- Email: [email protected]
Diarrhea, rapid transit
Chapter 26
Diarrhea, rapid transit Summary Essence: A functional disorder of excessive motricity of the enteric system for the Endobiogenic terrain Terrain: (1) Vagotonic individuals in which in the face of a (2) Stressor experience (3) A hyperfunctioning parasympathetic tone ≫ hypersympathetic activity with rapid ANS cycling leading to (4) Rapid motricity of the entire enteric system inducing (5) Diarrheal episodes
Treatment goals Symptomatic: Hydration with low-osmotic fluids, intestinal spasmolytics Terrain: ● ●
●
●
ANS: ⇓ global ANS tone CORTICO: regulate axis to prevent compensatory ANS relaunching THYRO: regulate axis to prevent compensatory ANS relaunching Medications: reduce or eliminate inducers such as magnesium products, laxatives, opiate withdrawal, antacids
Sample treatment 1. Amino acid therapy: 1 capsule 2–3 times per day: GABA (γ-aminobutyric acid) 100–250 mg 2. Oligoelement: 1 tablet AM and evenings starting 3 days before events that provoke anticipatory anxiety: Lithium 5 mg 3. Neuroendocrine-anxiolytic: 1–2 mL up to every 1 h PRN (as needed) until diarrhea resolves, or, 3–4 mL three to four times per day starting 3 days before events that provoke anticipatory anxiety (Table 26.1): Melissa officinalis MT 80 mL, Ilex aquifolium GM 20 mL, Leonurus cardiaca MT 20 mL + Artemisia dracunculus EO 1 mL
The Theory of Endobiogeny. https://doi.org/10.1016/B978-0-12-816965-0.00026-3 © 2020 Elsevier Inc. All rights reserved.
4. Neuroendocrine-anxiolytic essential oil blend: inhale as needed and/or apply to templar arteries or to pulse points or under nose: Cananga odorata 1 mL, Salvia sclarea EO 1 mL, Lavandula angustifolia EO 3 mL
Terrain in detail Precritical terrain The precritical terrain varies. It can be a localized sensitivity to autonomic tone, especially parasympathetic, at the level of the motor complex. More often, it is a central or global parasympathetic and alpha sympathetic tone in vagotonic individuals with anxiety, most often anticipatory in nature. Thus, many are spasmophilic in the precritical terrain. There may be insufficient GABA (γ-aminobutyric acid) or dysregulated central-peripheral serotonin activity that fragilizes the patient, making them more susceptible to anticipatory anxiety.
Agent The most common type of aggression is an anticipatory anxiety related to performance or iatrogenic causes (cf. The Theory of Endobiogeny, volume 3, Chapter 10).
Critical terrain It involves overstimulation of the enteric motor complexes typically by the regional ANS enervation. This, in turn, is typically overstimulated by global ANS activity and involves a hyperfunctioning central or global ANS response to a perceived aggressor that also focalizes at the level of the motor complexes of the enteric motor complex. External or internal aggressors relaunch alpha, with a sufficiently strong beta response that the cycle of para-alpha-beta remains entrained until there is a sufficient reduction of alpha-sympathetic tone. 1. ANS: hyper para ≫ hyper alpha with strong beta: hypercycle of ANS
187
188 SECTION | C Assessment and treatment of common disorders
TABLE 26.1 Historical findings, terrain and BoF correlations. Symptom
Terrain
BoF
Anxiety
↑ αΣ + TRH + central inflammation + insufficient GABA
↑ Thyroid relaunching corrected + ↑ noxious free radicals + ↓ βMSH/αMSH
Spasmophilia
↑ Leukocyte mobilization ↓ Platelet mobilization
Hypervigiliance Spasmophilic symptoms (cf. Spasmophilia)
2. Endocrine: a. Corticotropic Peripheral: insufficient response or output of global adrenal cortex hormones may entrain or sustain a hyperfunctioning alpha-sympathetic tone, αMSH and/or βMSH. b. Thyrotropic i. Central: a hyperfunctioning TRH may also play a role in sustaining an adapted peripheral beta-sympathetic activity and prolonging the anxiety state ii. Peripheral: insufficient response or output of peripheral thyroid hormones may entrain a hyperfunctioning alpha-sympathetic or βMSH activity to compensate.
Mechanisms The rate of intestinal motricity (viz. peristalsis) does not allow for sufficient regulation of the water content of stool for the Endobiogenic terrain.
Result Rapid transit diarrhea: ≥ 3 stools per day of watery consistency.
History and BoF findings During acute rapid transit diarrhea, patient will present with ≥3 stools per day of watery consistency usually in association with anticipatory anxiety. Other aspects of the history and Biology of Functions correlations are presented in Table 26.1.
Treatment The general emphasis of treatment is to regulate autonomic tone globally and at the level of the intestines using medicinal plants and lifestyle stress management strategies.
Medicinal plants 1. ANS: reduce global ANS, favor plants that are spasmolytic and/or with an intestinal tropism and/or anxiolytics: a. Artemisia dracunculus EO b. Matricaria recutita MT/EO c. Angelica archangelica EO
d. Artemisia dracunculus EO e. Origanum majorana EO 2. Alpha-sympatholytics with digestive tropism and endocrine activity: a. Melissa officinalis MT: thyrotropic adaptogen b. Salvia sclarea MT: neuroendocrine adaptogen, supports adrenal cortex and peripheral thyroid gland 3. General anxiolytics: a. Inhalation of essential oils during stress: Cananga odorata EO, Citrus aurantium amara EO b. Oral: Ilex aquifolium GM, Leonurus cardiaca MT, FE, BH BH, bulk herb; EO, essential oil; FE, fluid extract; GM, gemmomacerate; MT, mother tincture.
Lifestyle Encourage active ways of managing anxiety: breathe work, meditation, mindfulness, visualization, dyadic therapy.
Exemplary prescriptions Based on an Endobiogenic approach to rapid transit diarrhea, a number of prescriptions can be derived. One or more can be used based on the preference of the patient and efficacy. 1. Amino acid therapy: 1 capsule 2–3 times per day: GABA (γ-aminobutyric acid) 100–250 mg 2. Oligoelement: 1 tablet AM and evenings starting 3 days before events that provoke anticipatory anxiety: Lithium 5 mg 3. Neuroendocrine-anxiolytic: 1–2 mL up to every 1 h PRN until diarrhea resolves, or, 3–4 mL three to four times per day starting 3 days before events that provoke anticipatory anxiety: Melissa officinalis MT 80 mL, Ilex aquifolium GM 20 mL, Leonurus cardiaca MT 20 mL + Artemisia dracunculus EO 1 mL 4. Neuroendocrine-anxiolytic essential oil blend: inhale as needed and/or apply to templar arteries or to pulse points or under nose: Cananga odorata 1 mL, Salvia sclarea EO 1 mL, Lavandula angustifolia EO 3 mL
Diarrhea, rapid transit Summary Essence: A functional disorder of excessive motricity of the enteric system for the Endobiogenic terrain Terrain: (1) Vagotonic individuals in which in the face of a (2) Stressor experience (3) A hyperfunctioning parasympathetic tone ≫ hypersympathetic activity with rapid ANS cycling leading to (4) Rapid motricity of the entire enteric system inducing (5) Diarrheal episodes
Treatment goals Symptomatic: Hydration with low-osmotic fluids, intestinal spasmolytics Terrain: ● ●
●
●
ANS: ⇓ global ANS tone CORTICO: regulate axis to prevent compensatory ANS relaunching THYRO: regulate axis to prevent compensatory ANS relaunching Medications: reduce or eliminate inducers such as magnesium products, laxatives, opiate withdrawal, antacids
Sample treatment 1. Amino acid therapy: 1 capsule 2–3 times per day: GABA (γ-aminobutyric acid) 100–250 mg 2. Oligoelement: 1 tablet AM and evenings starting 3 days before events that provoke anticipatory anxiety: Lithium 5 mg 3. Neuroendocrine-anxiolytic: 1–2 mL up to every 1 h PRN (as needed) until diarrhea resolves, or, 3–4 mL three to four times per day starting 3 days before events that provoke anticipatory anxiety (Table 26.1): Melissa officinalis MT 80 mL, Ilex aquifolium GM 20 mL, Leonurus cardiaca MT 20 mL + Artemisia dracunculus EO 1 mL
The Theory of Endobiogeny. https://doi.org/10.1016/B978-0-12-816965-0.00026-3 © 2020 Elsevier Inc. All rights reserved.
4. Neuroendocrine-anxiolytic essential oil blend: inhale as needed and/or apply to templar arteries or to pulse points or under nose: Cananga odorata 1 mL, Salvia sclarea EO 1 mL, Lavandula angustifolia EO 3 mL
Terrain in detail Precritical terrain The precritical terrain varies. It can be a localized sensitivity to autonomic tone, especially parasympathetic, at the level of the motor complex. More often, it is a central or global parasympathetic and alpha sympathetic tone in vagotonic individuals with anxiety, most often anticipatory in nature. Thus, many are spasmophilic in the precritical terrain. There may be insufficient GABA (γ-aminobutyric acid) or dysregulated central-peripheral serotonin activity that fragilizes the patient, making them more susceptible to anticipatory anxiety.
Agent The most common type of aggression is an anticipatory anxiety related to performance or iatrogenic causes (cf. The Theory of Endobiogeny, volume 3, Chapter 10).
Critical terrain It involves overstimulation of the enteric motor complexes typically by the regional ANS enervation. This, in turn, is typically overstimulated by global ANS activity and involves a hyperfunctioning central or global ANS response to a perceived aggressor that also focalizes at the level of the motor complexes of the enteric motor complex. External or internal aggressors relaunch alpha, with a sufficiently strong beta response that the cycle of para-alpha-beta remains entrained until there is a sufficient reduction of alpha-sympathetic tone. 1. ANS: hyper para ≫ hyper alpha with strong beta: hypercycle of ANS
187
188 SECTION | C Assessment and treatment of common disorders
TABLE 26.1 Historical findings, terrain and BoF correlations. Symptom
Terrain
BoF
Anxiety
↑ αΣ + TRH + central inflammation + insufficient GABA
↑ Thyroid relaunching corrected + ↑ noxious free radicals + ↓ βMSH/αMSH
Spasmophilia
↑ Leukocyte mobilization ↓ Platelet mobilization
Hypervigiliance Spasmophilic symptoms (cf. Spasmophilia)
2. Endocrine: a. Corticotropic Peripheral: insufficient response or output of global adrenal cortex hormones may entrain or sustain a hyperfunctioning alpha-sympathetic tone, αMSH and/or βMSH. b. Thyrotropic i. Central: a hyperfunctioning TRH may also play a role in sustaining an adapted peripheral beta-sympathetic activity and prolonging the anxiety state ii. Peripheral: insufficient response or output of peripheral thyroid hormones may entrain a hyperfunctioning alpha-sympathetic or βMSH activity to compensate.
Mechanisms The rate of intestinal motricity (viz. peristalsis) does not allow for sufficient regulation of the water content of stool for the Endobiogenic terrain.
Result Rapid transit diarrhea: ≥ 3 stools per day of watery consistency.
History and BoF findings During acute rapid transit diarrhea, patient will present with ≥3 stools per day of watery consistency usually in association with anticipatory anxiety. Other aspects of the history and Biology of Functions correlations are presented in Table 26.1.
Treatment The general emphasis of treatment is to regulate autonomic tone globally and at the level of the intestines using medicinal plants and lifestyle stress management strategies.
Medicinal plants 1. ANS: reduce global ANS, favor plants that are spasmolytic and/or with an intestinal tropism and/or anxiolytics: a. Artemisia dracunculus EO b. Matricaria recutita MT/EO c. Angelica archangelica EO
d. Artemisia dracunculus EO e. Origanum majorana EO 2. Alpha-sympatholytics with digestive tropism and endocrine activity: a. Melissa officinalis MT: thyrotropic adaptogen b. Salvia sclarea MT: neuroendocrine adaptogen, supports adrenal cortex and peripheral thyroid gland 3. General anxiolytics: a. Inhalation of essential oils during stress: Cananga odorata EO, Citrus aurantium amara EO b. Oral: Ilex aquifolium GM, Leonurus cardiaca MT, FE, BH BH, bulk herb; EO, essential oil; FE, fluid extract; GM, gemmomacerate; MT, mother tincture.
Lifestyle Encourage active ways of managing anxiety: breathe work, meditation, mindfulness, visualization, dyadic therapy.
Exemplary prescriptions Based on an Endobiogenic approach to rapid transit diarrhea, a number of prescriptions can be derived. One or more can be used based on the preference of the patient and efficacy. 1. Amino acid therapy: 1 capsule 2–3 times per day: GABA (γ-aminobutyric acid) 100–250 mg 2. Oligoelement: 1 tablet AM and evenings starting 3 days before events that provoke anticipatory anxiety: Lithium 5 mg 3. Neuroendocrine-anxiolytic: 1–2 mL up to every 1 h PRN until diarrhea resolves, or, 3–4 mL three to four times per day starting 3 days before events that provoke anticipatory anxiety: Melissa officinalis MT 80 mL, Ilex aquifolium GM 20 mL, Leonurus cardiaca MT 20 mL + Artemisia dracunculus EO 1 mL 4. Neuroendocrine-anxiolytic essential oil blend: inhale as needed and/or apply to templar arteries or to pulse points or under nose: Cananga odorata 1 mL, Salvia sclarea EO 1 mL, Lavandula angustifolia EO 3 mL