Traditional Chinese Medicine considers this disease to fall under the categories of "abdominal pain," "diarrhea," and "abdominal mass." It is often caused by exposure to cold, heat, summerheat, or dampness, improper diet, emotional distress, or weakness of the zang-fu organs, which damages the spleen and stomach, leading to dysfunction in transportation and transformation. This results in the stagnation of water-dampness, phlegm-turbidity, retained food, and static blood in the intestines, obstructing the flow of qi and causing abdominal pain. The retention of food that fails to be digested, combined with turbid substances, leads to diarrhea. The accumulation of heat toxin results in high fever. The binding of stasis and heat, if it erodes the intestines and flesh, leads to the formation of fistulas. If stuffiness accumulates in the intestines, it manifests as abdominal mass.

bubble_chart Modern Research

Crohn's disease, also known as regional enteritis, segmental enteritis, and granulomatous small intestine colitis. The disease cause is not yet fully understood, mainly due to an immune response caused by infection. Clinically, it is characterized by abdominal pain, diarrhea, abdominal mass, fistula formation, and intestinal obstruction, and may be accompanied by fever, nutritional disorders, arthritis, and other manifestations. According to clinical classification, it can be divided into active and stage of remission.

Modern medicine believes that the main pathological changes of this disease are tissue changes caused by allergic reactions, namely granulomatous inflammation. In tissue culture, the patient's lymphocytes have cytotoxic effects on normal colon epithelial cells; anti-colon epithelial cell antibodies are found in the serum of about half of the patients, or antigen-antibody complexes are detected in the diseased tissue; patients often test negative for subcutaneous node bacterial toxins and 2,4-dinitrochlorobenzene skin tests, suggesting low cellular immune function; this disease is often complicated by extraintestinal manifestations, such as arthritis, iridocyclitis, etc., and is effectively treated with adrenal glucocorticoids, indicating autoimmune phenomena. The basic pathological features are intestinal lymphatic occlusion, lymphatic fluid fistula disease, submucosal edema, and granulomatous inflammation of the intestinal wall, among other pathological changes.

1. History Some patients may have a family genetic history. Most cases have a slow onset and a long course, which can last for several years. Early stages have varying lengths of active periods and stage of remission, followed by progressive development.
2. Symptoms The clinical manifestations of this disease, the severity of the condition, and the course of development are often inconsistent, usually related to the location, extent, and stage of the disease. Abdominal pain and diarrhea are common symptoms, often accompanied by irregular fever, abdominal mass, and fistula formation. Severe patients may have anemia, weight loss, hypoproteinemia, and other manifestations.
3. Laboratory and other examinations Blood tests: common anemia, increased white blood cell count, accelerated erythrocyte sedimentation rate. Stool examination: occult blood test is generally positive; increased fat content. Rectosigmoidoscopy, fiber colonoscopy, and gastrointestinal barium meal examination are often helpful in making a clear diagnosis.

bubble_chart Pattern Analysis

1. Dampness-heat︰Abdominal pain and diarrhea, urgent diarrhea or incomplete evacuation, yellow-brown and foul-smelling stool, burning sensation in the anus, thirst without desire to drink, scanty dark urine, red tongue with yellow-white greasy coating, soggy and rapid or slippery and rapid pulse. Clear heat and drain dampness, disperse and stop diarrhea. Modified Pueraria Root, Coptis, and Skullcap Decoction. Coptis Rhizome 10g; Skullcap Root 12g, Pueraria Root 20g, Lonicera 12g, Poria 20g, Plantain Seed 15g, Akebia Stem 15g, Submature Bitter Orange 12g, Aucklandia Root 12g. For chest and gastric stuffiness and fullness with thick greasy tongue coating, add Atractylodes Rhizome 12g, Magnolia Bark 12g; for undigested food retention, add Medicated Leaven 12g, Hawthorn Fruit 15g, Stir-fried Millet Sprout 10g, Stir-fried Germinated Barley 10g; if accompanied by summerheat-dampness pattern, add Patchouli 12g, Hyacinth Bean 10g, half a Lotus Leaf.
2. Liver Qi Depression︰Pain in the lower right abdomen or around the navel, often occurring after meals and worsening with irritability, accompanied by borborygmus. Relief may be felt with flatus or belching. The pain is associated with a desire to defecate, and symptoms improve after bowel movements. The tongue appears pale red with a thin white coating, and the pulse is wiry or choppy. Treatment involves soothing the liver and relieving depression, regulating qi, and alleviating pain. Modified Bupleurum Liver-Soothing Powder is used, consisting of Bupleurum 10g, Submature Bitter Orange 15g, Peony Root 20g, Liquorice Root 6g, Cyperus 12g, Finger Citron 12g, Sichuan Lovage Rhizome 12g, Red Peony Root 10g, and Corydalis Tuber 12g. For cases with blood stasis pattern, add raw Typha 10g and Trogopterus Dung 10g. For abdominal distension and fullness, add Magnolia Bark 12g and Areca Seed 10g. For abdominal pain with a desire to defecate, add White Atractylodes Rhizome 10g, Dried Tangerine Peel 12g, and Saposhnikovia Root 10g.
3. Heat Toxin Stagnation and Obstruction︰Acute pain in the lower right abdomen, or persistent pain throughout the abdomen that worsens upon pressure, fever, thirst, nausea, vomiting, severe constipation, scanty dark urine. The tongue is deep red with dry, old yellow coating, and the pulse is wiry, rapid, and forceful. Treatment involves clearing heat and removing toxins, as well as promoting bowel movement. Modified Five-Ingredient Toxin-Eliminating Decoction combined with Minor Purgative Decoction. Ingredients: Dandelion 20g, Lonicera 15g, Tokyo Violet Herb 30g, Glabrous Greenbrier 20g, Moutan Bark 15g, Red Peony Root 12g, Coptis Rhizome 10g, Raw Rhubarb Rhizome 30g (infused separately and added later), Magnolia Bark 12g, Submature Bitter Orange 10g. For heat toxins accumulating and forming masses, add Sparganium Rhizome 15g and Zedoary Rhizome 15g. For intermingled heat and blood stasis, add Peach Kernel 12g, Leech 10g, and Gadfly 10g. For persistent high fever, add Gypsum 30–50g (decocted first), Anemarrhena 12g, and Smallpox Powder 15g.
4. Qi Stagnation and Blood Stasis︰The abdominal pain is intermittent, with distension more pronounced than pain. The abdomen is distended, and a mass may be palpable. There is cessation of flatus and bowel movements, with a drum-like sound upon percussion and aggravated pain upon pressure. The tongue is red or purplish-dark, with tortuous sublingual veins, and the pulse is strong and forceful. The treatment principle is to expel stasis and unblock the fu organs, regulate qi, and resolve stuffiness. Modified Ge Xia Zhu Yu Tang is used: Peach Kernel 12g, Carthamus 15g, Chinese Angelica 10g, Sichuan Lovage Rhizome 12g, Trogopterus Dung 10g, Red Peony Root 12g, Cyperus 12g, Lindera 12g, Chinaberry Fruit 15g; Sparganium Rhizome 20g, Zedoary Rhizome 15g, raw Rhubarb Rhizoma 20–30g (infused separately and taken separately). For concurrent food retention and stagnation, add Radish Seed 15g and Areca Seed 15g. For severe abdominal distension, fullness, and pain, add Immature Orange Fruit 20g and Magnolia Bark 20g. For a hard, painful mass that resists pressure, add Eupolyphaga 10g and Turtle Carapace 30g.
5. Spleen-kidney Yang Deficiency︰The stool is sometimes loose and sometimes watery, with undigested food in it. Slight consumption of greasy food increases the frequency of bowel movements. There may also be abdominal pain, borborygmus followed by diarrhea, which relieves after defecation, fear of cold, preference for warmth, and poor appetite. The tongue texture is pale, swollen, and tender with tooth marks on the edges, covered by a thin white greasy coating. The pulse is deep, thin, and weak. Treatment involves tonifying the spleen and replenishing qi, warming the kidneys, and consolidating the intestines. Modified Ginseng, Poria, and White Atractylodes Powder combined with Four Miracle Pill are used. The prescription includes: Tangshen 15g, Poria 20g, White Atractylodes Rhizome 12g, Liquorice Root 5g, Hyacinth Bean 12g, Chinese Yam 30g, Psoralea 15g, Evodia 6g, Nutmeg 10g. For deficiency of middle yang, add Prepared Common Monkshood Daughter Root 10g and Blast-Fried Ginger 12g. For sinking of middle qi, add Bupleurum 10g, Cimicifuga Rhizome 10g, and Submature Bitter Orange 30g. For elderly or weak patients with chronic diarrhea, add Red Halloysite 20g and Limonite 20g.
6. Deficiency of Vital Qi with Blood Stasis︰A mass can be palpated in the lower right abdomen or around the navel, feeling hard to the touch and painful upon pressure, with fixed pain. The complexion is shallow yellow or dark, the body is emaciated, and there is mental fatigue and lack of strength, along with reduced appetite. The tongue texture is pale purple, with tortuous sublingual veins, and the coating is gray and rough or smooth and red without coating. The pulse is thin and rapid or wiry and thin. Treatment involves tonifying qi and nourishing yin, invigorating blood and resolving stasis. Modified Eight Precious Ingredients Decoction combined with Resolving Accumulation Pill is used. Ingredients include Chinese Angelica 10g, Prepared Rehmannia Root 12g, Red Peony Root 12g, Sichuan Lovage Rhizome 12g, Tangshen 12g, Astragalus Root 20g, Carthamus 10g, Ground Beetle 10g, and Turtle Carapace 30g. If the tongue is smooth and red without coating, add Coastal Glehnia Root 30g, Ophiopogon Tuber 30g, and Dendrobium 30g. If the mass is hard, add Pillbug 10g and Northeast Giant Black Chafer 10g. For women with amenorrhea or scaly skin, add Leech 10g and Gadfly 10g. If perianal fistula is present, surgical treatment should be considered.