Dysbiosis: A Modern TCM Approach
We are living in a fascinating time for understanding the human body. Especially in the last decade, the role of invisible but abundant microbes(bacteria, yeast, fungi, viruses) living on and in the human body has become a huge area of discovery. The National Institutes of Health started the Human Microbiome Project in 2008 to begin identifying these vast and unique communities of microbes playing a mostly positive role in human health, from our skin, teeth, digestive system, immune system, cognitive function and more.1
The research so far mirrors ecological research in the larger natural world. Our bodies are a complex system of unique and interdependent communities that live in a delicate balance with each other. It is estimated that these microbes outnumber human cells 3 to 1, highlighting how important they are to our health.
Much like our environment, modern life has disrupted the delicate balance of our microscopic world, and this appears to be connected to an increase in various chronic health issues. The term dysbiosis refers to this imbalance: When beneficial bacteria and other microbes are disturbed by various influences such as stress, poor diet, antibiotic therapy, etc., opportunistic pathogens can take over, contributing to chronic health issues like IBS, and in some cases, life-threatening acute infections like C. Diff. Modern medicine and technology have an extended lifespan and saved millions of lives. Antibiotics alone have been a miracle for many, but their overuse is a well-recognized problem globally. Like many things in life, it is a question of balance.2
Traditional Chinese Medicine has much to offer us in this arena. Historically, Chinese medicine developed in rural areas where farm laborers were frequently exposed to intestinal parasites and other pathogens from working the fields. This gave practitioners ample opportunity to develop successful techniques to treat these issues. The big-picture view of TCM is all about balancing natural elements: yin-yang,hot-cold, damp-dry, active-resting, etc. The long-term influences of lifestyle, diet, and stress/mental state are all considered as part of both the cause and the remedy for illness.
In the 21st century, TCM practitioners use these traditional principles as well as new tools from current research. Likewise, modern research on dysbiosis has reinforced some ancient concepts in TCM.
TCM Views on Dysbiosis
Because of its very different system of diagnosis and terminology, there isn’t one direct term that fits completely to dysbiosis, but there are at least a couple of concepts in TCM that relate to its modern description.
Damp Heat
In Chinese medicine, the concept of ‘damp heat’ is appropriate for many types of dysbiosis. For example, sugar is considered to increase dampness in the body, and in excess, gives rise to heat, which corresponds to inflammation, infection, pain, heartburn, diarrhea, urinary problems etc. ‘Heat’ can often be related to invasion from pathogens and infection in this description. Dairy, cold drinks and antibiotics are also influences that can contribute to ‘damp heat’ conditions. In western terms, this may relate to yeast and bacterial overgrowth that thrive on sugar or take over after antibiotic treatment has wiped out populations of beneficial bacteria in the gut. 3
Gu Syndrome
Another concept that may relate, though not as widely used by modern practitioners, is called ‘Gu Syndrome’. The ancient description of ‘Gu Syndrome’ is akin to being afflicted by evil spirits, and more literally to being infested with parasites like worms or amoebas. In modern terms, this idea can be applied to parasites, bacteria, candida, and viral infection, but also to the chronic symptoms that persist afterward that never seem to resolve.
Modern acupuncturists using this concept may apply it to those patients coming in with the ‘mystery illnesses’ of our time: chronic digestive issues, fatigue, and pain as seen in fibromyalgia and other hard to treat conditions. By this updated theory of ‘Gu Syndrome’, a prior illness or infection may be the culprit, lingering in the body, either literally, like a chronic virus, or indirectly by setting off a chronic imbalance in the body’s immune or inflammatory response to normal outside substances like foods, pollen, dust, etc. 4
There is also a cognitive/emotional component recognized in Gu syndrome as well. With the current view, the ‘evil spirits’ of brain fog, anxiety, and depression often present with these illnesses could be due in part to an imbalance in what is now called ‘the gut-brain axis’. Early research suggests there is indeed a strong link, and certain strains of probiotics may significantly improve mood and cognitive function.5 This parallels the central importance placed on digestion to overall health in Chinese medicine. All other systems rely on digestion to transform food into energy or ‘Qi’, and the mind/spirit or ‘Shen’ is easily disturbed when digestion is impaired.
Regaining Balance with TCM
Because proper digestion has been so important for centuries in TCM philosophy, there are many long-practiced techniques to approach dysbiosis from this point of view. First and foremost, it is important to understand that the core philosophy is not to treat ‘dysbiosis’, but to address the root imbalances of the individual. The treatment plan may look different from one person to the next. That being said, here are a few of the common ways an acupuncturist would approach this issue:
Acupuncture Points
Acupuncturists use interview information as well as pulse and tongue diagnosis to determine which acupuncture points to treat. For many digestive issues, this often includes points that support spleen/stomach function. Depending on the degree of the issue, a person may need to receive treatment one or more times a week for a series of weeks or months.6
Diet
Some versions of the traditional ‘Qing Dan’ diet, which literally translates as ‘clear bland’, is often recommended to help clear ‘damp heat’ and digestive disturbance as a whole. It is as the name describes: No spicy, salty, or sour food, only light seasoning, no added oils, no dairy or sugar, with an emphasis on moderate portions of whole grains, lightly cooked vegetables, and some protein from animal or beans. This is basically the diet of Taoist monk for centuries, thought to promote longevity and balance of mind and body. Modern acupuncturists, especially in the west, may modify this diet plan somewhat, and based on current research, some may recommend less grain and more healthy fats and probiotic-rich cultured vegetables, depending on the individual.
Herbal Formulas
There are a number of classic formulas and modern adapted formulas that support digestion by tonifying spleen/stomach qi and clearing damp-heat. The choice of formula depends on the total picture of the patient’s symptoms. A modern formula like Artestatin is well suited to clear damp-heat. Classic formula Si Jun Zi Tang, or Four Gentleman Decoction, is commonly used to strengthen weak digestion and loose stools, tonifying spleen qi. Another modern adapted formula, Atractylodes Tablets, may be useful for easing intestinal discomfort and helping the body to repair and protect the delicate mucosal lining of the digestive tract.
Lifestyle
It’s no secret that regular exercise and sleep are important to good health and longevity. In Chinese medicine, the timing of these activities is viewed as important as well. For digestive health, taking a walk after a meal is recommended to aid in peristalsis, the physical motion of the intestines that moves the digestive process along. Interestingly, recent studies suggest that regular exercise may even help maintain the balance of your gut flora, reduce inflammation, and increase levels of gut-protecting chemical N-butyrate.7
For sleep, TCM practice suggests following the rhythms of nature. Staying up late disrupts your organs’ house-cleaning schedule, especially those involved in digestion and elimination. If you are a night owl and find yourself with a host of health complaints, try shifting away from computers and TV screens earlier in the evening and getting as much sleep before midnight as possible.
As traditional medicine practices and modern science continue to converge, we’ll continue to learn more about how to best manage our own ‘personal ecosystem’. Traditional Chinese Medicine has many tools to help people regain the balance of their gut microbiome and overall health. Even using just a few of these tools daily can put one on the right path to long-term wellness.
References
1 Human Microbiome Project
2 CDC: 1 in 3 antibiotic prescriptions unnecessary, CDC, May 2016.
3 Flaws, Bob, Dipl. Ac. “Intestinal Dysbiosis, Leaky Gut, and Yin Fire”. 2004.
4 Quinn, Bob & Moreland, Erin. “An Interview with Heiner Fruehauf, Phd, L.Ac.”. 2008.
5 Wallace, Caroline J.K. Ann Gen Psychiatry. “The effects of probiotics on depressive symptoms in humans: a systematic review”. Feb 20, 2017.
6 New Chinese Medicine Tools to Replenish and Repair Our Gut, Margolin, Cathy, L. Ac., Pacific College of Oriental Medicine, May 6, 2015.
7 Monda, Vincenzo. “Exercise Modifies the Gut With Positive Health Effects” Oxid Med Cell Longev. March 5, 2017.
Keywords: TCM, Dysbiosis, Damp Heat, Gu Syndrome, Probiotics
Patrick Postlewait studied English Literature and Environmental Studies before spending the rest of his twenties working on an organic farm growing vegetables and herbs. He spent over a decade in the supplement and health food industry before becoming Brands Manager for Acupuncture Atlanta. When not at the clinic, he spends time with his wife and works as a studio musician and songwriter.
