Chronic Bloating Case

[tracyandrews]

CCs: chronic bloating, interrupted sleep, anxiety and occasional hot flashes. BXXXT+XXXT+FL for a long time has helped immensely with calming and improved sleep, but the pulse has changed and the bloating is not responding to herbs (her ND is testing for SIBO). Pulse is big wiry on both guan, R>L, L chi thin and barely wiry, slightly long. R deep wiry. Both cun and chi are deep with a very thin pulsation and are rolling up onto the hand. After reviewing many discussions on the forum, I think it could be WMW+TXS. Though there’s no clear tightness in the R cun. It is on the thin side and could possibly be described as wiry, but not distinctly tight. This patient can’t take granules due to food sensitivities. I can get WMW encapsulated by Blue Dragon and wonder about starting with that alone for a week so I can see the effect of WMW on its own. Then, if the pulse still indicates it, adding in bulk TXS would be the next step.. What do you folks think about this strategy? I’ve never seen Arnaud use WMW+TXS in clinic and have not used it myself, and I’m not feeling confident about the pairing, so I wanted to check in with the big ICEAM group brain first.

[Christoph Ludwig Beer]

oneeyedcat88

[amyobrien]

Urination and bowels ok?

[tracyandrews]

Daily BMs and slightly loose. Normal thirst and urination and a healthy appetite. No nausea or abdominal pain (I was looking at DCHT also, based on the pulse).

[laurieayres]

Schmerker

[tracyandrews]

The bloating is now the chief complaint. Though they are much better, anxiety and sleep could improve further.

[laurieayres]

With both guan big and wiry, and bloating as the main problem then maybe a HP formula. Stools are tending to loose, so less likely to be HPSWT. No superficial L cun, so less likely to be HPQWT –DH. So could be HPSJBXRSGCT (though no tight R cun, but the guans along with bloating and looser stools fit) to sort out the digestion, and if that doesn’t sort the sleep and anxiety, also then just see what’s there next. The fact that they can’t take granules because their digestion is so sensitive is quite a big indication of the weakness of tai yin.

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