a suspected case of appendicitis. But things did not proceed smoothly from there. The doctors felt a mass and, despite the lack of fever, they suspected a ruptured appendix and put him on sulfur antibiotics. The mass started to shrink, but something was not right. Studies were ordered to rule out a lymphoma. In the end they determined that he did not have appendicitis or lymphoma but rather, an inflammation of the small intestine, now called Crohn's disease or Ileitis, a fairly new diagnosis in those days. The standard treatment for this inflammation is asulfadine, a sulfa-containing drug, which explains why he initially responded to the sulfa-containing antibiotics. At the time I was a graduate student in insect physiology, and this hospital experience transformed me in several ways: I got over my fear of hospitals and turned my interest to human physiology and subsequently to medicine, and I became aware of the vast world of gastrointestinal problems.
The marriage lasted another 6 years, during which I went to medical school. Tom had two more episodes of severe abdominal pain in that interval: pain, which I had come to learn, was from intestinal obstruction caused by the recurring inflammation in the small bowel. Both episodes were treated with steroids, and he was able to avoid surgery. Many patients with Crohn's disease of the small bowel are not so lucky and have multiple surgeries to remove pieces of necrotic bowel during inflammatory episodes. Today the disease is also managed with drugs that interfere with cell division (like 6 mercapto-purine) and with steroids for immuno-suppression. So far, my ex-husband has managed well and has his whole intestine.
But why do some people, like Tom, develop GI symptoms? He has a complicated auto-immune disease and frankly, there is only speculation from a Western Medical view as to why some people develop these conditions.
So let's ask a more basic question: why do hundreds of millions of people in this country suffer on a regular basis from GI discomfort that interferes with the quality of everyday life? If you go to any drug store or supermarket chain you will see shelf after shelf of over-the-counter drugs that are used for indigestion, diarrhea, constipation, gas, heart burn, ulcer and stomach acid. Furthermore, the prescription medications for these symptoms constitute a multi-billion dollar industry.
This newsletter will explore some gastrointestinal problems from a Traditional Chinese Medical (TCM) and Western perspective.
1. Western Medical perspective on GI disease
2. TCM perspective on GI health
3. Integrative approach to GI health
Western Medical perspective on GI disease
That we primarily see gastrointestinal issues as disease in our culture is very telling. That we primarily look to medication to treat the symptoms reinforces the attitude that these symptoms, so commonly encountered in daily life, are somehow to be expected and are an inconvenience that can be pharmacologically treated. So we accept that we have excess acid or gas or that our bowels are sluggish and take the appropriate preparation. Moreover, we are willing to be scoped, x-rayed and prodded to confirm the medical diagnosis. To be fair, even in Western medicine there is an acknowledgment that diet and stress play a large part in the development of GI conditions, and further that nutrition and stress management can make a difference in the course of the symptomatology. However this approach has barely impacted the magnitude of the pharmacological approach.
Even the Western alternative medical community often takes an aggressive approach to GI symptoms, recommending arduous fasts for cleansing the gut and/or colonics to "clean you out".
2. TCM perspective on GI health

stomach meridianIllustration: The Stomach Meridian
TCM is all about balance, and the true scope of Chinese medicine includes dietary advice, as well as a belief in the body's ability to self-correct. How and what you eat makes an enormous difference, and if you are truly toxic in your gut, you will purge the contents by vomiting or through diarrhea.
In TCM all of the internal organ systems are interrelated. The main organ system dealing with the digestion is the spleen. (Note: In TCM the organ system is not the same as the anatomical organ we think of in Western medicine. Therefore the spleen in TCM refers to a series of functions that includes the internal organ, but does not refer to that organ directly). The job of the spleen is to process. It processes food and separates out the water. In Chinese Medicine it is also responsible for making blood. The blood producing aspect of its function makes it critically important in the health of menstruating women.
In TCM there is no distinction between the emotional, physical and spiritual aspect of the body's energy. All of the internal organ systems are associated with a particular emotion, and the spleen, the organ of worry, is also responsible for processing thoughts and for pensive rumination. Damage to an organ system can result in the manifestation of its associated emotion. Similarly, that emotion in excess can injure the associated internal organ system. Excessive worry can injure the spleen organ system.
When we overwhelm the spleen organ system with too much food or too much of the wrong kind of food, over time we damage its ability to process food well. We develop bloating and gas and stool problems related to incompletely processed food. This incomplete processing results in a condition known as dampness in TCM. The body becomes bogged down and stagnant with residue. The stagnating dampness can smolder and become hot, causing pain and distention.
What are the wrong kinds of food? The fast foods we consume as a nation are the ones hardest for the spleen to process: fried or greasy food, sugar-laddened and especially iced beverages. Alcohol is particularly hard on both the spleen and the liver.
All of the internal organ systems in TCM are paired with a corresponding yang organ that connects it to the outside of the body. The stomach is the paired yang organ of the spleen. Disharmony in the stomach organ system can also be the source of GI symptoms. For example, the qi (energy) in the stomach can become rebellious and move upward instead of down, resulting in burping or regurgitation.
I have already mentioned that worry can injure the digestion. Certainly we are a nation of worriers - more so since 9/11 than even before. But other emotions can impact the digestion as well. The liver organ system is associated with anger and depression. Repressed or long-term anger causes the liver to become constrained, i.e. too tight, like an over-turned violin string. The constrained liver energy can invade the spleen and result in the picture of disharmony we have described earlier. As stress is handled in the liver, it is easy to see that worried and stressed New Yorkers are prime candidates for GI problems. The same can be said for people all over the country who are concerned about their jobs, families, the state of the nation, etc.
So if TCM is about wellness, what can be done to promote healthy GI function?
Qi is the body's life force energy. It needs to be abundant to produce radiant health. The qi also needs to be freely flowing in the body with no areas of blockage, and it needs to be in a yin/yang balance. Qi manifests in two forms. There is ancestral or genetic qi (Jing) that you inherit, like good genes. The rest is made from the food you eat and the air you breathe. So you see that this optimal state of health is dependent on good digestion. In fact, the main point for energy in the body is Stomach 36, a point on the lower leg that has the Chinese name of Zu San Li, meaning "walk three miles." The belief is that if you have good digestion, you will have the energy to walk three miles.
Good GI health starts with good nutrition. It is particularly important to avoid the spleen injuring food mentioned above. Additionally, and especially if there is obvious injury to the digestion or a current problem such as nausea or diarrhea, it is good to eat warm, cooked food or at least food that is room temperature. The reason for this is that in order to assimilate food, the body has to first warm it to body temperature. If the qi in the GI organs is weak, this process requires extra work that further weakens the qi. The next job of good digestion is to break down food for assimilation. Cooked food is already partially broken down making it easier to digest. How we eat is also important. Food should be consumed in moderate amounts and in a harmonious environment.
Exercise is also an integral part of TCM. Millions of Chinese practice the martial art, Tai Qi (or Tai chi) daily. Moderate exercise tones the internal organs and promotes good digestion.
Acupuncture helps to strengthen and tone the internal organs, balance and unblock stagnant or constrained qi. In many cases Chinese herbal formulas can assist in these functions.
3. Integration.
I think it can be agreed that good nutrition is the foundation of a healthy GI system. A comprehensive discussion of that is precluded here due to space, but in short, the ideal is to eat quality food (preferably organic to eliminate toxins), simply prepared, in moderate amounts and chewed in a slow deliberate fashion.
From the western perspective, we know that a big part of digestion happens in the mouth. Chewing along with the salivary secretions in the mouth help break down the food. Not drinking beverages during a meal will help to prevent gulping air and inhaling rather than chewing food. Naturally occurring fiber, such as that found in fruits, grains and vegetables aids the movement of waste products though the GI tract.
Moderate exercise, not too close to meals, helps the integrity of the internal organs and brings good circulation to insure that the nutrients are well distributed throughout the body. The western herbs peppermint and chamomile help to promote digestion and also have calming properties. They can be imbibed as teas before and after meals. Some people also find it helpful to take digestive enzymes along with a meal to aid digestion.
There are individuals who are lactose intolerant and don't do well with dairy products, including milk and cheese. These individuals are often spleen damp and do better if they eliminate these items from their diet. Goat milk products are sometimes a well-tolerated substitute.
There are people who have had too much sugar and stress in their lives who have an overgrowth of harmful bacteria in the gut. These individuals can benefit from a careful detoxification of those organisms and a renewal with helpful microorganisms such as lactobacillus, the bacteria found in yogurt and kefir. There are some excellent supplements that can also facilitate this process.
Acupuncture helps to keep the body in optimal energetic condition for good digestion to occur. Acupuncture and Chinese herbs are excellent treatment options to correct any underlying disharmonies. Your Turning Point practitioner can determine which disharmony is present and treat accordingly. Additionally, at Turning Point we provide stress reduction and can advise about appropriate dietary changes, nutritional supplements and homeopathic remedies.

Back to top