Upper Abdominal Painaccording to TCM

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What is Upper Abdominal Pain?

Upper abdominal pain is a common symptom that affects the area above the navel, often reflecting disorders in the upper digestive tract. This discomfort can range from mild to severe and may manifest in various forms, such as epigastric pain, a burning sensation, or a sharp ache in the hypochondriac region. The pain may be intermittent, worsen with pressure, or sometimes alleviate with vomiting, indicating diverse underlying conditions.

How does TCM View Upper Abdominal Pain?

Traditional Chinese Medicine (TCM) interprets upper abdominal pain through the lens of Qi (energy) flow, organ health, and the balance of Yin and Yang. Unlike Western medicine, which often attributes pain to specific organ pathologies, TCM considers a broader spectrum of imbalances across the body's energy pathways.

Identifying the correct disharmony pattern is crucial for effective treatment, as TCM believes that each symptom, including pain, is a signal of an underlying imbalance.

Root Causes of Upper Abdominal Pain in TCM

TCM recognizes several patterns that can lead to upper abdominal pain, each associated with different symptoms and underlying imbalances. For example, Qi Stagnation, particularly Liver Qi Stagnation, can manifest as upper abdominal discomfort alongside emotional symptoms like irritability. Damp-Heat in the Stomach is another common cause, presenting with symptoms like nausea, fullness, and a feeling of heaviness.

Additionally, Phlegm accumulation, Qi Rebellion, and Yin Deficiency are recognized patterns, each contributing to the manifestation of pain in unique ways. Understanding these patterns is essential for tailoring the treatment to the individual's specific TCM diagnosis.

Explore below more details about what might cause Upper abdominal pain according to TCM.

  • By Syndrome
  • By Organ
  • Heat
  • Qi Stagnation
  • Phlegm
Detailed description of the cause

Heat

In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more

Heat Patterns That Can Lead to Upper Abdominal Pain

Common Symptoms: Feeling Of Heat Bitter Taste In The Mouth Upper Abdominal Fullness Feeling Of Heaviness Dry Mouth Without Desire To Drink Nausea Dull Yellow Complexion Sticky Taste In The Mouth

Pattern Name Relevant Symptoms Relevant Formulas
Damp-Heat in the Stomach Epigastric pain, Upper abdominal pain, Upper abdominal fullness, Feeling of heaviness, Face pain, Congested nose, Thick nasal discharge, Dry mouth without desire to drink, Nausea, Feeling of heat, Dull yellow complexion, Sticky taste in the mouth... see more Lian Po Yin | Ge Hua Jie Cheng San
Phlegm-Heat in the Lungs Epigastric pain, Coughing, Shortness of breath, Wheezing, Stifling sensation in the chest, Sputum, Feeling of heat, Thirst, Head and body heaviness, Dizziness, Copious thick yellow sputum... see more Xiao Xian Xiong Tang
Damp-Heat invading the Spleen Abdominal and epigastric pain, Loss of appetite, Feeling of heaviness, Dry mouth without desire to drink, Nausea or vomiting, Malodorous diarrhea, Anal burning, Feeling of heat, Scanty and dark urine, Low grade fever, Dull headache, Dull yellow complexion, Yellow sclera, Oily sweat, Itchy rashes, Bitter taste in the mouth, Upper abdominal fullness, Upper abdominal pain... see more Lian Po Yin
Heat in Lessor Yang Burning abdominal pain, Fever, Bitter taste in the mouth, Abdominal pain, Diarrhea, Sticky taste in the mouth, Malodorous diarrhea, Anal irritation, Upper abdominal burning pain, Tenesmus... see more Huang Qin Tang
Stomach Heat or Fire Burning epigastric pain, Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth, Mouth ulcers, Acid reflux, Nausea, Vomiting after eating, Excessive hunger, Bad breath, Feeling of heat, Acne... see more Tiao Wei Cheng Qi Tang | Qing Wei San | Xie Huang San | Fei Er Wan | Hua Ban Tang
Liver Qi Stagnation that transforms into Heat Intermittent epigastric pain, Intermittent upper abdominal pain, Hernia-Related pain, Dysmenorrhea exacerbated by hot food or drinks, Irritability, Bitter taste in the mouth, Peptic ulcer, Chronic gastritis, Hepatitis, Cholecystitis... see more Jin Ling Zi San

TCM Herbal Formulas for Upper Abdominal Pain

To address upper abdominal pain, TCM utilizes a variety of herbal formulas, each suited to counteract specific disharmonies. For Damp-Heat in the Stomach, formulas like Lian Po Yin, containing Huang Lian, work to clear Heat and expel Dampness. Phlegm-related discomfort might be treated with Si Ni San, which harmonizes the Liver-Spleen relationship.

For Qi Stagnation, Ban Xia Hou Pu Tang and Xiao Yao San are commonly prescribed to promote Qi movement and alleviate pain. When dealing with Rebellious Liver Qi affecting the Stomach, Xuan Fu Dai Zhe Tang offers relief by directing rebellious Qi downward. In cases of Stomach Yin Deficiency, Mai Men Dong Tang nourishes Yin and moistens Dryness, addressing the root cause of the pain.

Explore below some TCM herbal formulas used to address upper abdominal pain, organized by cause and by formula type.

  • By Cause
  • By Formula Type
  • Heat
  • Qi Stagnation
  • Phlegm

All Formulas Recommended for Upper Abdominal Pain Caused by Heat

Formula Patterns Suitable For
Lian Po Yin Damp-Heat in the Stomach, Damp-Heat invading the Spleen
Ge Hua Jie Cheng San Damp-Heat in the Stomach
Xiao Xian Xiong Tang Phlegm-Heat in the Lungs
Jin Ling Zi San Liver Qi Stagnation that transforms into Heat
Huang Qin Tang Heat in Lessor Yang
Tiao Wei Cheng Qi Tang Stomach Heat or Fire
Qing Wei San Stomach Heat or Fire
Xie Huang San Stomach Heat or Fire
Fei Er Wan Stomach Heat or Fire
Hua Ban Tang Stomach Heat or Fire

Acupoints for Upper Abdominal Pain

TCM also incorporates acupuncture as a method to relieve upper abdominal pain. Specific acupoints like Burong ST-19 and Chengman ST-20 are targeted to harmonize the Middle Burner and subdue rebellious Qi. Points along the Stomach, Pericardium, Bladder, Spleen, and Directing Vessel, such as Neiguan P-6 and Zhongwan REN-12, are selected based on their ability to regulate Qi, invigorate Blood, clear Heat, and resolve Dampness, providing a holistic approach to alleviating pain and restoring balance within the body's energy system.

Explore below some acupoints used to address upper abdominal pain, organized by meridian.

  • By Meridian
  • Stomach Channel
  • Pericardium Channel
  • Bladder Channel
Burong ST-19

Burong ST-19

2 cun below the sternocostal angel and 6 cun above the umbilicus, 2 cun lateral to the anterior midline.

Chengman ST-20

Chengman ST-20

5 cun above the umbilicus and 2 cun lateral to the anterior midline, or 1 cun below Burong ST-19.

Liangmen ST-21

Liangmen ST-21

4 cun above the umbilicus and 2 cun lateral to the anterior midline.

Guanmen ST-22

Guanmen ST-22

3 cun above the umbilicus and 2 cun lateral to the anterior midline.

Taiyi ST-23

Taiyi ST-23

2 cun above the umbilicus, 2 cun lateral to the anterior midline.

Huaroumen ST-24

Huaroumen ST-24

1 cun above the umbilicus and 2 cun lateral to the anterior midline.

Liangqiu ST-34

Liangqiu ST-34

2 cun above the upper-lateral border of the patella, on a line between the upper lateral patellar border and the anterior superior iliac spine (ASIS).

Zusanli ST-36

Zusanli ST-36

3 cun below Dubi ST-35, one finger breadth lateral to the anterior crest of the tibia, on the tibialis anterior muscle.

Jiexi ST-41

Jiexi ST-41

At the junction of the dorsum of the foot and leg, between the tendons of extensor digitorum and the extensor hallucis longus muscle. Approximately at the level of the tip of the external malleolus.

Chongyang ST-42

Chongyang ST-42

Distal to Jiexi ST-41, at the highest point of the dorsum of foot, between the tendons of the extensor hallucis longus and the extensor digitorum longus, directly lateral to the point where the dorsalis pedis artery may be palpated. The point is bordered proximally by the 2nd and 3rd metatarsal bones and distally by the 2nd and 3rd cuneiform bones.

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