It is certain that chronic hepatitis, if not treated systematically, can produce repeated clinical gastrointestinal wetness-heat symptoms. But it is worthwhile to pay attention to the fact that clinically, although chronic hepatophilic virus disease patients were treated with systemic TCM drugs, if during or after the course of treatment, they ate incompletely disinfected food (particularly raw ostrea, raw fish and poorly cooked mussel), the “gastrointestinal wetness-heat “ symptoms can still occur repeatedly.
This is usually due to the variety of pathogens of “virus gastroenteritis” and viruses exist widely in the daily environment of human beings. If one neglects personal hygiene, virus may re-infect the body, leading to activation of immune response followed by rapid enlargement of the liver. Acute hepatophilic virus infection may cause clinically chilliness and fever, generalized soreness of the body, symptoms of exopathy, abdominal pain and diarrhea. But the disease was often misdiagnosed as common cold and the treatment unfortunately delayed. Therefore, the best preventive measure is to keep food fitting with hygienic requirements.
“Disease comes in through the mouth” is a common sense that everyone knows and cook in the “fire” provides security for the humane diet. No virus can tolerate boiling for 3-10 minutes which results in its loss of infective ability. It is a pity that some people still like improperly cooked food only for the pleasure of good taste. Some cooks and undutiful suppliers instigate people to take such diet and they supply possibly contaminated food to them. In this way, the spread of virus gastroenteritis would be enhanced and promoted to attack the community repeatedly.
From the point of view of western medicine, diarrhea in chronic hepatitis is chiefly due to :
- The intestinal mucosa of chronic liver disease patients often show congestion, edema, erosion or even ulceration.
- Dysfunction of liver leads to mal-absorption of fat.
- Decrease of pancreatic secretory function affects digestive and absorptive function of small intestines.
- Over abundance of virus duplication or secondary bacterial infection causing enteritis;
- Carcinoma of liver may secret carcinoid hormones which can produce diarrhea symptoms.
Introduction of cases (continued)
| Case 6
Lin (code number 0416) female, 23 years of age. Her first visit was on June 1995 when she complained chiefly of repeated abdominal pain, belching, nausea, abdominal distention, diarrhea, thinness of body, insomnia, getting tired easily, profuse sputum, cough, thirst, bitterness of mouth and yellowish urine since childhood. She passed stools three or more times a day and had to defecate right after meal or following abdominal pain. The stools were loose or pasty and black or brownish in color. Physical examination: the patient was significantly thin, poorly nourished, anemic in appearance and normally developed; but the tongue coating thin and yellowish, abdomen soft and distended, liver enlarged to 1.5 cm below costal margin. After 3 parcels of TCM drugs, the liver retracted to the costal margin but the other symptoms did not improve. After 9 parcels, the liver recovered to 1.5 cm above costal margin. After 2 months of systemic TCM treatment, there was occasional bitterness of mouth, nausea, belching, intention of defecation after meal, distensive abdominal pain, diarrhea and stools 3 or more times a day. Because intestinal parasitic infection and tuberculous peritonitis were not ruled out, blood examination and pulmonary X-ray were done, but the results were normal. It was estimated that the weakness of spleen and stomache was caused by hepatitis, leading to symptoms of gastrointestinal dysfunction, which required TCM therapy for regulation and relief. Episodes during the course of treatment: on October 1997, owing to repeated abdominal pain, she was diagnosed as appendicitis by western doctors and given anti-inflammatory drugs orally. On April 1998, because of repeated nausea, diarrhea and watery stools, she was diagnosed as acute gastroenteritis and given anti-inflammatory drugs. After these two episodes of anti-inflammatory drug therapy, her return visit showed enlargement of liver which required TCM treatment and only after this that the liver returned to normal. This demonstrated that some antibiotics had ill effects on the liver, so that one should be cautious in their usage.
|
Observation of the characteristics of feces:
Case 7 Cheung (code number 1993), male, age 32 years. He had his first visit on November 1999 with the chief complaint of repeated sorethroat and symptoms of exopathy. He had left deviation of nasal spetum which was corrected by operation. He had diarrhea frequently and abdominal pain before defecation since childhood and in the recent years had severe alopecia. Physical examination: abnormality of hypochondria (肋脅畸形), hepatomegaly of 3 cm. After 3 parcels of TCM drugs, the liver was normal; the gastrointestinal symptoms disappeared and loss of hair significantly decrease. After 4 weeks of systemic TCM treatment, clinical cure was obtained and medication was stopped for observation. On March 2001, due to the intake of raw lobster, he suffered form diarrhea for a week, the stools watery, 3-4 times daily. His sleeping was poor and he also felt tired, so he sought for medical help. Physical examination: the liver enlarged to costal margin, being the first relapse of hepatomegaly. After one parcel of TCM drugs, the diarrhea stopped, sleeping improved but tenesmus and yellowish urine was still present. After 3 parcels, the liver was normal and he continued the TCM systemic medication.
|
| Case 8
Chiu (code number 049), male, age 54 years. His first visit was on January 1994 and had been diagnosed as hepatomegaly for investigation, hepatogenic malnutrition and underdevelopment, xeroderma, virus gastrointestinal disease. He complained of long term thinness of body, localized white thick coating of tongue, hepatomegaly of 3 cm. Clinical cure was obtained after effective systemic TCM treatment. It was observed that during the period of illness, hepatomegaly relapsed for 6 times, the liver enlarged to 1.5 cm to 4.5 cm and all these were cured by TCM drugs. On April 2001, he visited the clinic complaining of common cold and fever (ingested a kind of cooked beef), chilliness, hoarseness of voice, intermittent coughing, abdominal pain, diarrhea, loose stools twice a day, frequent flatus, thick white coating of whole tongue. He pulse was 120/minute, temperature 37.8℃; he had neither apparent distention of abdomen nor percussion tenderness of hepatic region. His liver enlarged to 4.5 cm, being the seventh episode of relapse. He took 2 parcels of TCM “QuGanDu” and after that, chilliness, fever and diarrhea disappeared. There was vague pain of the abdomen but it lasted shortly. Clinical cure was obtained after systemic TCM therapy.
|
| Case 9
Liu (code number 292), female, age 26 years. Her first visit was on August 1993, when she complained chiefly of loss of appetite, nausea after breakfast and frequent abdominal distention and pain and diarrhea for 3 years. She was often diagnosed as gastroenteritis and intestinal hypersensitivity. She could not drink milk, eat eggs and may other kinds of food. She had monthly menstrual pain, menorrhagia (月經量過多), but medication was not helpful. Repeated blood examinations did not show hepatitis. Physical examination: a thin patient with apparent anemic looking, poorly nourished and underdeveloped, liver enlarged to 1.5 cm below costal margin. She felt hungry after 9 parcels of TCM drugs, did not feel nausea in the morning and had no discomfort after taking milk. The liver was at costal margin. TCM medication was given for 3 months, and after then, the liver retracted to 1.5 cm above costal margin. Anemia improved gradually and she said that she began to develop and dysmenorrhea ceased, and the amount of menstrual blood had significantly decreased. In the past years, she received TCM treatment occasionally.
|
By Wong Kwok Hung
published on 24th April 2001
(translated by Professor ZHENG Hua En in November 2002)