CLINICAL APPLICATIONS

* Irritable bowel syndrome (IBS)

* Disharmony of the GI tract: alternating diarrhea and constipation with abdominal bloating, pain, flatulence and a feeling of incomplete evacuation, and straining and urgency of bowel movements

* Various bowel disorders, such as diverticulitis, mucous colitis, nervous bowel, irritable colon, and spastic colon

 

WESTERN THERAPEUTIC ACTIONS

* Soothes the irritation of the gastrointestinal tract caused by drugs, chemicals, and certain foods

* Regulates and restores gastrointestinal functions

* Relieves diarrhea and constipation

* Alleviates pain, inflammation, spasms and cramps

* Relieves bloating, flatulence, and inflammation

 

CHINESE THERAPEUTIC ACTIONS

* Tonifies the Spleen

* Regulates Liver qi

* Stops diarrhea

* Clears damp-heat

 

DOSAGE

Take 3 to 4 capsules three times daily with warm water. Dosage can be increased up to 8 to 10 capsules three times daily in acute cases until symptoms subside. For maximum effectiveness, take the herbs on an empty stomach.

 

INGREDIENTS

Bai Shao (Radix Paeoniae Alba)

Bai Zhi (Radix Angelicae Dahuricae)

Bai Zhu (Rhizoma Atractylodis Macrocephalae)

Bo He (Herba Menthae)

Chai Hu (Radix Bupleuri)

Che Qian Zi (Semen Plantaginis)

Chen Pi (Pericarpium Citri Reticulatae)

Chuan Mu Xiang (Radix Vladimiriae)

Dang Gui (Radix Angelicae Sinensis)

Dang Shen (Radix Codonopsis)

Fang Feng (Radix Saposhnikoviae)

Fu Ling (Poria)

Hou Po (Cortex Magnoliae Officinalis)

Huang Bo (Cortex Phellodendri Chinensis)

Huang Lian (Rhizoma Coptidis)

Huo Xiang (Herba Agastaches)

Pao Jiang (Rhizoma Zingiberis Praeparatum)

Qin Pi (Cortex Fraxini)

Wu Wei Zi (Fructus Schisandrae Chinensis)

Yi Yi Ren (Semen Coicis)

Yin Chen (Herba Artemisiae Scopariae)

Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle)

 

BACKGROUND

Irritable bowel syndrome (IBS) is a motility disorder involving the entire gastrointestinal tract causing varying degrees of abdominal discomfort and pain, constipation and/or diarrhea and abdominal bloating. In addition, patients often notice a change in the pattern of bowel movement, mucus in the stool, and sensation of incomplete evacuation after defecation. Though the exact cause is unknown and the pathophysiology is not completely understood, it has been found that emotional factors, diet, drugs, chemicals or toxic substances often precipitate or aggravate the condition. Optimal treatment, therefore, must focus on alleviating the gastrointestinal symptoms and eliminating the factors that trigger the bowel irritation.

 

FORMULA EXPLANATION

According to traditional Chinese medicine, irritable bowel syndrome (IBS) is a condition caused by Spleen qi deficiency and Liver qi stagnation. Gastrointestinal symptoms such as loose stools, mucus in the stool, pain, incomplete evacuation and bloating are all results of Liver overacting on the Spleen and Stomach. In addition to IBS, many other bowel disorders exhibit similar signs and symptoms described above. GI Harmony focuses on tonifying the Spleen, harmonizing the Stomach, spreading the Liver qi to relieve bloating and pain, and draining damp-heat in the Intestines to reduce inflammation.

        Dang Shen (Radix Codonopsis), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Poria), and Yi Yi Ren (Semen Coicis) tonify the Spleen and dispel dampness. Dampness in the body is manifested by the presence of mucus in the stool. Dampness in the Intestines also causes feelings of incomplete evacuation. The above herbs strengthen Spleen qi and avoid the conditions characterized by Wood overacting on the Earth element. Huo Xiang (Herba Agastaches), Fang Feng (Radix Saposhnikoviae), and Wu Wei Zi (Fructus Schisandrae Chinensis) stop diarrhea. Chai Hu (Radix Bupleuri), Hou Po (Cortex Magnoliae Officinalis), Chen Pi (Pericarpium Citri Reticulatae), Bo He (Herba Menthae), and Chuan Mu Xiang (Radix Vladimiriae) are qi-regulating herbs used to relieve bloating, pain, gas and stress. Bai Shao (Radix Paeoniae Alba) and Dang Gui (Radix Angelicae Sinensis) nourish blood to soften the Liver and relieve cramps. To reduce the inflammation in the intestines, heat-clearing herbs, such as Huang Bo (Cortex Phellodendri Chinensis), Huang Lian (Rhizoma Coptidis), Yin Chen (Herba Artemisiae Scopariae), Che Qian Zi (Semen Plantaginis), and Qin Pi (Cortex Fraxini), are used. Yin Chen (Herba Artemisiae Scopariae) also increases the production of bile to help digestion. Che Qian Zi (Semen Plantaginis) also dispels water through urination to consolidate stool. Pao Jiang (Rhizoma Zingiberis Praeparatum) and Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) harmonize the middle jiao. Finally, Bai Zhi (Radix Angelicae Dahuricae) enters the Stomach and the Spleen channels to stop diarrhea, eliminate pus, and relieve pain.

        GI Harmony is a comprehensive formula that addresses irritable bowel syndrome and many other bowel disorders. This formula treats the cause of the disorder by tonifying the Spleen and spreading Liver qi stagnation. Furthermore, this formula treats the symptoms by relieving bloating and flatulence, regulating bowel movement, and alleviating abdominal pain.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated during pregnancy and nursing.

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]^,[2],[3]

 

CLINICAL NOTES

* GI Harmony is an herbal formula derived from the standard treatment of IBS used in a clinical trial conducted by University of Western Sydney MacArthur in Australia. In this randomized, double-blind, placebo-controlled study, 116 patients who fulfilled the Rome criteria were allocated to one of three groups: individualized treatment, standard treatment, or placebo. After 16 weeks of treatment, the gastroenterologists evaluated the patients and concluded that both the individualized treatment and the standard treatment, in comparison with placebo, showed significant improvement in bowel symptom score, global improvement, and reduced degree of interference with life. This study is published on November 11, 1998 by Journal of American Medical Association (JAMA).[4]

* Patients should take Calm to continually relieve Liver qi stagnation, especially if they have a stressful lifestyle or career. GI Harmony and Calm can be taken at equal portions for patients who have IBS and are constantly stressed.

* Female patients suffering from IBS are likely to note aggravation of symptoms before each menstrual cycle. Calm is recommended with GI Harmony for maximum effect.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Rainbow pulse, a convex-shaped pulse that is thick, forceful, and expanding on and extends distally to the left cun.

* Floating and forceful pulse on the right cun and guan.

 

SUPPLEMENTARY FORMULAS

* For irritable bowel due to stress, add Calm.

* For irritable bowel with insomnia due to shen (spirit) disturbance in patients with excess, add Calm (ES).

* For irritable bowel with insomnia due to stress in patients with deficiency, add Calm ZZZ.

* For constipation, add Gentle Lax (Deficient).

* For hemorrhoids, add GI Care (HMR).

* For fistula and diverticulitis, add Resolve (AI) and Astringent Complex.

* For peptic ulcer, add GI Care.

* For burning diarrhea or dysentery, add GI Care II.

* For fatigue or weakness, add Imperial Tonic.

* For excess fire, add Gardenia Complex.

* For bleeding, add Notoginseng 9.

* For excessive damp and phlegm, add Pinellia Complex.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Dachangshu (BL 25), Tianshu (ST 25), Zhongji (CV 3), Shenque (CV 8)

¡± For diarrhea, add Zusanli (ST 36) and Sanyinjiao (SP 6).

¡± For Spleen and Stomach deficiencies, add Pishu (BL 20) and Zhangmen (LR 13).

¡± For Spleen and Kidney yang deficiencies, add Shenshu (BL 23), Mingmen (GV 4) and Guanyuan (CV 4).

¡± For epigastric distension and discomfort, add Gongsun (SP 4).

¡± For stress and emotional disturbances, add Ganshu (BL 18) and Xingjian (LR 2).

 

Classic Master Tung's Points:

* Irritable bowel syndrome (with 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), Simazhong (T 88.17), Minghuang (T 88.12), Ganmen (T 33.11), Changmen (T 33.10)

* Irritable bowel syndrome (with constipation): Tushui (T 22.11), Qimen (T 33.01), Qijiao (T 33.02), Qizheng (T 33.03), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Tongtian (T 88.03), Fuchang (T 77.12), Huochuan (T 33.04)

* Bloating: Pizhong (T 11.18), Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuaxia (T 77.11), Fuchang (T 77.12), Menjin (T 66.05), Huoju (T 66.11), Changmen (T 33.10), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Beimian (T 44.07), Fukuai (T 1010.15), Shangjiuli (T 88.26), Zhongjiuli (T 88.25), Xiajiuli (T 88.27), Sifuyi (T 1010.11), Sifuer (T 1010.10)

 

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

* Irritable bowel syndrome, diverticulitis: Changmen (T 33.10), Ganmen (T 33.11), Sihuazhong (T 77.09)

 

Balance Method by Dr. Richard Tan:

* Left side: Dadun (LR 1), Zhongfeng (LR 4), Gongsun (SP 4), Sanyinjiao (SP 6), Yinlingquan (SP 9), Hegu (LI 4), Shangyang (LI 1)

* Right side: Lieque (LU 7), Kongzui (LU 6), Neiguan (PC 6), Zhongchong (PC 9), Liangqiu (ST 34), Zusanli (ST 36), Tiaokou (ST 38), Chongyang (ST 42), Lidui (ST 45)

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

* Ear points: Shenmen and Intestine.

 

The selection of points may be alternated with the points below from treatment to treatment.

* Left side: Neiguan (PC 6), Zhongchong (PC 9), Chongyang (ST 42), Lidui (ST 45)

* Right side: Shangyang (LI 1), Hegu (LI 4), Dadun (LR 1), Zhongfeng (LR 4)

 

Ear Acupuncture:

* Sympathetic, Shenmen, Endocrine, Small Intestine, Large Intestine

* Select two to three points per treatment. Leave in the needles for 20 minutes. Treat daily or every other day.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Relaxing the bowels: Abdomen, Spleen, Lung, Liver, San Jiao, Large Intestine, Sigmoid, Digestive Subcortex

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

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

* Bloating and distension: Liver, Stomach, Spleen, Lung, Gallbladder, San Jiao, Large Intestine, Abdominal Distension Area, Digestive Subcortex

* Intestine dysfunction: Large Intestine, Small Intestine, Sigmoid, Liver, Spleen, San Jiao, Digestive Subcortex, Sympathetic

* Constipation: Large Intestine, Sigmoid, Liver, Spleen, Lung, San Jiao, Digestive Subcortex

* Stop bleeding: Pituitary, Diaphragm, Adrenal Gland, Spleen, corresponding point where there is bleeding

 

NUTRITION

* Diet is essential to complete recovery. Foods that are associated with gas production should not be consumed, such as onions, soda, beans, cabbage, brussel sprouts, cauliflower and broccoli. Use of probiotics helps to relieve bloating and other symptoms of IBS.

* 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 leafy 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, avoid eating them.

* 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 be avoided:

¡± Avoid any and all foods that contain sugar, such as cake, dessert, candy, chocolate, 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, 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:

* Diarrhea

¡± Recommendations: garlic, black pepper, blueberries, cinnamon, raspberry leaves, lotus seeds, burned rice, yams, sweet potatoes, fresh fig leaves, peas, buckwheat, litchi, guava peel, apple, charcoaled bread, ginger, pearl barley, basil, unripe prunes.

¡± Cook rice porridge with lotus seed and yam or with barley.

¡± Eat burnt rice or bread.

¡± Make tea from dried litchi and Chinese black dates.

¡± Take two tablespoons of dried apples, three times daily on an empty stomach with warm water.

¡± Cook rice porridge with ginger and black pepper.

¡± Drink black tea.

¡± Take two bulbs of garlic, bake until black. Then boil in water and drink the tea.

¡± Make tea from guava peel.

¡± Make tea from ginger, fennel, basil, and Chinese black dates.

¡± Make tea from unripe prunes.

¡± Eat sweet rice porridge.

¡± Avoid cold, raw foods, most fruits, juices, and overeating.

* Constipation

¡± Recommendations: bananas, apples, walnuts, figs, spinach, peaches, pears, pine nuts, sesame seeds, mulberries, grapefruit, yams, honey, apricot kernel, milk, yogurt, alfalfa sprouts, beets, cabbage, bok choy, cauliflower, and potato.

¡± Eat two bananas on an empty stomach, followed by a glass of water.

¡± Drink a glass of lukewarm water with 2 teaspoons of honey on an empty stomach.

¡± Drink blended beets and cabbage on an empty stomach.

¡± Make beet soup.

¡± Eat 5 to 10 figs on an empty stomach, followed by a glass of water.

¡± Eat a fresh apple on an empty stomach daily.

¡± Drink mulberry juice.

¡± Eat lightly steamed asparagus and cabbage at night before retiring.

¡± Avoid spicy foods, fried foods, and meat.

 

LIFESTYLE INSTRUCTIONS

* Stress is a major factor in patients suffering from IBS. A relaxed or positive outlook on life is very important to recovery. Patients should be advised to learn to become more relaxed.

* Application of a heat pad to the abdomen may help with relieving pain associated with bloating and distension. Light abdominal massage in circular motions clockwise and then counterclockwise starting from small circles gradually becoming bigger may also help relieve distension, discomfort and pain. A five-minute abdominal massage is recommended daily. Patients should be advised to pass gas whenever needed to relieve qi stagnation.

* Chronic diarrhea may be alleviated with topical application of herbs. Grind She Chuang Zi (Fructus Cnidii) or Wu Zhu Yu (Fructus Evodiae) into a fine powder, dry fry the powder until it is warm, and place the powder on the umbilicus covered by gauze or tape. Change the powder every 24 hours. If the herbs are unavailable, 60g of sea salt may be used as a substitute.

 

CASE STUDIES

* A female patient complained of irritable bowel syndrome (IBS) for the past 20 years. Symptoms included diarrhea 10 to 15 times per day immediately after meals. This condition was diagnosed as Liver overacting on Spleen and Stomach. The patient was treated with GI Harmony, four capsules three times a day. Within one month of acupuncture and GI Harmony the patient noticed more time elapsed before the diarrhea occurred after meals. By the end of two months, only two or three episodes had occurred during a two week period, followed by only one or two episodes each month after three months of treatment. Today the patient only keeps GI Harmony available if needed, but she has not had any flare-ups in two months. Submitted by C.C., Cromwell, Connecticut.

* S.F., a 42-year-old female, presented with a gastrointestinal disorder with symptoms consisting of diarrhea with extreme urgency, especially worse with stress. Pulse was wiry and thready and her tongue was red with a long center crack. An additional objective finding was dark circles under her eyes. The practitioner diagnosed this condition as Liver overacting on Spleen. Upon diagnosis the patient was given GI Harmony and Calm. With taking the herbs, the patient is doing well, having a bowel movement which is well formed. Additional lifestyle changes she had made were avoiding caffeine and going to bed before 11:00 p.m. Submitted by T.W., Perrysburg, Ohio.

* D.S., a 65-year old female, presented with chronic irritable bowel syndrome consisting of mostly loose stools and constipation occasionally. It was also noted she had her gallbladder removed. Objective findings included minimal discomfort in all quadrants. The practitioner diagnosed this condition as Spleen qi deficiency and damp-cold. GI Harmony was prescribed, in which the patient needed to take at higher amounts and for a longer period of time in order to experience quiet digestions. She was very pleased with the results of the formula. Submitted by J.L., San Diego, California.

* P.Q., a 42-year-old female, presented with acid reflux and a 20-year history of irritable bowel syndrome. She had been on Xanax (alprazolam), Nexium (esomeprazole) and other Western medications. After only four days of taking GI Harmony at four capsules, three times daily, the patient saw improvement. She is now successfully off all Western medications. The doctor commented that this formula is a ¡§miracle in a bottle.¡¨ Submitted by H.C., Stephens City, Virginia.

* G.M., a 42-year-old female, presented with pain in the lower jiao, extreme fatigue, constipation, depression, poor concentration, pain with diarrhea, palpitations and night sweats. The Western diagnosis was chronic fatigue syndrome [as the doctors couldn¡¦t find anything specifically wrong]; the TCM diagnosis was yin deficiency with deficiency heat. After taking Balance (Heat), GI Harmony and Gentle Lax (Deficient), the patient reported little to no night sweats within three weeks. Her bowels normalized, and the GI tract pain was much better. She stated that she felt she could now smile and face the day. Submitted by M.C., Sarasota, Florida.

* X.L., a 7.5-year-old dog, presented with irritable bowel syndrome consisting of both loose sticky stools and constipation. The practitioner diagnosed this condition as Liver qi stagnation with Spleen qi deficiency. Upon diagnosis, GI Harmony was prescribed. The pet was given half a capsule whenever an event of IBS symptoms came about. With taking the herbs the stools would usually clear up right away and would have perfect stools for many days. Submitted by J.L., San Diego, California.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

GI Harmony is formulated to treat irritable bowel syndrome (IBS) and other bowel disorders, such as diverticulitis, mucous colitis, nervous bowel, irritable colon, and spastic colon. It contains herbs that neutralize factors that trigger and aggravate these bowel disorders, such as emotional disturbances, diet imbalance, and exposure to drugs, chemicals or toxic substances.

        Irritable bowel syndrome is a disorder characterized by irritable and irregular bowel movement with alternating diarrhea and constipation. Therefore, the primary treatment emphasis must be to regulate and restore normal gastrointestinal functions. Bai Zhu (Rhizoma Atractylodis Macrocephalae) is one of the most important herbs to balance gastrointestinal dysfunction. This herb is well known for its dual effect on the digestive tract: it treats diarrhea at low doses and constipation at high doses. With this dual effect to balance the intestines, Bai Zhu (Rhizoma Atractylodis Macrocephalae) is the ideal herb for cases where there is alternation of diarrhea and constipation.[5] In addition to Bai Zhu (Rhizoma Atractylodis Macrocephalae), GI Harmony uses many other herbs to influence and support the gastrointestinal tract. Diarrhea can be prevented and treated with herbs such as Bai Zhu (Rhizoma Atractylodis Macrocephalae), Wu Wei Zi (Fructus Schisandrae Chinensis), Che Qian Zi (Semen Plantaginis), and Fu Ling (Poria). In one study, 320 infants with diarrhea were treated with an herbal powder containing Bai Zhu (Rhizoma Atractylodis Macrocephalae) three times daily before meals with good results.[6] In another study, 63 out of 69 infants with diarrhea showed complete recovery within one to two days following treatment using an herbal decoction containing 30 grams of Che Qian Zi (Semen Plantaginis) and a small amount of sugar.[7] Furthermore, in a clinical study, 93 infants with diarrhea were treated with Fu Ling (Poria) with good symptomatic relief and a shortened duration of diarrhea.[8] On the other hand, constipation can be alleviated and treated with herbs such as Bai Shao (Radix Paeoniae Alba), Gan Cao (Radix et Rhizoma Glycyrrhizae), Dang Gui (Radix Angelicae Sinensis) and Pao Jiang (Rhizoma Zingiberis Praeparatum). According to one report, over 60 patients with chronic habitual constipation were treated with great success using an herbal formula with 24 to 40 grams of fresh Bai Shao (Radix Paeoniae Alba) and 10 to 15 grams of fresh Gan Cao (Radix et Rhizoma Glycyrrhizae) in decoction.[9] Use of Dang Gui (Radix Angelicae Sinensis), Gan Cao (Radix et Rhizoma Glycyrrhizae) and others in an herbal formula showed 94% rate of effectiveness for treatment of chronic constipation in 50 elderly patients.[10]

        Beyond constipation and diarrhea, GI Harmony contains other herbs that regulate and restore normal gastrointestinal functions. Dang Shen (Radix Codonopsis) has marked preventative and treatment effects on peptic ulcers. It increases gastric emptying time, decreases severity of ulceration, and increases the amount of prostaglandin in the stomach.[11] Deoxyschizandrin, one ingredient of Wu Wei Zi (Fructus Schisandrae Chinensis), inhibits the secretion of gastric acid, and has shown beneficial effects in treatment of gastric ulcer.[12] Hou Po (Cortex Magnoliae Officinalis) has an inhibitory effect on the gastrointestinal system, leading to decreased secretion of gastric acid.[13] Many components of Gan Cao (Radix et Rhizoma Glycyrrhizae) have shown protective and treatment effects for peptic ulcers. The mechanisms of action include inhibition of gastric acid secretion, binding and deactivation of gastric acid, and promotion of recovery from ulceration.[14] Hou Po (Cortex Magnoliae Officinalis) decreases incidence of intestinal bloating.[15] Administration of Chuan Mu Xiang (Radix Vladimiriae) shows 100% effectiveness in 29 patients to reduce flatulence due to indigestion, acute gastroenteritis, gastric nervosa, and post-surgical complications.[16] Lastly, an herbal formula composed of 80% Huang Lian (Rhizoma Coptidis) demonstrates effective in treating 100 patients with inflammatory bowel condition, such as acute gastroenteritis or enteritis.[17] Lastly, Pao Jiang (Rhizoma Zingiberis Praeparatum) has been shown to enhance intestinal peristalsis, increase production of gastric mucous membranes, and restore normal intestinal activity.[18]^,[19]

        From Western medicine perspectives, though the cause and pathophysiology of irritable bowel syndrome are not completely known and understood, the severity of the disease and frequency of attacks are clearly associated with factors such as emotion, diet, drugs, chemicals or toxic substances. Therefore, GI Harmony contains many herbs to specifically address these factors. Chai Hu (Radix Bupleuri) is one of the most effective and most frequently used herbs to regulate the emotion and treat psychological disorders, including but not limited to depression,[20] neurosis,[21] schizophrenia,[22] and psychosis.[23] Since the bowel irritation may be associated with intake of certain foods, drugs, chemicals or other toxic substances, GI Harmony contains herbs to detoxify these offending substances. Administration of Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) shows a marked protective effect against irritation of the gastrointestinal tract caused by aspirin and non-steroidal-anti-inflammatory drugs (NSAIDs).[24] In addition, glycyrrhizin, one of the main constituents of Gan Cao (Radix et Rhizoma Glycyrrhizae), has a remarkable detoxifying effect to treat various kinds of poisonings, including but not limited to drug poisoning (chloral hydrate, urethane, cocaine, picrotoxin, caffeine, pilocarpine, nicotine, barbiturates, mercury and lead), food poisoning (tetrodotoxin, snake, and mushrooms), and others (enterotoxin, herbicides, pesticides).[25]

        Lastly, to treat pain and inflammation, GI Harmony uses many herbs with analgesic, anti-inflammatory and antispasmodic effects. Dang Gui (Radix Angelicae Sinensis) has a strong analgesic and anti-inflammatory effect, with potency and efficacy similar or greater than aspirin.[26]^,[27] Bai Zhi (Radix Angelicae Dahuricae) has potent analgesic, anti-inflammatory and antispasmodic effects.[28]^{,[29],[30],[31]} Use of Bai Zhi (Radix Angelicae Dahuricae) in an herbal formula has been shown to effectively treat 40 patients with gastric pain due to gastric ulcer, duodenal ulcer, and chronic gastritis.[32] Bai Shao (Radix Paeoniae Alba) and Gan Cao (Radix et Rhizoma Glycyrrhizae) are two herbs with strong and synergistic, analgesic, and antispasmodic activities.[33]^,[34] In fact, the use of these two herbs show great success in treating 85 patients with intestinal cramps and spasms in one clinical study.[35] To harmonize the gastrointestinal tract and normalize its functions, GI Harmony uses many herbs with different mechanisms of action to reduce inflammation and relieve irritation. Fang Feng (Radix Saposhnikoviae) and Che Qian Zi (Semen Plantaginis) show a marked effect to suppress inflammation via the inhibition of nitrite production.[36]^,[37] Hou Po (Cortex Magnoliae Officinalis) illustrates its anti-inflammatory properties through the inactivation of NF-kappaB, which is an important factor in the regulation of inflammatory reaction.[38] Huang Lian (Rhizoma Coptidis) and Huang Bo (Cortex Phellodendri) both have a great effect to reduce inflammation by inhibiting the production of proinflammatory cytokines, such as interleukin-1beta and tumor necrosis factor-alpha (TNF-£\).[39] In fact, the combination of Huang Lian (Rhizoma Coptidis) and Huang Bo (Cortex Phellodendri) exert anti-inflammatory activity as potent as the effects associated with dexamethasone (Decadron) or celecoxib (Celebrex) for treating both acute and chronic inflammatory diseases.[40] Lastly, Gan Cao (Radix et Rhizoma Glycyrrhizae) demonstrates marked anti-inflammatory effects. The exact mechanisms of action vary among experts. Some believe that the enhanced cortisone effect is due to decreased metabolism by the liver, or increased plasma concentration caused by decreased protein binding.[41] Nonetheless, Gan Cao (Radix et Rhizoma Glycyrrhizae) has potent steroid-like effect, with potency of glycyrrhizin and glycyrrhetinic acid comparable to 1/10^th that of cortisone.[42]

        In summary, GI Harmony contains herbs with marked effectiveness to treat irritable bowel syndrome. GI Harmony regulates the bowel movement, and relieves abdominal discomfort and pain, and neutralizes the irritation caused by toxic and other offending substances (such as drugs and chemicals).

 

COMPARATIVE ANALYSIS

Irritable bowel syndrome (IBS) is a motility disorder that affects the entire gastrointestinal tract. This disorder has no known anatomic cause. Therefore, most drug treatments focus on relieving symptoms. Anticholinergic drugs [such as Pro-Banthine (propantheline)], tranquilizers [such as Librium (chlordiazepoxide)], and sedatives [such as phenobarbital] are frequently given to relieve gastrointestinal symptoms and to calm patients. Those with depression are treated with antidepressants, and ones with diarrhea are treated with antidiarrheals. While this discussion of drug treatment is an oversimplification, it nonetheless illustrates that these drugs only treat symptoms, and not the cause, of irritable bowel syndrome. Therefore, though they offer short-term effectiveness, symptoms often flare-up again once the drugs are discontinued.

        Use of acupuncture and herbs is effective to treat various gastrointestinal disorders, including but not limited to irritable bowel syndrome, diverticulitis, mucous colitis, nervous bowel, irritable colon, and spastic colon. Not only do they control the symptoms, they often change the underlying constitution of the body to achieve long-term results. In fact, most patients remain symptom free for at least several months after the herbs are discontinued.

        It is important to remember that stress and diet are two main factors that trigger irritable bowel syndrome. In addition to considering drugs or herbal treatment, it is important to follow the guidelines described in this monograph, and make diet and lifestyle changes. Only then will treatment successfully ensure short- and long-term effectiveness, and minimize the frequency and severity of irritable bowel syndrome.