Education, Science, Technology, Innovation and Life
Open Access
Sign In
  1. Home
  2. Journals
  3. MEDS Chinese Medicine
  4. Vol 8, Issue 1, 2026

Exploring the Treatment of Post-Stroke Gastrointestinal Dysfunction with Herbal Enemas Based on the Brain-Gut Axis Theory: A Case Report

Download as PDF

DOI: 10.23977/medcm.2026.080108 | Downloads: 4 | Views: 68

Author(s)

Linhui Li 1, Cuiru Lin 2, Yuan Qin 1, Yingping Ren 1

Affiliation(s)

1 Tianjin University of Traditional Chinese Medicine, No. 10 Poyang Lake Road, Tuanbo New City West Area, Jinghai District, Tianjin, China
2 The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, No. 69 Zengchandao, Hebei District, Tianjin, China

Corresponding Author

Cuiru Lin

ABSTRACT

Based on the theory of the brain-gut axis, this paper discusses the application of herbal enema in patients with post-stroke gastrointestinal dysfunction, which often manifests as constipation, blood in stool, diarrhea, epigastric distension, nausea, belching and other symptoms that seriously affect the recovery process. Current treatment programs are mostly symptomatic but with suboptimal clinical efficacy. This study reports a case of a 77-year-old male patient who presented with unfavorable left limb movement and speech disorder for more than one month after infarction in the right basal ganglia region, accompanied by obvious manifestations of gastrointestinal dysfunction including watery diarrhea, abdominal distension, and positive fecal occult blood. Despite receiving conventional anti-platelet aggregation, antihypertensive, and cerebral circulation improvement treatments, as well as oral acid-suppressing and stomach-protecting medications, intestinal flora regulators, and antidiarrheal drugs, the symptoms were not relieved. Abdominal and pelvic CT examination revealed a large amount of stool accumulation in the intestine, based on which herbal enema therapy was administered with a formula composed of Shengdihuang (Rehmanniae Radix), Beishashen (Glehniae Radix), Huangqi (Astragali Radix), Dahuang (rhubarb root and rhizome), Zhishi (Aurantii Fructus Immaturus), Houpo (Officinal magnolia bark), and others, delivered once daily for four consecutive days. Following this regimen, the patient exhibited dark-brown, hard stools with reversion of fecal occult blood test results to negative, accompanied by clinical stabilization and marked improvement in mental status and consciousness level. As a safe and effective complementary therapy, herbal enema has shown promising applications in relieving gastrointestinal dysfunction and improving patients' mental status and consciousness level after ischemic stroke; however, large-scale randomized controlled studies are needed to verify its complementary or synergistic effects on patients' full recovery.

KEYWORDS

Brain-gut axis, herbal enema, stroke, gastrointestinal dysfunction, case report

CITE THIS PAPER

Linhui Li, Cuiru Lin, Yuan Qin, Yingping Ren. Exploring the Treatment of Post-Stroke Gastrointestinal Dysfunction with Herbal Enemas Based on the Brain-Gut Axis Theory: A Case Report. MEDS Chinese Medicine (2026). Vol. 8, No. 1, 63-69. DOI: http://dx.doi.org/10.23977/medcm.2026.080108.

REFERENCES

[1] Feigin V L, Abate M D, Abate Y H, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the global burden of disease study 2021[J]. Lancet Neurology, 2024, 23(10): 973-1003. 
[2] Camara-Lemarroy C R, Ibarra-Yruegas B E, Gongora-Rivera F. Gastrointestinal complications after ischemic stroke[J]. Journal of the Neurological Sciences, 2014, 346(1-2): 20-25. 
[3] Su Y, Zhang X, Zeng J, et al. New-onset constipation at acute stage after first stroke: incidence, risk factors, and impact on the stroke outcome[J]. Stroke, 2009, 40(4): 1304-1309. 
[4] Cheng X, Qiu X, Liu Y, et al. Trimethylamine N-oxide promotes tissue factor expression and activity in vascular endothelial cells: a new link between trimethylamine N-oxide and atherosclerotic thrombosis[J]. Thrombosis Research, 2019, 177: 110-116. 
[5] Huang Q, Xia J. Influence of the gut microbiome on inflammatory and immune response after stroke[J]. Neurological Sciences: Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2021, 42(12): 4937-4951. 
[6] Miao J W, Cheng B, Li N, et al. Recent advance in regulation mechanism of gut brain axis[J]. Chinese Journal of Neurology, 2020, 19(4): 422-426. 
[7] Socała K, Doboszewska U, Szopa A, et al. The role of microbiota-gut-brain axis in neuropsychiatric and neurological disorders[J]. Pharmacological Research, 2021, 172: 105840. 
[8] Holzer P, Farzi A. Neuropeptides and the microbiota-gut-brain axis[J]. Advances in Experimental Medicine and Biology, 2014, 817: 195-219. 
[9] Cryan J F, O’Riordan K J, Cowan C S M, et al. The microbiota-gut-brain axis[J]. Physiological Reviews, 2019, 99(4): 1877-2013. DOI:10.1152/physrev.00018.2018.
[10] Arya A K, Hu B. Brain-gut axis after stroke[J]. Brain Circulation, 2018, 4(4): 165-173. 
[11] Guo K L, Jiang M, Chen G H. Research on the Treatment of Ischemic Stroke Based on "Brain-Gut Axis" [J]. Journal of Liaoning University of Traditional Chinese Medicine, 2023, 25(11): 122-127. 
[12] Kong W Y, Hao O M. Exploration on the treatment of pediatric heat - bound constipation with concurrent diarrhea by “treating obstruction with purgation” method[J]. Journal of Pediatric Traditional Chinese Medicine, 2024, 20(06): 4-7. 
[13] Liu S Y, Fu Y L. Analysis of herbal dosages of the literature on the clinical observation of Dachengqi decoction[J]. Global Traditional Chinese Medicine, 2016, 9(5): 571-574. 
[14] Zhang L C, Zhang Y L, Zhou Z, et al. Clinical observation on ischemia apoplectic coma with Retention Enema of Modified Minor Decoction of Daehengqi Decoction[J]. Global Traditional Chinese Medicine, 2009, 2(1): 31-34. 
[15] Li J, Yuan M, Liu Y, et al. Incidence of constipation in stroke patients: a systematic review and meta-analysis[J]. Medicine, 2017, 96(25): e7225. 
[16] Han I J, Lee J E, Song H N, et al. Imaging and clinical predictors of acute constipation in patients with acute ischemic stroke[J]. Frontiers in Neuroscience, 2023, 17: 1263693. 
[17] Huang K Y, Liang S, Fu S P, et al. Application of Gastrointestinal Adjustment in the Treatment of Encephalopathy with Acupuncture and Moxibustion: Based on the Theory of Axis of Brain and Intestines[J]. Chinese Journal of Traditional Chinese Medicine, 2016, 57(13): 1099-1104. 
[18] Suenghataiphorn T, Yanpiset P, Xanthavanij N, et al. Increased risk of stroke in constipation patients: systematic review and meta-analysis[J]. Journal of clinical gastroenterology, 2024. 
[19] Luo Y, Yan B C, Zhang L, et al. The New Explanation of Disturbance of Consciousness of Acute Cerebral Apoplexy with Phlegm Heat Excess Syndrome Based on Brain-gut Axis[J]. Chinese Journal of Traditional Chinese Medicine, 2020, 29(7): 1219-1223. 
[20] Ma X S, Wang F Y, Fu J J, et al. Discussion on Material Basis and Scientific Connotation of Spleen Governing Transportation and Transformation from the Aspect of Brain-gut Interaction[J]. Chinese Journal of Traditional Chinese Medicine, 2016, 57(12): 996-999. 
[21] Ohara TE, Hsiao EY. Microbiota-neuroepithelial signalling across the gut-brain axis. Nat Rev Microbiol. 2025 Jan 2. 
[22] Lu S, Zhao Q, Guan Y, et al. The communication mechanism of the gut-brain axis and its effect on central nervous system diseases: A systematic review. Biomed Pharmacother. 2024;178:117207. 

Subscription
E-Mail Alert
Most popular papers
Call for Special Issue
Publication Ethics & OA Statement
Plagiarism Policy
Contact Us
Downloads: 10176
Visits: 760360

Sponsors, Associates, and Links

All published work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2016 - 2031 Clausius Scientific Press Inc. All Rights Reserved.