Two Formulas and One Patent Medicine I Use for Radiation Enteritis

After radiotherapy, cancer patients often develop complications such as radiation enteritis. It is very stubborn and hard to treat: patients have chronic diarrhea and bloody stool, and some become severely anemic from long-term bleeding, requiring regular transfusions.

TCM treatment of radiation enteritis is also tricky. It is hard to cure completely, and most patients need long-term medication. I have treated several cases; though I cannot cure the disease entirely, I can reduce suffering and relieve bloody stool and diarrhea in some patients.

I now share my usual formulas and patent medicine for reference.

My most-used formula is Huaihua San, from Puji Benshi Fang. The original text says it treats "changfeng and zangdu" (intestinal wind and visceral toxin), a TCM condition whose main symptom is blood in the stool—before, after, or mixed with stool.

Huaihua San is cold in nature, suited to "intestinal wind bleeding" from heat-toxin. A typical side effect of radiotherapy is burning of human tissue; from the TCM view, radiation damage is dominated by heat-toxin, so Huaihua San is especially on-pattern.

Of course it fits not only radiation enteritis with bloody stool but also bleeding from intestinal metastatic tumors in colorectal or other cancer patients.

Huaihua San contains Huaihua (Sophora Flower), Cebaiye (Biota Leaf), Jingjiesui (Schizonepeta Spike), and Zhiqiao (Bitter Orange). My usual dose: Huaihua 12g, Cebaiye 12g, Jingjiesui 6g, Zhiqiao 6g. If bleeding is severe, Cebaiye, Jingjiesui, and Zhiqiao are best char-fried, because charring improves hemostasis.

Huaihua San clears the intestine and stops bleeding, and disperses wind and moves qi. But its anti-diarrheal effect is weak; if the patient has diarrhea, add Huanglian (Coptis) 6g, Huangbai (Phellodendron) 6g, and Cheqianzi (Plantago Seed) 15-30g.

Another formula I use is the late anti-cancer TCM master Liang Xiuqing's family Chunbaipi Tang: Chunbaipi (Ailanthus Bark) 15g, Baimaogen (Imperata Root) 30g, Machixian (Purslane) 10g, Shenqu (Medicated Leaven) 15g. Dr. Liang used it for stubborn bloody stool with good effect.

When one formula fails, I sometimes combine both for the patient, often more effective than either alone.

If the decoction helps, patients can have it made into pills (themselves or at a pharmacy), 6-12g two to three times daily. This is convenient and eases the financial burden.

There is also a patent medicine called Fukean Pian, used by a cervical-cancer patient after her own radiotherapy for her radiation enteritis.

It contains some regional herbs and stops diarrhea and abdominal pain. After hearing this patient's report, I tried it on some radiation-enteritis patients with some effect.

If a radiation-enteritis patient is already anemic, add Huangqi Danggui Buxue Tang or Bazhen Tang to nourish blood and reduce transfusion needs.