CLINICAL APPLICATIONS

* General gastrointestinal deficiency and weakness: fatigue, poor appetite, loose stools or diarrhea, anorexia, borborygmus, bloating, weight loss, sallow complexion, weak pulse, and scalloped tongue

* Spleen qi deficiency causing various gastrointestinal disorders: diarrhea, superficial gastritis, and chronic colitis

* Malnutrition in children or those with poor appetite and loose stools

 

WESTERN THERAPEUTIC ACTIONS

* Balancing effect to regulate and restore gastrointestinal functions

* General supportive effect to treat gastrointestinal disorders 

* Strengthens the gastrointestinal tract to improve appetite, digestion, and absorption

 

CHINESE THERAPEUTIC ACTIONS

* Tonifies Spleen qi

* Stops diarrhea

* Promotes digestion

* Dispels dampness and stagnation

 

DOSAGE

Take 2 to 4 capsules three times daily on an empty stomach, one hour before or two hours after meals. The formula can be used to treat diarrhea symptomatically. However, to achieve long-term and lasting effect, GI Tonic should be taken continuously for three to six months to change the constitution of the Spleen and the Stomach.

 

INGREDIENTS

Bai Zhu (Rhizoma Atractylodis Macrocephalae)

Bian Dou (Semen Lablab Album)

Fu Ling (Poria)

Gan Cao (Radix et Rhizoma Glycyrrhizae)

Jie Geng (Radix Platycodonis)

Lian Zi (Semen Nelumbinis)

Ren Shen (Radix et Rhizoma Ginseng)

Sha Ren (Fructus Amomi)

Shan Yao (Rhizoma Dioscoreae)

Yi Yi Ren (Semen Coicis)

Zhi Huang Qi (Radix Astragali Praeparata cum Melle)

 

BACKGROUND

Fatigue is a general symptom that may be caused by many underlying disorders, including but not limited to anemia, fibromyalgia, depression, stress and anxiety, chronic infection, and gastrointestinal and endocrine disorders. Though the causes vary widely, they share one thing in common ¡V compromised digestion of food and absorption of nutrients. As a result, the body becomes increasingly weaker and the patient feels chronically fatigued. Therefore, the first step toward recovery is to restore gastrointestinal health so the patient can absorb nutrients from foods and begin the healing process.

 

FORMULA EXPLANATION

GI Tonic is designed to treat Spleen deficiency leading to symptoms of fatigue, poor appetite, diarrhea, loose stools, borborygmus, bloating and other gastrointestinal disorders. In traditional Chinese medicine, the main function of the Spleen is to extract qi from the food and turn it into energy. When the Spleen and the Stomach are deficient, they will not be able to carry out the normal gastrointestinal functions. As a result, food may travel quickly out of the body without being digested or absorbed. A weak digestive system would directly result in low appetite. Lack of nutrients would lead to weak extremities, weight loss and sallow facial appearance. Deficiency of the Spleen may cause accumulation of dampness, which may obstruct the qi flow and cause fullness in the chest.

        GI Tonic contains many herbs to strengthen the Spleen and dispel dampness to restore normal gastrointestinal functions. Ren Shen (Radix et Rhizoma Ginseng) and Zhi Huang Qi (Radix Astragali Praeparata cum Melle) tonify the yuan (source) qi and Spleen qi to relieve weakness and fatigue. They also have a strong effect to increase energy and vitality. Bai Zhu (Rhizoma Atractylodis Macrocephalae) and Fu Ling (Poria) strengthen the Spleen, dispel dampness and relieve diarrhea. As they strengthen the Spleen, they also help increase appetite as well. Shan Yao (Rhizoma Dioscoreae), Bian Dou (Semen Lablab Album) and Lian Zi (Semen Nelumbinis) tonify both qi and Spleen yin. They are also slightly astringent in taste, and therefore have stabilizing and binding effect to relieve diarrhea or loose stools. Yi Yi Ren (Semen Coicis) dispels dampness, promotes urination and expels excess fluid retention in the body. Sha Ren (Fructus Amomi) is aromatic as it dries up dampness and stops diarrhea. It also regulates qi to relieve bloating and borborygmus. Jie Geng (Radix Platycodonis) raises qi and prevents prolapse that may be caused by diarrhea. Gan Cao (Radix et Rhizoma Glycyrrhizae) is used to harmonize the middle jiao and also the entire formula.

        In short, GI Tonic contains herbs with great effect to tonify Spleen qi, stop diarrhea, promote digestion, and dispel dampness and stagnation. It is an excellent formula to treat gastrointestinal disorder characterized by generalized weakness and deficiency.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated in cases of interior heat accumulation, exterior wind-cold, or exterior wind-heat.

* This formula should not be used by itself in cases of diarrhea due to damp-heat in the Intestines, with such symptoms as burning sensations in the anus, tenesmus and foul-smelling stool. This condition is an indication of infection, and must be treated first with herbs that clear damp-heat from the Intestines.

 

CLINICAL NOTES

* GI Tonic may be used on a short-term basis (one to two weeks) to treat diarrhea symptomatically, or on a long-term basis (three to six months) to restore gastrointestinal health.

* GI Tonic is beneficial for patients suffering from all kinds of gastrointestinal disorders involving Spleen qi deficiency. By strengthening the Spleen, it increases the production of post-natal qi and improves the wellness of the patient.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Small pulse, a thin and weak pulse that disappears upon pressure on the right guan.

 

SUPPLEMENTARY FORMULAS

* For early morning diarrhea with coldness, add Kidney Tonic (Yang).

* For constipation with irritable bowel syndrome, add Gentle Lax (Deficient) and GI Harmony.

* For hemorrhoids, add GI Care (HMR).

* For irritable bowel syndrome with irritability and stress, add GI Harmony and Calm.

* Diarrhea or dysentery due to infection of the gastrointestinal tract, use GI Care II instead.

* For inflammatory bowel syndrome or ulcerative colitis caused by damp-heat in the Intestines, use GI Care (UC) instead.

* For extreme fatigue and deficiency in qi, blood, yin and yang, add Imperial Tonic.

* For an immediate boost of energy, add Vibrant.

* For depression, add Shine or Shine (DS).

* For hepatitis, add Liver DTX.

* For bleeding, add Notoginseng 9.

* For excess damp and phlegm, add Pinellia Complex.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Pishu (BL 20), Shenshu (BL 23), Zhongwan (CV 12), Tianshu (ST 25), Shangjuxu (ST 37), Yinlingquan (SP 9), Guanyuan (CV 4), Mingmen (GV 4)

 

Classic Master Tung's Points:

* Diarrhea: Qimen (T 33.01), Qijiao (T 33.02), Qizheng (T 33.03), Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuaxia (T 77.11), Menjin (T 66.05), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21)

* Poor appetite: Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuaxia (T 77.11)

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Poor digestion: Tongwei (T 88.10)

* Poor appetite: Pizhong (T 11.18), Linggu (T 22.05)

* Loose stool: Changmen (T 33.10)

 

Balance Method by Dr. Richard Tan:

* Left side: Neiguan (PC 6), Lieque (LU 7), Zusanli (ST 36), Yanglingquan (GB 34)

* Right side: Hegu (LI 4), Waiguan (TH 5), Yinlingquan (SP 9), Ququan (LR 8)

* Left and right sides can be alternated from treatment to treatment.

 

Ear Acupuncture:

* Large Intestine, Small Intestine, Lung, Spleen

 

Auricular Medicine by Dr. Li-Chun Huang:

* Relieving diarrhea: Spleen, Occiput, Large Intestine, Sympathetic, Rectum, Shenmen, Digestive Subcortex. Bleed Ear Apex.

* Strengthen the Spleen and promoting digestion: Spleen, Stomach, Mouth, Pancreas, Endocrine, Digestive Subcortex, Small Intestine

 

NUTRITION

* Eat a variety of fresh, organic fruits and vegetables of all colors. 

* Incorporate more high-fiber whole grains and nuts into diet.

* Drink warm or hot liquids with meals. Putting cold and ice on any part of the body will immediately constrict the flow of blood to that region. Similarly, drinking cold or iced drinks with meals will hinder the natural peristaltic movements of the digestive system.

* Foods with antioxidant effects, such as vitamin A, C and E are beneficial as they neutralize the free radicals and minimize damage to cells. Beneficial foods include citrus fruits, carrots, green leaf vegetables, and green tea.

* Chew food completely and thoroughly. The digestive tract can process and absorb smaller pieces of food much better than food that is incompletely chewed. Larger pieces of food can lead to incomplete digestion and digestive discomfort.

* Always eat breakfast. According to the TCM clock, the most optimal time for the digestive system is in the morning from 8 to 10 a.m.

* Give the body two to three hours between the last meal of the day and bedtime. During sleep, the digestive system slows down as well. Make sure the body has adequate time to digest the food before going into sleep mode.

* If the patient is allergic to any food or feel uncomfortable after eating certain foods, then avoid eating it.

* Avoid fast food, processed foods, junk food, artificial sugars, and carbonated drinks. Stay away from meat, greasy food, alcohol, caffeine, dairy products (except for unsweetened low-fat yogurt), tap water, iron supplements, and vegetables and fruits with pesticides.

* The Spleen is responsible for generating post-natal qi, and good Spleen function also contributes to a healthy immune system. Foods that damage the Spleen should avoided:

¡± Avoid any and all foods that contain sugar, such as cake, dessert, candy, chocolate, soda, canned juice, soft drinks, caffeinated drinks, stevia, sugar substitutes, agave, xylitol, and corn syrup.

¡± Avoid raw or uncooked meats, such as sashimi, sushi, steak tartar, and seared meat.

¡± Minimize consumption of foods that are cooling in nature, including tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, bitter melon, cucumber, gourd, luffa, eggplant, winter melon, watermelon, honeydew, citrus, oranges, guava, grapefruit, pineapple, plums, pear, banana, papaya, watermelon, white radish, mustard leaf, potherb mustard, Chinese kale, napa, and bamboo sprout. Do not eat foods straight from the refrigerator. Long-term intake of cold fruits and vegetables like the ones listed above may be damaging to the Spleen. The cooling property of foods can be neutralized by cooking or adding 20 pieces of Gou Qi Zi (Fructus Lycii).

¡± Avoid carbohydrates like white rice or bread as they may produce dampness.

¡± No seafood especially shellfish, like crabs, oyster, scallops, clams, lobster and shrimp (they enter the yangming Stomach channel).

¡± Avoid fermented foods like cheese or fermented tofu.

¡± Do not eat dairy products, such as milk, cream, cheese, and ice cream.

¡± No lamb, beef, goose or duck.

¡± Avoid deep-fried or greasy foods.

* Warm and hot natured foods that damage qi and yin should be avoided, such as:

¡± certain fruits like mango and durian that produce heat.

¡± stimulants like coffee, alcohol, and energy drinks.

¡± spicy/pungent/aromatic vegetables such as pepper, garlic, onions, basil, rosemary, cumin, funnel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, and wasabi.

* Avoid food and drinks with artificial coloring.

* Consume as few meat products as possible. Do not eat processed meats, such as lunch meats, hot dogs and sausages, as they contain nitrites that are associated with inflammation and chronic disease.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Weak digestion: make a soupy porridge with cornmeal. Especially good for recovery from flu or cold.

* Weak digestion and diarrhea: toast 2 tablespoonfuls of quinoa until slightly brown, steep in hot water with 3 slices of ginger and a pinch of cardamom.

 

LIFESTYLE INSTRUCTIONS

* Sanitation of food is important to prevent further damage to the digestive system.

* Do not sit directly on wet cement or marble floors to prevent invasion of damp-cold.

* A positive outlook on life is important. Worrying and thinking too much consume Spleen qi.

* Individuals suffering from irritable bowel syndrome with alternating spells of constipation and diarrhea should stay away from stress as it may aggravate the symptoms.

 

CASE STUDIES

* J.S., a 67-year-old female, presented with gas, bloating, and diarrhea. She had already been to a Western doctor to rule out any internal abnormalities. The practitioner diagnosed this condition as Spleen qi deficiency; the Western diagnosis was irritable bowel syndrome. GI Tonic was prescribed to treat the condition symptomatically and it produced excellent results. The patient was also aware of her trigger foods and attempted to avoid them. The patient continues to keep the GI Tonic available, especially when traveling, in case of traveler¡¦s diarrhea. Submitted by S.R., Waterbury, Connecticut.

* A 25-years-old female with a long-term history of digestive problems presented with indigestion and diarrhea. She stated that she experienced abdominal pain and diarrhea whenever she eats food that is slightly unclean or spoiled. In addition, she has poor appetite and indigestion. She has a skinny appearance and an aversion to cold. The diagnosis was diarrhea due to Spleen and Stomach deficiencies. She started taking GI Tonic, and began to improve within one week. She continued to take the herbs for one month to strengthen the underlining deficiencies. Submitted by J.C., Diamond Bar, California.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

GI Tonic is an herbal formula designed to improve the overall health of the body by supporting the gastrointestinal tract. It contains herbs with a balancing effect to regulate and restore gastrointestinal functions. Clinically, GI Tonic addresses both the causes and the symptoms of gastrointestinal problems, such as diarrhea, gastritis and colitis characterized by weakness and deficiency. Lastly, GI Tonic is also effective in relieving anorexia and malnutrition secondary to gastrointestinal disorders.

        Optimal health cannot be restored unless the underlying gastrointestinal disorders are first corrected. Without proper absorption of food and nutrients, the body simply cannot heal and recover. Thus, GI Tonic uses many herbs to restore physical and physiological functions of the gastrointestinal tract. Bai Zhu (Rhizoma Atractylodis Macrocephalae) and Sha Ren (Fructus Amomi) have dual effects to regulate the gastrointestinal tract. At low doses, they have a stimulating effect on the stomach and the intestines, and at high doses, they have an inhibiting effect. Because of this balancing effect, these two herbs can be used for various gastrointestinal disorders, including both diarrhea and constipation.[1]^,[2]

        GI Tonic contains many herbs that have been shown in clinical studies to treat various gastrointestinal disorders. In one clinical study, 95 patients with chronic diarrhea were treated using this formula with an overall effective rate of 71.6%.[3] In another study, 42 children with diarrhea due to deficiency of the Spleen were treated, resulting in improvement in all cases.[4] The individual herbs in GI Tonic have also shown great promise for treatment of gastrointestinal conditions. For example, 93 infants with diarrhea were treated with Fu Ling (Poria) with complete recovery in 79 cases, improvement in 8 cases, and no effect in 6 cases (93.4% effective rate).[5] In another study, 320 infants with diarrhea were treated three times daily with Bai Zhu (Rhizoma Atractylodis Macrocephalae) and Shan Yao (Rhizoma Dioscoreae) with good results.[6] Furthermore, 10 children diagnosed with Spleen deficiency according to traditional Chinese medicine were treated with a decoction of Ren Shen (Radix et Rhizoma Ginseng) twice daily for 7 to 14 days. At the end of the study, it was reported that all had an increase in appetite, cessation of spontaneous perspiration, increase in body weight, and improvement of facial complexion.[7]

        Herbs in GI Tonic have also shown a marked effect for treatment of gastrointestinal disorders, such as superficial gastritis and peptic ulcer disease. In one study, 32 patients were treated with complete recovery in 15 cases (46.8%), a marked effect in 9 cases (28.1%), a moderate effect in 7 cases (21.8%), and no effect in 1 case. The overall effective rate was 96.7%.[8] In another study, 43 patients with gastric or duodenal ulcer were treated successfully using Sha Ren (Fructus Amomi) in powder form. The study reported significant improvement in such symptoms as epigastric pain, abdominal distension, and acid reflux.[9] Furthermore, Gan Cao (Radix et Rhizoma Glycyrrhizae) and Jie Geng (Radix Platycodonis) have gastroprotective effects. Many components of Gan Cao (Radix et Rhizoma Glycyrrhizae) prevent and treat peptic ulcers. The mechanisms of this action include inhibition of gastric acid secretion, binding and deactivation of gastric acid, and promotion of recovery from ulceration.[10] Administration of Jie Geng (Radix Platycodonis) is beneficial in the treatment of stomach and duodenal ulcers via inhibition of gastric acid secretion.[11] Lastly, administration of Huang Qi (Radix Astragali) for one month is also associated with a marked effect for the treatment of peptic ulcer disease.

        Ren Shen (Radix et Rhizoma Ginseng) is one of the most effective herbs to improve the overall health of the body. Traditionally, it used to tonify yuan (source) qi to strengthen the body and restore vitality. Today, this effect is often described as ¡§adaptogenic effect,¡¨ implying that it helps the body to adapt and cope with mental and physical stress.[12]^,[13] In Germany, Ren Shen (Radix et Rhizoma Ginseng) is approved by the Commission E to treat lack of stamina in individuals with declining performance, capacity for work, and concentration; and during convalescence.[14] Furthermore, to manage mental stress, Ren Shen (Radix et Rhizoma Ginseng) has been shown a positive cognitive effect to improve memory and learning ability.[15] This herb also alleviates feelings of mental fatigue experienced by participants during the later stages of the sustained, cognitively demanding task performance.[16] To manage physical stress, Ren Shen (Radix et Rhizoma Ginseng) has demonstrated a marked influence on the endocrine system. It stimulates the pituitary gland to increase the secretion of ACTH, which in turn stimulates the adrenal glands to produce cortisol.[17] According to studies, subjects that are given Ren Shen (Radix et Rhizoma Ginseng) show 132 to 179% better physical performance in swimming than ones that are not.[18] Lastly, Ren Shen (Radix et Rhizoma Ginseng) is frequently coupled with Bai Zhu (Rhizoma Atractylodis Macrocephalae), as both herbs have an adaptogenic effect and synergistically enhance each other.[19]

        In summary, GI Tonic is an essential formula for the treatment of various gastrointestinal disorders, including but not limited to diarrhea, colitis, superficial gastritis, and inflammatory condition of the intestines. GI Tonic contains herbs that will address both the cause and the symptoms of such gastrointestinal problems, thereby providing both immediate and long-term relief.

 

COMPARATIVE ANALYSIS

One striking difference between Western and traditional Chinese medicine is that Western medicine focuses and excels in crisis management, while traditional Chinese medicine emphasizes and shines in holistic and preventative treatments. Therefore, in emergencies, such as gunshot wounds or surgery, Western medicine is generally the treatment of choice. However, for treatment of chronic idiopathic illness of unknown origins, where all lab tests are normal and a clear diagnosis cannot be made, traditional Chinese medicine is distinctly superior.

        In cases of chronic energetic and gastrointestinal disorders, where all tests are normal but there are still general and non-diagnostic signs and symptoms, Western medicine offers few treatment options since there is not a clear diagnosis. On the other hand, traditional Chinese medicine is beneficial as it excels in maintainance and preventative therapies. Herbs can be used to regulate imbalances and alleviate associated signs and symptoms. Therefore, herbal therapy should definitely be employed to prevent deterioration of this condition, and to restore optimal health.