Herbs and Acupuncture for IBS Diarrhea

Chief Complaint: chronic diarrhea
Western Diagnosis: IBS
Medical History: 34 year old Caucasian female, bookkeeper. Presents with scoliosis, lower and upper back pain, irregular menses. Patient does not exercise and eats lots of fried foods.
Questioning exam: Patient sighs frequently, has breast tenderness, distention, bloating and gas. Chronic dawn diarrhea with undigested food and mucous. Symptoms increase with menses. Patient has a heavy flow with many, large clots and dark blood. She sees floaters and frequently feels hot. She has seasonal allergies.
Pulse exam: Pulse is wiry, especially in the guan position.
It has a rolling quality at the deepest level.
Rate is normal, moderate.
Tongue exam: Tongue is red with yellowish coat that is thick in the lower jiao.
OM Diagnosis: Patient has chronic diarrhea d/t liver qi stagnation overacting on the spleen. The liver qi stagnation is causing mild heat and the spleen weakness is causing some damp accumulation.
Her menstrual symptoms strongly indicate Liver involvement and her digestive complaints display a weak spleen.
Treatment Principle: Soothe and disperse the Liver qi, tonify the Spleen.
Point Prescription: Liv 3, GB 34- move liver qi
Liv 13- Sp mu pt
LI 11- clear heat
LI 4 – four gates
Herbal Formula: Si jun zi tang + chen pi
Xiao yao san
Lifestyle Prescription: Avoid spicy, fried, and dairy foods.
Results: Patient reports improved digestion, less gas and bloating, but still having 2-3 loose bowel movements each day. There is less discomfort overall. Patient has not had a period yet.
Synopsis: I didn’t feel it was appropriate to use a lot of warming herbs on her bowels because of her heat signs.