AKOM News (https://www.akomnews.com)
Contributed by Dr. Jewon Lee, Director of BM Korean Internal Medicine Clinic
: Peering into Internal Medicine, 11th
2024. 7. 17.
"My stomach hurts so bad sometimes because of Crohn's disease."
A teenage female patient came in with her parents.
She was diagnosed with Crohn's disease 4 months ago and is receiving medication at a Western medical university hospital, but she also said she wanted to receive Korean medicine treatment.
Clinical reasoning was conducted from the internal medicine perspective of Korean Medicine Doctor (KMD).
The symptoms began about 3 years ago with bright red bloody stools. About 1 year ago, the symptoms worsened, and she was treated at a clinic-level Western medical institution, but her symptoms persisted. Four months before her visit, she was recommended to undergo a colonoscopy, and the results suggested that she had Crohn's disease. She was transferred to a Western medical university hospital, a higher-level medical institution, and underwent an abdominal CT scan, which confirmed her Crohn's disease.
At the time of her visit, she was taking four types of medication prescribed by a Western medical university hospital: azathioprine, mesalazine, trimebutine, and iron preparations. However, she said that she suffered from severe abdominal pain once every two weeks and that she endured it by taking additional acetaminophen.
The patient's medical records were reviewed. An abdominal CT scan showed edematous changes in the ascending colon and active inflammation along the terminal ileum and small intestine in the right abdomen. A diagnostic blood test performed two weeks before her visit showed abnormal findings, including CRP 11.4 mg/L, MCV 81.5 fL, and ESR 33 mm/hr.
She mainly consumed spicy and stimulating foods such as mala-tang (麻辣烫; 麻辣燙; málàtàng; 'numb spicy hot'), bread, and sweet desserts. On the other hand, she rarely ate vegetables and was very picky.
After being diagnosed with Crohn's disease, she tried to eat mostly Korean food, but she could only barely stop eating mala-tang. She was not properly controlling dangerous external factors such as processed foods, refined sugars, and chemical additives.
Based on her clinical symptoms, medical history, and test results, her condition could be sufficiently diagnosed as Crohn's disease. However, I told her and her parents that they should not be obsessed with the disease name.
From the internal medicine perspective of KMD, the cause of the symptoms is not the disease name 'Crohn's disease'. The biggest cause of the symptoms is eating habits, and the body is reacting to an external factor called unhealthy food.
If we only focus on the disease name, we can make the mistake of overlooking the real cause of the symptoms.
I emphasized that the immune response and inflammatory response, which can be called the body's defense and recovery ability, may not be helpful in recovering health if they are suppressed or blocked by chemical synthetic drugs such as azathioprine and mesalazine.
A diet was prescribed considering her constitution and symptoms.
The most emphasized aspect of the diet prescription was green and yellow vegetables that the patient rarely consumed.
And considering the Pattern/syndrome Diagnosis (辨證) of Spleen Qi Deficiency (脾氣虛) or Qi Deficiency Damp Phlegm (氣虛濕痰), a prescription was prepared based on Samryeongbaekchul-san (蔘苓白朮散), which has the effects of benefiting Qi (益氣), strengthening the spleen (健脾), and removing dampness and relieving diarrhea (渗濕止瀉).
Along with taking the herbal medicine(decoction), all other drugs except azathioprine were immediately discontinued, and the immunosuppressant azathioprine was gradually reduced and stopped after 2 weeks of treatment.
After 8 weeks of treatment, the right lower abdominal tenderness was significantly relieved. An abdominal ultrasound examination also showed improvement in the edematous changes in the ascending colon and terminal ileum. After 16 weeks of treatment, the symptoms improved and were almost nonexistent.
After 22 weeks of treatment, calprotectin levels were significantly reduced, and a colonoscopy revealed a scarred ileocecal valve, but the terminal ileum and the entire colonic mucosa were normal, confirming that Crohn's disease was in a quiescent state.
KMD's Korean Internal Medicine Clinic that performs blood and stool tests
KMD's internal medicine goes beyond the name of the disease and focuses on restoring the harmonious life activities of our body.
This is a huge advantage of internal medicine by KMD.
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Peering into Internal Medicine⑪ - AKOM News
“My stomach hurts so bad sometimes because of Crohn's disease.”
The great advantage of "Internal Medicine by KMD" is that it can help you recover harmonious life activities beyond the disease name.
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