Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized primarily by abdominal pain or discomfort that may improve after a bowel movement and is often accompanied by changes in bowel habits. There are no structural changes or biochemical abnormalities that can explain the symptoms. IBS is generally classified as diarrhea-predominant, constipation-predominant, mixed, or unclassified. In Traditional Chinese Medicine (TCM), it falls within the categories of “diarrhea,” “constipation,” and “abdominal pain.”

TCM Pattern Differentiation and Medication Reference

|Common Symptoms

Clinical description:

Stools are loose or watery at times; dull abdominal pain; symptoms may occur or worsen after fatigue or exposure to cold; fatigue, poor appetite, and tired, weak limbs; pale tongue with teeth marks on the edges and a white, greasy coating; weak pulse

In plain language:

  • Stools may sometimes be soft and loose and at other times watery, looser than usual.
  • A dull, uncomfortable ache or discomfort in the abdomen.
  • These symptoms may occur or become worse after fatigue or exposure to cold.
  • Feeling tired, with poor appetite and tired, weak limbs; everyday activities may feel effortful.
  • The tongue may look pale, with teeth marks along the edges and a white, greasy coating.
  • The pulse may feel weak and lacking in strength.

|Treatment Approach

Clinical description:

Strengthen the Spleen and supplement Qi; transform Dampness and relieve stagnation

In plain language:

  • Use TCM approaches to support Spleen and Stomach function and supplement Qi, with the aim of easing poor appetite, post-meal bloating, upper abdominal discomfort, fatigue, and loose stools.
  • Use approaches intended to transform and disperse Dampness and relieve stagnation, with the aim of easing a heavy, bloated feeling, a sticky sensation in the mouth, belching, acid reflux, nausea, constipation, or sticky stools that are difficult to pass.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

Shen Ling Bai Zhu Wan
Bu Zhong Yi Qi Wan

|Common Symptoms

Clinical description:

Abdominal pain followed by diarrhea, with pain easing after a bowel movement; episodes are often associated with emotions; irritability and frequent sighing; distension and fullness in the flanks; poor appetite and nausea; wiry, thready pulse; pale, enlarged tongue with teeth marks along the edges

In plain language:

  • Abdominal pain is followed by diarrhea, and the pain eases after a bowel movement. Episodes are often associated with emotional distress.
  • Feeling irritable and easily angered, with frequent sighing.
  • A feeling of fullness and distension below the ribs on both sides, with discomfort during movement.
  • Poor appetite, eating less, and a feeling of nausea or queasiness.
  • The pulse may feel taut like a string and somewhat fine.
  • The tongue may look pale and slightly enlarged, with teeth marks along the edges.

|Treatment Approach

Clinical description:

Calm the Liver and support the Spleen

In plain language:

  • Use TCM approaches to soothe the Liver Qi and regulate emotional tension, with the aim of easing distension and pain in the flanks, chest discomfort, irritability, and frequent sighing.
  • Use approaches to support Spleen Qi and digestive function, with the aim of easing poor appetite, post-meal bloating, fatigue, and loose or watery stools.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Abdominal pain and diarrhea on waking in the morning; cold abdominal pain that improves with warmth; aversion to cold and cold limbs; soreness and weakness in the lower back and knees; poor appetite; pale, enlarged tongue with a white, slippery coating; deep, thready pulse

In plain language:

  • Abdominal pain occurs upon waking in the morning, followed by diarrhea.
  • A cold sensation and pain in the abdomen that eases with warmth.
  • Feeling cold throughout the body, with cold hands and feet, as well as soreness and weakness in the lower back and knees.
  • Little desire to eat and poor appetite.
  • The tongue may look pale and enlarged, with a white, slippery coating.
  • The pulse may feel deep and somewhat fine.

|Treatment Approach

Clinical description:

Warm and supplement the Spleen and Kidneys

In plain language:

  • Use warming and supplementing approaches to support Yang of the Spleen and Kidneys, with the aim of easing cold sensitivity, cold hands and feet, poor appetite, post-meal bloating, and fatigue.
  • At the same time, warm the lower back and abdomen and support the body’s lower region, with the aim of easing loose or watery stools, frequent clear urination, soreness and weakness in the lower back and knees, and low energy.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

Si Shen Wan
Fu Zi Li Zhong Tang

|Common Symptoms

Clinical description:

Abdominal pain and diarrhea; urgent bowel movements or a sensation of incomplete evacuation; burning sensation at the anus; chest discomfort, irritability, and thirst with a desire to drink; dry, bitter taste in the mouth; red tongue with a yellow, greasy coating; slippery, rapid pulse

In plain language:

  • Abdominal pain and diarrhea occur together.
  • Bowel movements may come on urgently, or you may still feel that you have not fully emptied your bowels afterward.
  • A burning or fiery sensation around the anus.
  • A feeling of tightness or discomfort in the chest, along with irritability and thirst or a desire to drink frequently.
  • A dry mouth and a bitter taste.
  • The tongue may look red, with a yellow, greasy coating.
  • The pulse may feel slippery and fast.

|Treatment Approach

Clinical description:

Clear Heat and drain Dampness

In plain language:

  • Use TCM approaches intended to clear internal “Heat” and excess Dampness, with the aim of easing a hot, heavy feeling, fatigue, bitter or sticky taste in the mouth, dark or scanty urine, and a thick, greasy tongue coating.
  • Also support the removal of Dampness, with the aim of easing upper abdominal discomfort and bloating, poor appetite, nausea, post-meal bloating, and sticky stools that are difficult to pass.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Hard, dry stools that are difficult to pass; lower abdominal pain and distension or tenderness when pressed; dry mouth and bad breath; red tongue with a yellow, dry coating and little moisture; rapid pulse

In plain language:

  • Stools may become dry and hard and be difficult to pass.
  • Pain in the lower abdomen, with a feeling of distension and pain when pressed.
  • A dry mouth and noticeable bad breath.
  • The tongue may look red, with a yellow, dry coating and little moisture on its surface.
  • The pulse may feel fast.

|Treatment Approach

Clinical description:

Drain Heat and promote bowel movements; moisten the intestines and promote bowel movements

In plain language:

  • Use approaches intended to reduce internal “Heat” and promote bowel movements, with the aim of easing hard, dry stools, a burning sensation at the anus, abdominal bloating and pain, and straining to pass stool.
  • Use approaches intended to moisten the intestines and soften stools, with the aim of easing constipation, incomplete evacuation, abdominal bloating and pain, and dry mouth or throat.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Constipation, difficulty passing stool despite the urge to go, and straining; distension or pain that moves around the chest, flanks, or lower abdomen; irritability and a wiry pulse

In plain language:

  • Constipation, with difficulty passing stool despite the urge to go.
  • Distension and pain in the chest, flanks, or lower abdomen, sometimes seeming to move from place to place.
  • Feeling irritable and easily angered.
  • The pulse may feel taut and firm, like a stretched string.

|Treatment Approach

Clinical description:

Soothe the Liver and regulate Qi; move Qi and relieve stagnation

In plain language:

  • Use TCM approaches intended to regulate Liver Qi and address Qi stagnation, with the aim of easing distension and pain in the flanks, chest discomfort, low mood, irritability, and frequent sighing.
  • Use approaches intended to promote Qi movement and relieve digestive stagnation, with the aim of easing upper abdominal discomfort and bloating, fullness after eating, belching, acid reflux, nausea, hiccups, constipation, or unsatisfactory bowel movements.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical description:

Constipation with hard, dry, pellet-like stools; stools may not be hard, but bowel movements require effort; pale or red tongue with little coating; weak, thready pulse

In plain language:

  • Constipation, with dry, hard, pellet-like stools. Stools may not be hard, but passing them requires effort.
  • The tongue may look pale or red, with very little coating.
  • The pulse may feel fine and weak, with little strength.

|Treatment Approach

Clinical description:

Supplement Qi and nourish Yin; moisten the intestines and promote bowel movements

In plain language:

  • Use approaches intended to supplement Qi and nourish Yin, with the aim of supporting energy and bodily moisture and easing fatigue, shortness of breath, weakness, dry mouth or throat, and irritability.
  • Use approaches intended to moisten the intestines and soften stools, with the aim of easing constipation, hard stools, straining, abdominal bloating, or incomplete evacuation.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.

References

  1. Gastrointestinal Motility Group, Chinese Society of Gastroenterology, Chinese Medical Association. Consensus opinion on the diagnosis and treatment of irritable bowel syndrome[J]. Chinese Journal of Digestion, 2008(28): 38-40.
  2. Spleen and Stomach Diseases Branch, China Association of Chinese Medicine. Consensus opinion on TCM diagnosis and treatment of irritable bowel syndrome[J]. China Journal of Traditional Chinese Medicine and Pharmacy (formerly Chinese Journal of Medicine), 2010, 25(7): 1062-1065.
  3. Moore Communications, Inc. Breakthrough in Patient Care for Irritable Bowel Syndrome [symposium update][M]. Fort Lauderdale, Fla: GlaxoWellcome, 2000.
  4. Pan Guozong, Lu Sucai, Ke Meiyun, et al. Epidemiological study of irritable bowel syndrome in the Beijing area: a cluster, stratified, random survey[J]. Chinese Journal of Epidemiology, 2000(21): 26-29.
  5. Chen Shizhu. Epidemiology and etiology of irritable bowel syndrome[J]. World Chinese Journal of Digestology, 1998(6): 913-914.
  6. Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China (2015 edition)[M]. Beijing: China Medical Science Press, 2015.
  7. Fan Debin, Qin Xueping, Xu Jinzhu, et al. Clinical observation of Yiqi Runchang Capsules for the treatment of 100 cases of constipation with Qi and Yin deficiency[J]. Yunnan Journal of Traditional Chinese Medicine and Materia Medica, 2009, 30(2): 33.
  8. Li Shumin, Zhang Qingfu, Zhang Lin, et al. A randomized, double-blind, double-dummy, positive-controlled phase III clinical trial of Yiqi Tongbian Granules for constipation in middle-aged and older adults with Qi and Yin deficiency[J]. Chinese Archives of Traditional Chinese Medicine, 2007(25): 253-255.