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by U.S.A. Medical Doctor & Herbalist.

Chronic diarrhea is either caused by retentions of pathogenic factors in bowels or deficiency of bioenergies inputs into neuromuscular system in the gut

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Diarrhea, to public, means liquidy stools with increased frequency. Its biomedical definition is stool weight > 200 grams/day. ( not useful clinically)

Chronic Diarrhea is diarrhea lasting > 3 to 4 weeks. Biomedicine proposes 5 different causative mechanisms.

#1) Secretory diarrhea is abnormal fluid and electrolyte transport across mucosa of small intestine and colon, with large volume loose stools which usually persist despite fasting. Its causes are a) laxative abuse, or b) decreased funtional surfaces for absorption ( crohn's disease, resection of intestines, chloridorrhea or chloride rich watery diarrhea due to defective CL/HCO3 mucosal exchange, and hormones from tumors causing production of intestinal secretagogues ).

#2) Osmotic Diarrhea means that osmotically active solutes enter colon and draws fluids exceeding the resorptive capacity of colon ( which may be 3.2 liters/day, and thus,this type of diarrhea is not severe unless the colonic transit time is very shortened usually from autonomic dysfuntion). Its causes are a) osmotic laxatives ( Magnesium), b) lactase deficiency.

#3) Fat malabsorption with greasy stools and nutritional deficiency are usually diagnosed.

#4) Inflammatory mechanisms include mucosal exudation, hypersecretion of electrolytes and fluids, and hypermotility of colon. Its most common cause is inflammatory bowel disease including ulcerative colitis, and are usually diagnosed.

#5) Dysmotility of bowel with rapid transit due to visceral autonomic neuropathy ( " diabetic diarrhea" ),or disordered neurohormonal regulation of colonic and anorectal function ( " Irritable bowel syndrome" ).

Chronic Idiopathic Diarrhea is functional diarrhea where all the biomedical diseases and over usage of medications are ruled out, and are quite common. Biomedical treatments are permanent usage of opiodlike drugs such as imodium or peptobismol, and may not work.Chronic diarrhea can be explained by the theory of physicians herbal formula combining the concepts of eastern herbal medicine and pathophysiology. She can also be diagnosed and healed by eastern herbal medicine.

According to eastern herbal medicine, chronic diarrhea is caused by 2 major categories of mechanisms. #1) is chronic retention of pathogenic factors in bowels which cause hypersecretory mucosa, exudative inflammatory mucosa, and disordered motility of colon.

1A), called damp heat in colon, causes foul smelling yellow diarrhea with frequency, abdomenal discomfort, and burning anus. Treated by Acute Diarrhea ( it treats also chronic diarrhea due to damp heat)

1B), called blood stasis often shows blood in stools. Not a common syndrome.

1C), called liver Qi stagnation with some heat in colon, treated by Irritable Bowel

#2) category is Qi / Yang ( "bioenergy and warming bioforce" )deficiency of spleen, stomach,or kidney. Deficiency of bioenergy is manifested by the hypofuntioning of enteric and autonomic nervous system. Submucosal nervous plexus which controls absorption and secretion of electrolytes and fluids are devoid of energy, and fail to control chloride ion channels and produce watery diarrhea. Sympathetic nervous system ( "active Qi/ Yang" )which provide inhibitory control on the smooth muscles of colon may fail and hypermotility of colon ensues.

2A) called Spleen Qi deficiency results in chronic loose or watery stools and fatigue. Treated by Chronic Diarrhea

2B) called Kidney and spleen Yang deficiency is not a common cause of diarrhea in western

culture, except in very elderlies.

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