Herbal treatments for endotoxemia (Chinese Medicine)

Enterogenous Endotoxemia in Chronic Hepatitis– Part 1


Enterogenous endotoxemia (EE) is a very common complication in chronic liver diseases. The incidence rate of EE in chronic hepatitis is approximately 50 to 58% with varying degress of severity. In other liver diseases such as acute hepatitis, fulminant hepatitis, and cirrhosis, the approximate ranges are 16% to 43%, 58% to 100%, and 79% to 92%, respectively. From these figures, we can see that EE is an important complication that can worsen the liver’s pathology and promote other disorders. Therefore, preventing and treating EE is an important task in the care of chronic liver diseases.

The endotoxin absorbed from the intestines passes through the barriers of the intestinal mucus membrane, Kupffer cells of the liver, serum detoxification mechanisms and finally into the systemic blood stream of the body. During active liver disease, there is often an accompanying inflammatory bowel disorders that makes the mucus membrane of intestine more penetrable. Hypertension of portal vein causes congestive intestinal disorders, in which the blood congestion, swelling, erosive lesions of mucus membrane in the intestinal wall causes the mucus membrane barrier to leak. In addition, the liver inflammation weakens the Kupffer cells' phagocytosis function, which allows the intestinal endotoxin (IE) to seep through the liver and enter the systemic circulation, bypassing the phagocytosis of Kupffer cells. Studies found that the level of IE in cirrhotic patients' liver vein was 73±110ng/L and 31± 58 ng/L in the systematic vein. The difference was statistically significant (p<0.001 and suggested that the cirrhotic liver could not clear the IE from the portal vein.

Damaged Kupffer cells can further promote liver damage. When large amounts IE enter the liver, it will directly cause liver damage when the Kupffer cells can not clear it. The IE can also trigger the release of cytokines in the damaged Kupffer cells, which will exacerbate the inflammation in the liver. In the late stage of cirrhosis, there is portal-systemic shunt and the IE can enter the systemic circulation directly, completely bypassing the liver. This is mainly caused by the hypertension of the portal vein, which causes the lymph fluid production in the mesenterium to increase, allowing the IE to easily enter the systemic circulation via lymph circulation. Thus, EE is very common in the advanced stage of the liver disease EE.

In addition to causing direct liver damage and promoting other liver complications, EE can also obstruct bile secretion and cause bile retention. It can cause the blockage of the blood circulation in the liver vein and cause congestion in the liver. The common symptoms of EE are: fevers, failure of gastrointestinal functions, manifestations outside the liver such as kidney injuries, swelling and erosive bleeding of stomach membrane, disseminated intravenous clotting, and lung injuries. In many cases, the EE can also cause ascites and jaundice.

Treating the underlying liver disease and controlling the inflammation of the liver is the fundamental treatment for preventing and treating EE. Maintenance of regular bowel movement is also very important. To suppress the over-growth of bacteria in the intestines, Herbs such as Allicin and Coptin can be very effective.

Prevention and Treatment of EE With Modern Chinese Medicine

To prevent and treat EE, the first important thing is to actively treat the underlying liver inflammation, reduce the hypertension of the portal vein, and reverse liver fibrosis. Once liver functions are improved, the factors promoting EE will also be gradually eliminated.

Symptomatic treatments are also important in reducing the production of intestinal endotoxin (IE). Treating constipation and regulating bowel movement can effectively reduce the production of IE and for this, we use the Rhubarbin Tablet or formula # 733 (Rhubarb and Mirabilitum Combination) to adjust the bowel movements to two to three times a day and slightly loosen the stool. This treatment can reduce the amount of time that the stool remains in the colon and reduce the production and absorption of IE. In addition, using colonotherapy to eliminate stagnant stool in the colon can also reduce IE production. Anti-bacterial herbs, can dramatically suppress the overgrowth of bacterial flora and thus reduce IE production. Because the high potency of these herbs can suppress healthy bacterial flora, weekly breaks are recommended and during the break, acidophilus and yogurt can be used to re-establish the growth of healthy bacteria.

If EE has already been developed, treatment should focus on resolving the EE pathology and detoxify the IE. In China, many single herbs and their active ingredients have been studied and proven to be effective treatments for EE. These include: Chuan Xiong (Cnidii Rhizoma), Dan Shen (Salviae Miltiorrhziae Radix), Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix), have been found to de-activate the IE. Pu Gong Ying (Taraxaci Herba), Ban Lan Gen (Isatidis Radix), Jin Yin Hua (Lonicerae Flos), and Shan Dou Gen (Sophorae Subprostratae Radix) can decompose the IE. Da Huang (Rhei Rhizoma), Huang Lian (Coptis chinensis Franch), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), and Dan Shen (Salviae Miltiorrhziae Radix), can reduce the production of the IE in the intestine.

mphatesmpb wrote:Been looking into some factors which regulate absorption of endotoxins from the intestines. Liver seems to play an important role in preventing endotoxins from entering circulation. It seems that liver dysfunction can also cause increased intestinal permeability and endotoxemia.

On another recent thread it was noted that mesenteric lymph nodes also play an important role in regulating endotoxin absorption.

Enterogenous Endotoxemia in Chronic Hepatitis– Part 1


Enterogenous endotoxemia (EE) is a very common complication in chronic liver diseases. The incidence rate of EE in chronic hepatitis is approximately 50 to 58% with varying degress of severity. In other liver diseases such as acute hepatitis, fulminant hepatitis, and cirrhosis, the approximate ranges are 16% to 43%, 58% to 100%, and 79% to 92%, respectively. From these figures, we can see that EE is an important complication that can worsen the liver’s pathology and promote other disorders. Therefore, preventing and treating EE is an important task in the care of chronic liver diseases.

The endotoxin absorbed from the intestines passes through the barriers of the intestinal mucus membrane, Kupffer cells of the liver, serum detoxification mechanisms and finally into the systemic blood stream of the body. During active liver disease, there is often an accompanying inflammatory bowel disorders that makes the mucus membrane of intestine more penetrable. Hypertension of portal vein causes congestive intestinal disorders, in which the blood congestion, swelling, erosive lesions of mucus membrane in the intestinal wall causes the mucus membrane barrier to leak. In addition, the liver inflammation weakens the Kupffer cells' phagocytosis function, which allows the intestinal endotoxin (IE) to seep through the liver and enter the systemic circulation, bypassing the phagocytosis of Kupffer cells. Studies found that the level of IE in cirrhotic patients' liver vein was 73±110ng/L and 31± 58 ng/L in the systematic vein. The difference was statistically significant (p<0.001 and suggested that the cirrhotic liver could not clear the IE from the portal vein.

Damaged Kupffer cells can further promote liver damage. When large amounts IE enter the liver, it will directly cause liver damage when the Kupffer cells can not clear it. The IE can also trigger the release of cytokines in the damaged Kupffer cells, which will exacerbate the inflammation in the liver. In the late stage of cirrhosis, there is portal-systemic shunt and the IE can enter the systemic circulation directly, completely bypassing the liver. This is mainly caused by the hypertension of the portal vein, which causes the lymph fluid production in the mesenterium to increase, allowing the IE to easily enter the systemic circulation via lymph circulation. Thus, EE is very common in the advanced stage of the liver disease EE.

In addition to causing direct liver damage and promoting other liver complications, EE can also obstruct bile secretion and cause bile retention. It can cause the blockage of the blood circulation in the liver vein and cause congestion in the liver. The common symptoms of EE are: fevers, failure of gastrointestinal functions, manifestations outside the liver such as kidney injuries, swelling and erosive bleeding of stomach membrane, disseminated intravenous clotting, and lung injuries. In many cases, the EE can also cause ascites and jaundice.

Treating the underlying liver disease and controlling the inflammation of the liver is the fundamental treatment for preventing and treating EE. Maintenance of regular bowel movement is also very important. To suppress the over-growth of bacteria in the intestines, Herbs such as Allicin and Coptin can be very effective.

Prevention and Treatment of EE With Modern Chinese Medicine

To prevent and treat EE, the first important thing is to actively treat the underlying liver inflammation, reduce the hypertension of the portal vein, and reverse liver fibrosis. Once liver functions are improved, the factors promoting EE will also be gradually eliminated.

Symptomatic treatments are also important in reducing the production of intestinal endotoxin (IE). Treating constipation and regulating bowel movement can effectively reduce the production of IE and for this, we use the Rhubarbin Tablet or formula # 733 (Rhubarb and Mirabilitum Combination) to adjust the bowel movements to two to three times a day and slightly loosen the stool. This treatment can reduce the amount of time that the stool remains in the colon and reduce the production and absorption of IE. In addition, using colonotherapy to eliminate stagnant stool in the colon can also reduce IE production. Anti-bacterial herbs, can dramatically suppress the overgrowth of bacterial flora and thus reduce IE production. Because the high potency of these herbs can suppress healthy bacterial flora, weekly breaks are recommended and during the break, acidophilus and yogurt can be used to re-establish the growth of healthy bacteria.

If EE has already been developed, treatment should focus on resolving the EE pathology and detoxify the IE. In China, many single herbs and their active ingredients have been studied and proven to be effective treatments for EE. These include: Chuan Xiong (Cnidii Rhizoma), Dan Shen (Salviae Miltiorrhziae Radix), Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix), have been found to de-activate the IE. Pu Gong Ying (Taraxaci Herba), Ban Lan Gen (Isatidis Radix), Jin Yin Hua (Lonicerae Flos), and Shan Dou Gen (Sophorae Subprostratae Radix) can decompose the IE. Da Huang (Rhei Rhizoma), Huang Lian (Coptis chinensis Franch), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), and Dan Shen (Salviae Miltiorrhziae Radix), can reduce the production of the IE in the intestine.

Objective: This study evaluated the short-term effect of bamboo shoot consumption as a dietary
fiber source on blood glucose, lipid profiles, hepatic function, and constipation symptoms in healthy
women.
Methods: Eight subjects, 21- to 23-y-old women, with normal health status received a dietary
fiber-free diet (control), a diet containing 25 g of cellulose, and a diet containing 360 g of bamboo
shoots, with each diet segment lasting 6 d. At the end of each diet, blood biochemical parameters,
such as glucose, triacylglycerols, total cholesterol, high-density lipoprotein cholesterol, low-density
lipoprotein cholesterol, glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, and
atherogenic index were measured and a questionnaire test for the evaluation of fecal excretion was
taken. For statistical analysis, analysis of variance was performed.
Results: Serum total cholesterol, low-density lipoprotein cholesterol, and the atherogenic index
were decreased with the bamboo shoot diet feeding compared with the dietary fiber-free diet. There
were no differences in serum glucose levels among the tested diets. Fecal volume and bowel
movement frequency in subjects fed the bamboo shoot diet were significantly increased.
Conclusion: Bamboo shoots as a dietary fiber source has beneficial effects on lipid profile and
bowel function.