AKOM News
Contributed by Dr. Jewon Lee, Director of BM Korean Internal Medicine Clinic
: Peering into Internal Medicine, 30th
2026. 5. 20.
"To cure a disease, one must seek its root (Chibyeong-pilgu-eobon / 治病必求於本)."
- 『黃帝內經』 「素問·陰陽應象大論」
This suggests that the true essence of medicine goes beyond symptomatic treatments that merely suppress symptoms and correct numbers; it is about restoring the harmony and homeostasis of human life activities and metabolism.
1. Unending Indigestion and Reflux Esophagitis: Is Medication the Only Answer?
"I suffer from indigestion, and sour fluid frequently comes up."
A male patient in his 60s visited our clinic with gastrointestinal symptoms that had persisted for years.
He was diagnosed with 'gastritis' or 'reflux esophagitis' at a Western medicine clinic and was taking multiple gastrointestinal drugs such as rabeprazole, mosapride, and UDCA.
However, the symptoms only eased temporarily while taking the medication, and the cycle of worsening symptoms kept repeating.
2. Finding the Real Cause Hidden Behind Fragmented Symptoms
To approach the inner aspect and the root of the disease, we conducted a detailed medical history review and precise examinations.
Figure 1. Nodules with Rim Calcification Observed in the Left Thyroid Lobe.
These are cross-sectional (A) and longitudinal (B) views of a nodule accompanied by rim calcification among multiple nodules in the left lobe. Strong hyperechoic calcification formed along the nodule border and the characteristic acoustic shadowing caused by it are observed. This was a major lesion that served as the basis for past surgery recommendations and biopsies, providing a crucial clue to understanding the patient's medical history and health status.
The results revealed that it was not simply a stomach issue.
- Polypharmacy: Diagnosed with diabetes and hyperlipidemia about 10 years ago, he was taking multiple chemical drugs including glimepiride, metformin, and rosuvastatin. In particular, his diabetes medication (Sulfonylurea) had been increased from 1mg a day two years ago to 4mg a day.
- Uncontrolled Blood Sugar: Contrary to the patient's memory, his actual HbA1c test result was very high at 8.3%.
- Absence of Gallbladder and Other History: He had undergone a total cholecystectomy for a gallbladder polyp about 3 years ago and was complaining of unexplained left knee pain for the past year. A thyroid ultrasound also revealed multiple nodules with rim calcification.
The patient's gastrointestinal symptoms and joint pain were not localized problems.
They were a chain reaction of systemic metabolic disorders highly entangled with 'digestive imbalance due to the absence of the gallbladder', 'metabolic and hormonal imbalance due to uncontrolled blood sugar', and 'effects of polypharmacy'.
Table 1. Changes in Metabolic Indicators and Body Composition Following Deprescribing and Korean Medicine Treatment.
Despite stopping chemical medications for diabetes and hyperlipidemia, the HbA1c significantly improved from 8.3% to 7.0%. The TG/HDL ratio, a core indicator of metabolic health, also improved from 1.7 to 0.9, confirming stable metabolic recovery and maintenance of kidney function (eGFR) along with fat-centered weight loss (-5.0kg) without significant muscle mass reduction.
3. Deprescribing and Multimodal Korean Medicine Treatment
We diagnosed this condition as the Middle-Type (Jungso / 中消) of Wasting and Thirsting Disorder (Sogal / 消渴) and a Damp-Heat Pattern (Seub-yeol-jeung / 濕熱證), prescribing Modified White Tiger Decoction (Gagam-baekho-tang / 加減白虎湯) recorded in Donguibogam (Principles and Practice of Eastern Medicine).
During the treatment, we closely monitored him using a Continuous Glucose Monitor (CGM).
Because existing chemical drugs can cause gastrointestinal side effects or hinder blood sugar control, we performed a Comprehensive, Multimodal Korean Medicine intervention that re-evaluated and adjusted the need for these medications (Deprescribing).
4. Metabolic Recovery and "Graduating" from Disease Proven by Data
Figure 2. Monthly Blood Glucose Variability and Distribution Changes During Treatment (Monthly Box Plot).
Shows the monthly trend of blood glucose according to the treatment progress. Blood glucose variability (box size and outliers) decreased after treatment compared to before treatment.
As a result of the patient's active participation in the treatment, remarkable changes occurred in just 8 weeks.
- Blood Sugar Stabilization: Despite stopping diabetes medication, his HbA1c level significantly improved from 8.3% to 7.0%. Severe blood sugar fluctuations also disappeared in the CGM data.
- Healthy Weight Loss: His weight dropped from 72.7kg to 65.6kg, a loss of 7.1kg, mainly from body fat without a significant decrease in skeletal muscle mass.
- Metabolic Indicator Improvement: Triglycerides (TG), a risk factor for cardiovascular disease, decreased from 96 to 73, and good cholesterol (HDL) increased from 58 to 79. The TG/HDL ratio, a key marker of metabolic health, improved from 1.7 to 0.9, confirming stable metabolic recovery.
Along with this systemic metabolic recovery, the gastrointestinal symptoms and knee pain that had tormented the patient for a long time naturally improved.
5. Korean Medicine Physician as a True 'Primary Care Physician for Chronic Diseases'
Not just chasing fragmented symptoms or immediate numbers, but harmonizing the patient's entire life to restore the balance of life activities.
Guiding the patient out of the shackles of polypharmacy toward true healing is the genuine role of a primary care physician.
Equipped with both the traditional wisdom of a holistic view and the tools of modern science, a Korean Medicine physician will fulfill the mission of restoring true 'healthy freedom' to patients.
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Peering into Internal Medicine 29 - AKOM News
"I suffer from indigestion and frequent acid reflux"
Coordinating the patient's entire life beyond fragmented symptoms to lead them to "graduate" from their illness: The proven capability and mission of a Korean Medicine physician as a primary care physician for chronic diseases.
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