(275) Q & A: Atonic constipation

[HB KIM]

Q:  I'm going to be seeing a 19 y/o female with atonic constipation. For the past 6 months she's been getting colonics every 2 days because of her discomfort and inability to have a bowel movement.

According to her mom she has gone thru a number of tests, MRI, etc., with everything appearing normal, as far was western med is concerned. The colonics relieve the discomfort/bloatiness, so a blocked colon/LI does not seem likely.

I've only talked to her briefly, but she is fairly athletic, eats a pretty good diet, and is an active teenager. I did check her pulse and it's very deep and deficient, but with some tightness deep on the R. guan. Her tongue was swollen, dusky, with very thin coat.

Any ideas on kick-starting the "lazy bowels"?


A:   Pattern and Formula for Constipation

1. Excess Heat: dry stool, hard stool, scanty urination, abdominal pain and distention, dry mouth, bad breath, yellow and dry tongue coating, deep-rapid pulse
Ma Zi Ren  10g
Bai Shao  5g
Zhi Shi  5g
Da Huang  10g
Hou Po  5g
Xing Ren  5g

2. Qi Stagnation: hard stool, belching, hypochondriac and abdominal distention, no appetite, greasy coating, wiry pulse
Bing Lang  9g
Chen Xiang  9g
Mu Xiang  9g
Wu Yao  9g
Da Huang  9g
Zhi Ke  9g

3. Qi Deficiency: hard to defecate, pale complexion, mental fatigue, shortness of breath, slightly pale tongue with thin coating, deficient-rapid pulse
Huang Qi  15g
Chen Pi  15g

4. Blood Deficiency: hard stool, pale complexion, dizziness, palpitation, thin coating, thready pulse
Ma Zi Ren  15g
Da Huang  15g
Tao Ren  5g
Dang Gui Wei  5g
Zhi Shi  5g
Bai Shao  5g
Sheng Ma  5g
Ren Shen  3g
Gan Cao  3g
Chen Pi  3g
Mu Xiang  2g
Bing Lang  2g

5. Yang Deficiency: hard to defecate, pale urination, cold limbs, abdominal pain get better with warmth, dislike of cold food, white coating, deep-slow pulse
Dang Gui  12g
Niu Xi  6g
Rou Cong Rong  7.5g
Ze Xie  4.5g
Sheng Ma  2.5g
Zhe Ke  3g


Note: Please use the herbal formula by differential diagnosis.  If you can't diagnose clearly, please try the following formula
Dang Gui  6g
Chuan Xiong  6g
Bai Shao  6g
Shu Di  6g
Qiang Huo  6g
Fang Feng  6g
Da Huang  6g
Sheng Ma  6g
Hou Po  6g
Zhi Ke  6g
Xing Ren  6g
Tao Ren  6g
Hong Hua  1.5g

Acupuncture: For your case, please try the following treatment
Right side: Sedate SJ6 and KD6
Left side: Sedate LI1 and ST45, Tonify GB41, ST43