I sometimes like to start off my articles by saying “the other day a patient asked me….” This article is of that same nature, but rather than it being one person, this reflects a topic that comes up at least several times a week. The specific topic relates to digestive function, and the general topic relates to how different systems use language to describe health issues.
Two years ago, I wrote a brief article entitled Most People have a Compromised Digestive System. Around the same time I also wrote A Few Quick Facts about the Spleen in Chinese Medicine and Why Even Healthy Foods Aren’t Healthy for Everyone. These articles describe both the importance of the digestive system in Chinese medicine, and the unique approach Chinese medicine takes to identifying, diagnosing and treating digestive system disturbances.
Digestion means many things in Chinese medicine. As a whole, this term reflects the ability of the body to process, absorb, metabolize and utilize food, and to similarly process and eliminate waste. Digestive system disturbances manifest as weight gain or loss, issues of appetite, nausea, reflux, bloating, gas, elimination, etc.
When I question people about their digestion, most respond that it is “not a problem.” When I further question them about, let’s say, the reflux medication they are taking, they respond that the reflux is under control and it is not a problem. That is the extent of the average person’s concept of digestion – as long as there is no active reflux, digestion is fine. My point is that people are often conceptually unaware of the function of the digestive system, and the related symptoms that arise when it is imbalanced.
This lack of understanding is the first part of this discussion. The second is languaging and modern marketing of digestive tract products that fall under the category of “gut health.” Like the terms heart health, brain health, and anything else health, gut health has no real meaning. It might not seem important up front, as the implication is certainly obvious enough – take care of your gut. But it is the context in which it is found that is problematic at times. Here is a real-life example. I may be treating someone for several months or longer, including teaching them about treatment of the Spleen and digestive system and its related functions in Chinese medicine. Then they go to see a functional medicine or integrative medicine practitioner of some sort. They come back with a “diagnosis” of “gut health problem”. This problem was determined through a functional medicine test that identified dysbiosis. The remedy for this is probiotics and berberine, for example.
There is now a generalized and oversimplified relationship that has been created: disease=gut health=probiotics. The term “gut health” is presented as if it is a diagnosis, and one that can only be evaluated and treated through a particular modality. However, Chinese medicine has a complex understanding of the digestive system and its role in health and disease. Addressing digestive complaints is always part of Chinese medical treatment. The remedies that are commonly used in functional, integrative, holistic, naturopathic medicine are often, from the perspective of Chinese medicine, damaging to the digestive tract and can make the problem worse.
The issue of treatment is important. But what is equally important is the language and marketing used in relation to this system of medicine, the testing, and the products. The importance of the digestive system is not a new or unique concept. It is not tied to functional medicine or stool tests. It is not treated effectively through the use of probiotics and other commonly used supplements. As is true with all conditions, digestive system dysfunction requires complex, individualized treatment. It is not separate from the rest of Chinese medicine, and is always part of treatment.
Practitioners and industries create new language to market new services or approaches. While this is not inherently bad, it is sometimes confusing and misleading. It leads people to believe they have yet another problem that requires another practitioner and even more supplements. Rather than being truly integrated into the overall evaluation and treatment, it becomes a separate and often conflictual therapy. Working consistently within a given modality generally yields the best results.