What Does the TCM Think about Endometriosis and How Do We Treat It?

What is Endometriosis?

Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside or lining the tissue of the uterus, but in a location outside of the uterus. Endometrial cells are cells that are shed each month during menstruation. The cells of endometriosis attach themselves to tissue outside the uterus and are called endometriosis implants. These implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain.

Who is Affected by Endometriosis?

While most cases of endometriosis are diagnosed in women aged around 25 to 35 years, endometriosis has been reported in girls as young as 11 years of age. Endometriosis is rare in postmenopausal women. Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.

What Causes Endometriosis?

The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the backing up of menstrual flow into the Fallopian tubes and the pelvic and abdominal cavity during menstruation. The cause of retrograde menstruation is not clearly understood. But retrograde menstruation cannot be the sole cause of endometriosis. Many women have retrograde menstruation in varying degrees, yet not all of them develop endometriosis.
 Another possibility is that areas lining the pelvic organs possess primitive cells that are able to grow into other forms of tissue, such as endometrial cells. (This process is termed coelomic metaplasia.) It is also likely that direct transfer of endometrial tissues during surgery may be responsible for the endometriosis implants sometimes seen in surgical scars. Transfer of endometrial cells via the bloodstream or lymphatic system is the most likely explanation for the rare cases of endometriosis that develop in the brain and other organs distant from the pelvis.
Finally, there is evidence that shows alternations in the immune response in women with endometriosis, which may affect the body's natural ability to recognize and destroy any misdirected growth of endometrial tissue.

What are Endometriosis Symptoms?

Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Pelvic pain usually occurs during or just before menstruation and lessens after menstruation. Some women experience painful sexual intercourse (dyspareunia) or cramping during intercourse, and or/pain during bowel movements and/or urination. Even pelvic examination by a doctor can be painful. The pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment. Pelvic pain in women with endometriosis depends partly on where the implants of endometriosis are located. Other symptoms that can be related to endometriosis include:

• Lower Abdominal Pain;
• Diarrhea and/or Constipation;
• Low Back Pain;
• Chronic Fatigue;
• Irregular or Heavy Menstrual Bleeding;
• Blood in the Urine.

Rare symptoms of endometriosis include chest pain or coughing blood due to endometriosis in the lungs and headache and/or seizures due to endometriosis in the brain.

What Does the TCM Think about Endometriosis and How Do We Treat It?

In TCM, we do not have this name “Endometriosis,” we deal with the symptoms such as dysmenorrhea, dyspareunia, infertility,and recurrent pelvic pain. Traditional Chinese Medicine(TCM) it attributed to dysmenorrhea, infertility, pelvic mass, irregular menstruation and other symptoms category. TCM's position is concerned, the disease mostly due to qi and blood stasis, qi and blood deficiency, cold in uterus. In TCM, the endometriosis is sperated to many types such as Qi and blood stagnation, Damp-heat and blood stasis, Qi deficiency and blood stagnation,Yin deficiency and blood stasis, Yang deficiency and blood stasis. The basic of these types are blood statsis, therefore, we have to circulate blood and relieve pain. In my experience, pain can be relieved in next period, and after three months treatment (usually the menstruation kinds of diseases should treat three months), most of my patients would feel much better.

Sciatica Treatment

Recently, there are many patients suffer sciatica and that really bothers them. So today I would like to explain why Acupuncture and Tuina(Massage) can treat people who suffer from sciatica pain.

What are causes of sciatica?

Firstly of all, what are causes of sciatica? The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. Sciatica pain is typically felt from the low back to behind the thigh and radiating down below the knee. While sciatica is most commonly a result of a lumbar disc herniation directly pressing on the nerve, any cause of irritation or inflammation of the sciatic nerve can reproduce the symptoms of sciatica. This irritation of nerves as a result of an abnormal intervertebral disc is referred to as radiculopathy. Aside from a pinched nerve from a disc, other causes of sciatica include irritation of the nerve from adjacent bone, tumors, muscle, internal bleeding, infections, injury, and other causes. Sometimes sciatica can occur because of irritation of the sciatic nerve during pregnancy.

What are sciatica symptoms?

Sciatica causes pain, a burning sensation, numbness, or tingling radiating from the lower back and upper buttock down the back of the thigh to the back of the leg. The result is lumbar pain, buttock pain, hip pain, and leg pain. Sometimes the pain radiates around the hip or buttock to feel like hip pain. While sciatica is often associated with lower back pain (lumbago), it can be present without low back pain. Severe sciatica can make walking difficult if not impossible. Sometimes the symptoms of sciatica are aggravated by walking or bending at the waist and relieved by lying down. The pain relief by changing positions can be partial or complete.

How dose Acupuncture and Tuina(Massage) do?

Acupuncture can calm the irritate nerves down and combine with Tuina that can relax muscle very well. During the acute period, the irritation nerves would cause huge pain and abnormal sensation, such as burning and numbness. So nerves should be allayed immediately to prevent causing further damage. After treatment most of my patients would feel relaxation. That is why acupuncture can treat sciatica well. Acupuncture is a really good treatment for sciatica.

Diarrhea Treatment. Treat Diarrhea.

Diarrhea describes bowel movements (stools) that are loose and watery. It is very common and usually not serious. Many people will have diarrhea once or twice each year. It typically lasts two to three days and can be treated with over-the-counter (OTC) medicines. Some people have diarrhea often as part of irritable bowel syndrome or other chronic diseases of the large intestine.

Doctors classify diarrhea as "osmotic," "secretory," or "exudative."

• Osmotic diarrhea means that something in the bowel is drawing water from the body into the bowel. A common example of this is "dietetic candy" or "chewing gum" diarrhea, in which a sugar substitute, such as sorbitol, is not absorbed by the body but draws water from the body into the bowel, resulting in diarrhea.
• Secretory diarrhea occurs when the body is releasing water into the bowel when it's not supposed to. Many infections, drugs, and other conditions cause secretory diarrhea.
• Exudative diarrhea refers to the presence of blood and pus in the stool. This occurs with inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, and several infections.

What Causes Diarrhea?

The most common cause of diarrhea is a virus that infects the gut. The infection usually lasts for two days and is sometimes called "intestinal flu" or "stomach flu."Diarrhea may also be caused by:

• Infection by bacteria (the cause of most types of food poisoning) • Infections by other organisms
• Eating foods that upset the digestive system
• Allergies to certain foods 
• Others 

Diarrhea may also follow constipation, especially for people who have irritable bowel syndrome.

What Are the Symptoms of Diarrhea?

• Abdominal bloating or cramps
• Thin or loose stools
• Watery stool 
• Sense of urgency to have a bowel movement

Etiology & Pathology of diarrhea in TCM

Syndrome differentiation

• Cold and Damp: Watery, thin diarrhea which has no strong or foul odour. Generally this is an acute type and has abdominal pain and digestive sounds from the intestines which are relieved by heat. There is a cold type of abdominal cramping. The patient will generally feel cold and prefer warm drinks.
• Damp and Heat: Foul smelling diarrhea which leaves a burning feeling on the anus. There is commonly yellow mucus and possible blood found in the stool. There will be a unfinished feeling after passing stool and a general sense of feverishness. The patient will have a red complexion and possibly sweat easily.
• Food Stagnation: Acute diarrhea due to over eating or inadquate digestion. Diarrhea which is irregular and has very strong odour and a general sense of bloating and possible abdominal pain. Patient will have frequent belching and burping up of old sour food.
• Spleen Qi Insufficiency: Diarrhea which is chronic. There is undigested food found within the stools. The diarrhea is very soft and may or may not be accompanied with pain. The pain with this type of diarrhea may be due to the anus dropping (prolapsed anus) or pain associated with abdominal spasming. In either case the patient will express a general sense of fatigue, easily bloat with specific foods or after large meals, have a low appetite and in severe cases have a slight yellow complexion.
• Kidney Insufficiency: Chronic Diarrhea occuring consistently early in the morning (around 5am). This type of diarrhea is commonly accompanied with mild abdominal pains which is relieved after a bowel movement. There will also be signs of low back ache, weak knees, waking at night to urinate, low sex drive and mild fatigue.
• Excess Water In Intestines: Chronic case of diarrhea which is watery, frothy and almost "bubbly". This is commonly known as a dysfunction of intestiness where there is excess water retained within the intestines giving rise to borborygmi(noise in abdomen), loss of weight, poor appetite, bloated abdomen, low amounts of urine but a good thirst.
• Liver Qi Stagnation: Diarrhea which is aggravated by emotional stimulus . Sadness, grief, frustration, anger, anxiety will all aggravate this type of diarrhea. There may be abdominal cramping and pressure or pain under the rib cage. This can be easily associated with IBS (Irritable Bowel Syndrome). 

Diarrhea Treatments

Herbs and Acupuncture should be combined together. I like to use acupuncture to adjust patients' meridians and they would feel their abdomen sudden relax and comfortable. Herbs would give them benefit in balancing their organs, such as spleen,stomach,and kidneys.

I have one patient who has suffered diarrhea at for several years. The patient had to go to washroom at lease 10 times a day. After one time treatment, the patient only need to go to washroom 5 times a day, and then, after 5 times treatments the patient has turned to normal 1 to 2 times a day. Acupuncture and TCM are really ways to treat diarrhea.

What are Common Causes of Low Back Pain? What do TCM Treatments Help?

Common causes of Low Back Pain (Lumbar Backache) include lumbar strain, nerve irritation, lumbar radiculopathy, bony encroachment, and conditions of the bone and joints. Each of these is reviewed below.

1. Lumbar strain
Sprains and strains imply stretching or tearing of the tissue involved, either muscles (strain) or ligaments (sprain). (For more detailed information, please refer to this article)

2. Nerve irritation
The nerves of the lumbar spine can be irritated by mechanical pressure (impingement) by bone or other tissues, or from disease, anywhere along their paths -- from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease , bony encroachment, and inflammation of the nerves caused by a viral infection (shingles).

3. Lumbar radiculopathy
Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration ("wear and tear") of the outer ring of the disc, traumatic injury, or both.

4.Bony encroachment
Any condition that results in movement or growth of the vertebrae of the lumbar spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foraminal narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body, commonly as a result of arthritis), spondylolisthesis (slippage of one vertebra relative to another), and spinal stenosis (compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal).

5. Bone and joint conditions
Bone and joint conditions that lead to Low Back Pain include those existing from birth (congenital), those that result from wear and tear (degenerative) or injury, and those that are due to inflammation of the joints (arthritis).

6. Other causes of Low Back Pain include kidney problems, pregnancy, ovary problems, and tumors.

Traditional Chinese medicine theory :Waist is the house of kidneys and the kidney meridian go through the spine. It indicates the close relationship of low back pain and kidney, and waist meridian, tendons, choroid lesions may also cause low back pain. There are three types low back pain in TCM.

1. Cold-damp lumbago
It is usually because people exposure in cold conditions after sweating , so that blood and Qi are blocked in low back.

2. Muscular strain lumbago
It dues to lumbar muscle sprain, bruise or impact injury , resulting in meridian damaged, and causing Qi and blood run obstructed.

3. Lumbago due to kidney-asthenia
Chronic illness or old and feeble, or frequent sex, and consumption of energy, would cause kidney Qi deficiency.

Acupuncture is a really go way to dredge the block. One of the theory of TCM is “Block Cause Pain” and “Unobstructed No Pain”. After removing the block, most patient would feel relax right away and after drinking warm water and hot shower they would feel much better. The third kind patients whose treatments have to combine acupuncture and herbal therapy. Their kidneys need to be strengthened first.