The Acupuncture Treatment of Crohn’s Disease
Chief Complaint: Crohn’s disease.
Medical History: Crohn’s disease first diagnosed twenty years previous to first visit (patient 52 years old). Soon after a right hemi-colectomy was carried out, and about 40cm of Small Intestine including appendix and ileal sphincter was removed. About 16 years of relative health followed, after which disease progressed to include ulceration in the colon. Prognosis was for a permanent stoma, and the aim of treatment was literally to see if any improvement could be gained. At time of first consultation, patient was suffering from frequent sudden senses of pain and distension, followed by immediate need to evacuate bowels. This occurred 6-7 times a day, and included bleeding.
Other complaints included tiredness “similar to ME”, and “pimpliness” particularly on back shadowing the pathway of the SI channel on the left hand side, and between Bl19 and Bl19 across the spine. This was from long term steroid use. Patient was currently on 30mg predniselone.
Two months previous to consultation, px had suffered a gallstone attack, and doctor had recommended removal of gallbladder.
Patient’s appetite was good, and he was drinking roughly 3L of liquid (water & decaff) per day.
He had been a heavy smoker and drinker till about fifteen years previous.
He tended to sleep from 6-8pm, then wake until 2am, when he’d sleep till around 6am.
He considered himself to be an introvert. He worked as a designer in an engineering environment, and considered that he’d had to develop an extremely hard skin as a result. He said that he made his living “analysing things”.
Pulse exam: His pulse was generally soft, with particular emptiness at SI, Lu & LI, and TH positions.
His abdomen was generally soft and puffy, with particular areas of tension on the right hand side of the navel around St25 and below it towards the Ren line. The patient had a large scar from his operation on the Ren line skirting around the left hand side of the navel, extending from ensiform to pubic bone.
On his back, there was a significant area of discolouration just superior and medial to the right hand scapula – this was thirty years old, but had been checked and confirmed as being non-cancerous.
The gastrocnemius muscles were palpated for reactivity, but none was found.
Tongue exam: His tongue was a little red, with a thick white coat in the central and rear areas, and teeth marks on either side. It had a tendency to quiver.
OM Diagnosis: The assessment was applied through the Manaka yin-yang balancing model.
The patient was initially diagnosed for treatment using ion-pumping cords for Yangwei/Daimai Extraordinary vessel pairing to right side only.This was based primarily on abdominal findings.
Treatment Principle: Manaka’s five step treatment principles were applied. This incorporated, at every treatment the use of:
step 1 – ion pumping cords to one or two pairs of points
step 2 – “kyutoshin” (moxa on needle) to two or three pairs of points on back (generally shu points associated with ion pumping treatment points which exhibited reactivity to palpation
step 3 – in this patient’s case wasn’t applied.
step 4 – symptomatic treatment addressed at presenting problems, generally either light needling, “okyu” (direct small moxa pieces burnt to skin), and “chinetskyu” (large cones of moxa, burnt to just warm points)
step 5 – home therapy, and retained needles, comprising of self applied okyu to directed points and “hinaishin” intradermal needles retained for up to a week in SI auricular point and St27.
Point Prescription: The step one treatment varied over the ten treatments, including Yangwei/daimai, GB/Ht polar channel pairs, Ren/yinqiao mai, and Ki/LI polar channel pairs. There were significant pulse changes which were clearly evident from these treatments. The patient also reported subjective significant response to the okyu treatment, particular to the lower he/sea points, St37 & St39,which were applied each treatment from third onwards often unilaterally depending on reactivity. From treatment 9 the patient was instructed on home use of moxa to these points and encouraged to do this on a daily basis.
Herbal Formula: None
Lifestyle Prescription: None
Results: Improvements began to be reported after the second treatment. There was less bleeding in the stools, and there were “more good days than bad”. The patient was very encouraged by the early response (having initially committed himself realistically to a minimum of five treatments).
By treatment four, he was reporting that the severe diarhea had gone.
By treatment 6, energy levels were beginning to rise, and two week gaps between treatments were agreed. He also felt confident to cancel his appointment with his specialist (which implied further surgery) which had been scheduled for that week, and which he felt was no longer necessary.
At treatment 7 he was reporting slightly more tiredness.
By treatment 9 energy levels were again improving, there were now only 4 or 5 bowel movements a day, and negligible bleeding. Treatment ten was the last treatment – the patient was confident in use of moxa, and was feeling “better and better with more peace in my gut, with no blood”.
The patient canceled the next treatment, feeling that he was now managing his condition.
(Midway through treatment, incidentally, he referred his teenage daughter for acupuncture.)
There was only a very slight improvement to the pimples on his back, which became slightly less widespread, and particularly insignificant in the area between Bl19 and Bl19.
Synopsis: I was pleased with the response to a chronic condition, particularly his response to the okyu moxa to the lower he/sea points. Personally, I would have liked to have continued treatment for a further period of time to consolidate progress, but it was incontestable that his treatment goals had been met, and that, with the addition of home moxa techniques, he had not only found a way of avoiding further surgery but was finding ways to manage a condition that was unlikely to simply disappear.