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Let's Talk IBS

2/26/2014

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IBS or Irritable Bowel Syndrome affects approximately 15% of the US population according to recent research, though only 5-7% of the adult population has actually been diagnosed with the disease.  Its a functional disorder of the Large Intestine and is typically characterized by alternating constipation and diarrhea combined with intestinal cramping, though some people will tend towards more constipation or more diarrhea depending.  In summary - not fun.

As someone who suffers from IBS I can tell you that it can be painful, debilitating, embarrassing and even exhausting at times.  I can also tell you that there is hope, that while Western medicine does now have pharmaceutical tools to treat IBS, it doesn’t hold the only key or the only answers.  Acupuncture is an incredibly powerful treatment for IBS, is completely natural, and is actually what inspired me to become an acupuncturist because of the difference it made in my life.  

I suffered daily bouts of cramping, constipation and diarrhea for 7 years and then tried Acupuncture.  In 3 months, my symptoms were completely gone and Chinese Medicine did not require me to continue regular treatment to maintain results.  It was astonishing and life changing, and is absolutely the reason I am here writing this article today.

What Is IBS? What Causes IBS?

The simplest definition of Irritable Bowel Syndrome or IBS is bowel irregularity including discomfort and constipation or diarrhea that lasts 3 months or more. Technically, IBS is a functional disorder of the bowel.  This means that the smooth muscle of the Large Intestine is affected and cannot perform regular peristalsis or movement.  Instead of a smooth squeeze along the intestines, the IBS sufferer will experience sections of the Large Intestine cramping and releasing irregularly causing discomfort and bowel pattern changes, or lack of pattern altogether.  

The medical criteria for diagnosing IBS (ROME 3 Criteria) is actually very simple:
Recurrent abdominal pain or discomfort** at least days/month in the last months associated with two or more of the following:

  1. . Improvement with defecation
  2. . Onset associated with a change in frequency of stool
  3. . Onset associated with a change in form (appearance) of stool 

* Criterion fulfilled for the last 3months with symptom onset at least 6months prior to diagnosis
** “Discomfort” means an uncomfortable sensation not described as pain. 

According to the National Institute of Health, people who have IBS experience some combination of the following IBS symptoms:
  • Bowel movements that occur more or less often than usual
  • Stool that appears less solid and more watery, or harder and more lumpy, than usual
  • Bowel movements that improve the discomfort
  • Diarrhea—having loose, watery stools three or more times a day and feeling urgency to have a bowel movement.
  • Constipation—having fewer than three bowel movements a week. During a bowel movement, stools can be hard, dry, and small, making them difficult to pass. Some people find it painful and often have to strain to have a bowel movement.
  • Feeling that a bowel movement is incomplete.
  • Passing mucus—a clear liquid made by the intestines that coats and protects tissues in the GI tract.
  • Abdominal bloating.

In some cases the cause of IBS can be clearly defined - food sensitivities or celiac disease for example - but in other cases, the exact root cause can be hard to pinpoint.  The National Institute of Health lists 9 different identified causes for IBS:
  1. Brain-Gut Signal Problems - neurological  miscommunication
  2. GI Motor Problems - spasm as mentioned above
  3. Hypersensitivity - a neurological hyper-awareness of bowel sensation
  4. Mental Health Problems - seratonin plays a role in gut motility so if your seratonin is irregular for any reason, your gut is readily affected. This means STRESS can cause IBS.
  5. Bacterial Gastroenteritis - gut infections can cause irritation and IBS
  6. Small Intestinal Bacterial Overgrowth - bacterial overgrowth can cause gas, diarrhea and weightloss due to malabsorption of nutrients.
  7. Body Chemicals - hormones can affect the gut and research shows that younger women are more likely to experience IBS during their menstrual cycle, and that post-menopausal women tend to suffer from less IBS.
  8. Genetics - GI problems often run in families, but whether this is due more to genetics or to shared lifestyle and eating habits is not completely clear as no specific gene for IBS has been identified.
  9. Food Sensitivity - sensitivities such as lactose intolerance, gluten intolerance and celiac (which is technically an autoimmune disorder) are known to cause IBS symptoms.

Acupuncture and IBS - IBS Treatment, IBS Management

Acupuncture is an excellent treatment for IBS.  In the short term it can calm down an acute IBS episode relieving pain, discomfort and improving bowel patterns, and long term it can be a tool for IBS management and in some cases, it can provide complete resolution of symptoms.

Treatment is recommended weekly for 4-6 weeks as a starting course, though long time sufferers of IBS can require 3-6 months of regular acupuncture to create a lasting effect.  When combined with herbs, diet and lifestyle changes if needed, Acupuncture can be completely transformative.  A trial course of treatment along with assessment by a qualified practitioner determines how much intervention beyond acupuncture is necessary in any individual case.

Chinese Medicine defines IBS by several different energetic patterns. The possibilities for individual diagnosis are quite extensive since TCM treats every individual differently, but there are three diagnoses that are more common than the rest:
  1. Liver Overacting Spleen - this means that when you get stressed out your Liver Qi, which becomes stagnant and hot during stress, overacts and attacks the Spleen impairing the Spleen’s ability (energetically) to function and perform digestion.

  2. Spleen Qi Deficiency (Xu) - the Spleen is the primary organ of digestion in Chinese Medicine.  If your Spleen Qi is weak or deficient due to lifestyle, prolonged stress, eating irregularly or improperly, it will not be able to perform regular digestive function and IBS can result.

  3. Damp Heat in the Large Intestine - this most directly correlates to bacterial overgrowth, though the presence of bacteria is not necessary to make this diagnosis from a TCM perspective. Anything causing a sensation of heat in the intestines combined with gas, bloating and diarrhea can be considered Damp Heat in the Large Intestine.

Keep in mind that if you went to see your Western Doctor with one of these Traditional Chinese Medicine diagnoses, they wouldn’t find anything that directly correlated - your Spleen and Liver would test just fine for example.  These are energetic principles consistent with the Qi-based diagnoses and treatment Acupuncture provides.

The differential diagnoses above, which can be combined in some cases, determines the specific acupuncture points and herbs selected in treatment.  

Research shows that acupuncture and herbal treatment for IBS is quite effective - upwards of 80% of patients in some studies report improvement (Bensoussan et al. 1585-1589, 1998). Research also shows that acupuncture can virtually eliminate sympathetic nervous system response (fight or flight response) in some cases which lends credence to the validity of acupuncture to treat stress induced IBS in particular (Middlekauff et al. 399-406, 2002).

Rebecca's Story

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I suffered from IBS for 7 years, from the age of 14 to 21.  I developed an eating disorder in highschool and a combination of overeating plus excessive laxative use altered my bowel patterns permanently.  Even though I resolved those behaviors and patterns by the time I started college, I continued to suffer from IBS regardless of my eating habits.  I experienced pain, cramping and bloating every day and variable alternating diarrhea and constipation.  It was exhausting and felt like chronic pain, like a constant background noise to my life I had to fight against to consciously do everything.  I didn’t know what to eat or what not to eat and it didn’t really seem to matter - I suffered no matter how good or how bad my eating habits were.  The only thing that consistently helped was exercise so I got a lot of it - 10+ hours a week of martial arts, dance, weight lifting and cardio at different times.

I went to see my western physician who told me I had IBS and recommended I try to eat healthy and hope it would resolve.  She offered no specific dietary advice and, luckily for me frankly, there were no pharmaceutical interventions available at the time.  I was actually getting ready to go to China for a year to study overseas and I was very frightened.  If I couldn’t eat “regular” food in America that I was used to without having IBS, what was I going to do in China where the water isn’t clean and the foods are fairly different?

My mother had been seeing an acupuncturist since I was 9 years old, so she took me to see him during the summer before I left for China.  He had a clear diagnosis for me - even though I didn’t understand what it was or what it meant - specific dietary recommendations and a clear treatment plan.  He recommended weekly acupuncture and daily Chinese herbs for 3 months.  

After two weeks my pain was 75% resolved and my bowel patterns were almost normal.  By the 3 months mark all of my IBS symptoms were completely resolved.  It felt like a miracle to go from 7 years of pain and discomfort to nothing, but there it was - Chinese medicine had a diagnosis, a treatment and ultimately for me, a cure.

Six years later, as I was coming to the end of grad school, my symptoms resurfaced due to stress and hormonal changes.  I tried all the same things but it didn’t quite work - ultimately I learned that I had developed a Gluten intolerance (most likely due to epigenetic changes related to stress) and a soy sensitivity.  Once I cut those things out of my diet, I had no further problems and I continue to enjoy regular comfortable digestion to this day.

I completely have Acupuncture and Chinese Medicine to thank for my healthy digestive function.  The complete resolution of my symptoms at age 21 was phenomenal, and even my later gluten and soy sensitivity revelation was due to the guidance of another LAc.   That experience put me on the path that led to me becoming an Acupuncturist, and helping people with digestive disorders is one of my true passions.

What do I do for IBS? Tips for Managing IBS.

As a sufferer myself, I know how difficult it can be to deal with this disorder.  My number one recommendation if you have IBS is to see an Acupuncturist for a thorough assessment and to follow a 1-3 month course of treatment to see if Acupuncture is the right course for you.  Including that, however, here are some simple tips that can help with managing IBS:
  • Get Acupuncture!
  • Increase water intake - aim to drink ½ your body weight in ounces per day
  • Increase fiber intake - research shows that good fiber intake can decrease IBS symptoms.  It can be as simple as oatmeal for breakfast every day, or taking 2 Tbsp psyllium husk or ground flax seed 2x/day.  If you increase your fiber intake you must increase your water intake as well, however.
  • Drink Ginger Tea - fresh ginger tea is a natural anti-inflammatory and harmonizes digestion in Chinese Medicine. Boil 2-3 slices of ginger for 20 minutes, drink tea.
  • Drink Peppermint and Orange Peel Tea - peppermint disperses Liver Qi in Chinese Medicine meaning it is good for reducing stress, and orange peel resolves gas and bloating.  Combine the two into a powerful gut calming tea - simply boil a few slices of orange peel and steep a peppermint teabag in the water.  You can combine this with fresh ginger as above as well
  • Make Stress Reduction a priority
  • Get Regular Exercise

Questions? Concerns? Want to know more?  Contact Rebecca via email or book an appointment or consultation online today.
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The Best Way to Treat a Cold

2/19/2014

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Chinese Medicine has been treating colds and flus without the help of western science for over 3,000 years.  There is a very sophisticated differentiation between types and stages of viral illness in Chinese herbal medicine, and concrete symptoms associated with each different presentation.  Do you have chills? Fever? Alternating chills and fever?  A sore throat? Congestion in the head vs. the chest or both? Malaise? Fatigue? Phlegm that is difficult to expel or easy?  All of this and more combine to create your specific and unique picture which can be diagnosed and treated with Chinese Medicine. 

Thousands of years of clinical history as well as an individualized approach to treating viral illness gives Chinese Medicine a corner on the market of tried, tested, and truly effective supplements to treat illness and I’m going to share my top 5 supplements for cold and top 5 supplements for flu recovery here with you today. 

I keep all of these are remedies on hand in the office and at home.  I prescribe them regularly and use them often for myself and my family. At home, if we get sick we are usually over the illness in 3-5 days thanks to the remedies below.  If you are pregnant or nursing, however, please consult your physician or TCM practitioner before taking any type of new remedy.

Top 5 Supplements for Colds and How to Use Them

PictureHonesuckle, a.k.a. Jin Yin Hua
  • Yin Qiao Jie Du Pian - this is a “modern” chinese herbal remedy specific for colds that begin with a sore throat.  The formula is named for the two primary herbs in the decoction - Jin Yin Hua (honeysuckle) and Lian Qiao (forsythia). If you feel a tickle in your throat, starting taking this remedy at the full dose indicated on the bottle immediately and continue for 3-5 days. If someone around you is sick with a sore throat and/or cough, take this herbal remedy at 1/2 dose as a preventative for the duration of illnesses presenting around you.

  • Chuan Xiong Wan - this herbal remedy is for colds or allergies that begin with or prominently feature headache. It is named for the primary herb, Chuan Xiong (linguisticum) in the remedy, but also contains a high dose of Green Tea. Take at full dose indicated on the bottle for the duration of illness.

  • Bi Yan Pian - also known as “Chinese nose inflammation pills” this simple formula is the closest thing to herbal sudaphed around.  Take at full dose as indicated on the bottle for nasal congestion as needed - especially useful for airplane travel.

  • Qing Qi Hua Tan Wan - also known as “Clean Air Teapills” or “Transform Phlegm Teapills.” This remedy is specifically for stubborn chest congestion.  If you have a cough with phlegm that feels “stuck” especially if you feel like just getting it out would make everything feel better, this is the formula for you.  Take at full dose as indicated on the bottle for chest congestion with yellow or green phlegm.

  • Ban Lan Gen Chong Ji - is a Chinese herbal instant drink containing a high dose of Ban Lan Gen (isatis root).  Ban Lan Gen is a strong anti-viral herb and is also used in China for Cancer treatment.  Safe for children, it can be combined with any other herbal remedy for an additional anti-viral boost.

Top 5 Supplements for Flu and How to Use Them

PictureFresh Ginger Root a.k.a. Sheng Jiang
  • Huo Xiang Zheng Qi Wan - is a specific remedy for flu symptoms.  The primary herb, Huo Xiang (Agastache), treats nausea, vomiting and fungal infections among other things and is balanced by 13 other herbs including ginger, licorice, magnolia bark and orange peel to treat chills, fever, body aches and congestion in addition your typical flu related digestive symptoms.  Take at full dose as indicated on the bottle for the flu for the duration of illness.

  • Oscillococcinum - is a homeopathic remedy for treating the flu.  As a homeopathic it is safe for anyone of any age and will not interact with any other treatment or remedy. It is quick acting, especially for body aches and pains, and is best taken at first sign of possible flu-like illness. Take at full dose as indicated on the packaging for 3-5 days in the early stages of illness.

  • Elderberry Syrup - This simple antiviral is safe for pregnant and nursing mothers as well as infants and children. Elderberry can be delivered in a tea format as well as tincture, but a glycerine based syrup is my favorite since it is safe and sweet. Follow dosage on bottle 2-3 times a day for basic antiviral protection, consult a provider for child and infant dosing.

  • Fresh Ginger Tea - fresh ginger (NOT dried) is the gold standard treatment in Chinese Medicine for nausea.  Slice off 2-3 1/4” slices from a fresh ginger root (peels included), drop into a small saucepan of water, and boil for 20 minutes.  Drink this tea as needed throughout the day for symptoms of nausea.

  • Chinese Herbal Soup - this mix can be picked up in my office or ordered from People’s Herbs and shipped direct.  It contains a mix of edible tonic herbs such as Goji berry, Loquat Fruit, seaweed and Lotus seed that can be added to your favorite vegetarian or chicken soup recipe to give it a strong energy boosting effect.  Instructions are included, best eaten daily during the recovery phase of illness.  Suitable for recovery from any protracted illness or post partum.

Questions? Contact Rebecca:

Do you have questions or want to know more? Need help ordering in office or online?  Contact Rebecca via email here, or book a free consult online anytime.

Yours in Health and Wellness,

~Rebecca
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Acupuncture - For Kids?

2/12/2014

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PicturePediatric Point Chart
Yes!  Sort of.  Let me explain.  Acupuncture is for kids, you can do acupuncture on children from birth on and it is perfectly safe and very beneficial.  When performing acupuncture for kids needles are inserted shallowly and for short duration - just in and out for babies and infants without any “needle retention time” where you rest on the table with the needles for a while.  The “sort of” part comes in because acupuncture is not strictly necessary for kids under the age of 6 - Pediatric Tuina, or Chinese pediatric therapeutic massage, is just as effective and completely non-invasive.


What Is Tuina?

Tuina translates literally into “leg pulling” but it involves much more than that.  In China it is taught as part of Traditional Chinese Medicine along with Acupuncture and Chinese Herbal instruction.  Tuina encompasses everything we think of as massage, chiropractic and physical therapy - deep tissue-type therapeutic massage is combined with specific acupressure and stretching techniques, and in some cases manipulations are performed to align joints [note that manipulation is not taught in the West due to acupuncture license restriction, however].  Then exercises are prescribed to help you hold and maintain your results. 

It also incorporates pediatric techniques using acupressure and massage to stimulate Qi and heal illness in children from birth to 12, though from birth to 6 years of age is when it is most effective.  This is because children under 6 do not have fully formed energetic systems yet - there are fewer points and general energetic areas that treat different ailments vs. the full 12 meridian system and 365+ points we see in adults.  At age 6 the meridians become full, and children can be treated in the same manner as adults, but depending on their physical, mental and emotional maturity, sometimes Pediatric Tuina still works just as well if not better up until age 12.

Benefits of Pediatric Tuina

  • Non-Invasive treatment involving massage only
  • Effective in reducing fever, and shortening the duration of illness
  • Effective in moderating digestive issues including constipation and diarrhea
  • Basic protocols can be learned by parents and continued at home, so minimal office time is necessary
  • Children are in “full Yang state” i.e. growing and changing fast! 1-2 treatments including home care are often enough to change or resolve illness
Pediatric tuina is really amazing and I feel extremely lucky to have studied extensively with my teacher, Yan Lu, LAc. It can treat many ailments and promote general health - I use in on my children and have seen it work wonders in clinic.  One of the best parts is that it is completely non-invasive - no needles, just gentle massage techniques - and with a little instruction, any parent can learn to do a basic protocol at home to promote general health including good digestion and strong immunity.

Whenever I treat children especially under 6, I prefer to have parents in the room and rather than perform the entire treatment myself, I will demonstrate the technique a few times and then instruct the parent in performing it.  This puts children at ease and empowers the parents to heal their children at a time when they feel at a loss for what to do.

There are Pediatric Tuina protocols for quite an array of childhood illnesses, including fever, vomiting, diarrhea, constipation, bed wetting (as support along with behavior modification efforts at home), asthma, night crying, abdominal pain, even abdominal parasites!  Its a powerful tool that I am lucky to know and proud to be able to share.

Is Pediatric Tuina Right for Me and My Child?

If you’re wondering if pediatric tuina could be right for your child, the best thing to do is talk to a provider.  Feel free to book a consultation online which we can complete in person or over the phone to determine if it could be the right fit for you.  If you’re ready to give it a try, book an acupuncture appointment and make a note that you’re interested in Pediatric Tuina and that’s what we’ll do!

Until next time,

~Rebecca

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The Importance of Supplements

2/5/2014

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Vitamins and herbal supplements are everywhere nowadays, and it can be very overwhelming to figure out what you need to take when, and why.  Add to that the recent study which I referenced in a previous blog article about over the counter supplements not being what they seem, and beyond being overwhelming, it can be downright frightening to purchase something over the counter.

As a Licensed Acupuncturist with a Master’s Degree in Acupuncture and Traditional Chinese Medicine, Chinese Herbal Medicine, Chinese nutrition and Western nutrition were central to my studies and I feel strongly that vitamins and herbal supplements should be part of everyone’s lifestyle, but getting the right supplements from the right manufacturer in the right dosage is key to optimizing your nutrition and ensuring excellent health.

Food - Not What It Used To Be

The food we eat today isn’t the same as the food our parents ate, let alone our grandparents.  Grains have been crossbred and modified to the point that the gluten content has more than tripled in some cases shedding some (possible) light on the noticeable increase in gluten intolerance and celiac disease we’ve seen in the past 5-10 years.

Growing methods, fertilizer choice and GMO status affect nutrients in our foods as well, and the vitamin and mineral content of our produce has greatly declined over the past 50 years. Did you know that some commercially grown oranges contain NO Vitamin C at all when tested?  Tomatoes can vary in iron content from 1,938 parts per million to 1 part per million.  A huge discrepancy.

If you’re eating 100% organic 100% of the time and consuming no refined sugars, grains, hydrogenated fats, alcohol or drugs (including pharmaceuticals), managing stress (depletes nutrition) as a priority and getting regular exercise (optimizes bodily function) 3-5 times a week, you are probably living well enough and eating nutritiously dense enough that vitamins and supplements aren’t going to be a big factor in your health and aging over time.  If you’re not, however, vitamins and supplements can be key to helping you feel better, stay healthier, boost your immune system, and temper the natural affects of aging.

The Benefits of Herbal Supplements

PictureTest Results from New York Times Published Study
High quality supplements are your insurance policy against the sad state of food in our world today.  We can’t always eat perfectly, and even if we do we can’t guarantee that what should be in our food, is in our food.  Add to that the mounting research that a low calorie diet is a factor in maintaining healthy weight, a healthy heart, and longevity, and it becomes that much more important to ensure that you are getting the best nutrients in an efficient and trusted delivery system.

Western and herbal supplements ARE that delivery system and a little bit can go a long way.  Key, however, is making sure that you are getting them from a trusted source. If you read the New York Times article linked in my previous blog article, you’ll see that only 2 of the bottles they picked up over the counter and tested had exactly what the label said they had - the rest of the 44 bottles included some substitution or dilution, and some included none of the substance they were selling at all!  

This is appalling, and an important cautionary tale. It is also something natural medicine providers like myself learned about in school - that there is a stark difference in quality between over the counter supplements and the more expensive lines sold by providers only such as Biotics, Integrative Therapeutics, Seroyal and Standard Process.  These more expensive lines have been thoroughly vetted and tested and are assured to contain exactly the nutrients the bottle claims. 

If you want to get the herbal supplements you are paying for, buy them from a trusted provider.

Vitamins, Supplements and Herbal Medicine at Home - A Little Can Go A Long Way

I recommend all of my patients take a basic regime of the following to make up for the lacking quality of our food supply and to combat modern day stress, fatigue and aging:

  • A Multivitamin (your insurance policy for good nutrition!)
  • Vitamin D (cancer preventative, immune boosting, bone health - necessity!)
  • Omega Fatty Acid (promotes heart health, essential for cellular integrity)
  • Probiotic (gut health, essential to immune system)
  • Basic Chinese Herbal Tonic (Qi balancer for health optimization)

I also have a shorter list of the top 3 herbs and supplements everyone should take for basic health if you want a bare bones recommendation, but the list above is my preferred basic recommendation for optimal health.

If you want to know what is right for you personally, I highly recommend coming in for an appointment to assess your body’s physical and energetic needs.  This way I can make an individualized recommendation and help you find the quality supplements that will reliably deliver what is promised! Don’t be fooled by the “talker” displays at the grocery or drug store - get your supplements from a trusted professional and be assured of what you are paying for.

Until next time,

~Rebecca
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    Rebecca M H Kitzerow is a Licensed Acupuncturist practicing in La Center, Washington. With over a decade of experience she has won 10 Nattie consumer choice awards from Natural Awakenings Magazine since 2014.

    Rebecca practices a variety of Acupuncture and Traditional Chinese Medicine techniques including Tan Acupuncture, Kiiko style Japanese Acupuncture, Traditional Chinese Herbal Remedies, Cosmetic Acupuncture, Foot Reflexology, Cupping and Gua Sha. Rebecca strives to help people Be Well and Stay Well in every way.

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