Traditional Chinese Internal Medicine Stomach Disorders

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NEW! Visit our Weblog Discussion Board. Click here. Share Your Thoughts! "I believe that the wholistic approach of Traditional Chinese Medicine is essential to foster true healing of body mind and spirit. TCM is a worthy reflection of the essence of humankind. It has given me powerful tools which I can use to grow, lead, and succeed in the cultivation of wellness for persons that become a part of my journey." For more information on Spence Pentland, practitioner of acupuncture and Chinese medicine in Vancouver BC Click here. Internal Medicine – Stomach Disorders Back To Internal Medicine Home Page Abdominal Pain Acid Reflux Constipation Diarrhea Dysphagia Hiccup Stomach Ache Upset Stomach Vomiting Important: as with all items posted on TCM Health-info, it is very strongly recommended that you seek proper advise from your healthcare professional before administering any form of treatment to yourself. This website is for informational purposes and does not replace the proper diagnosis of your physician. Overview Of Stomach Function: The stomach’s main functions are to aid in digestion and the production of food Qi (Gu Qi). The stomach controls the “rotting and ripening” of food and drinks ingested. The stomach and spleen together are regarded as the ‘root of post-haven Qi’. The spleen and stomach are both responsible for transporting Gu Qi throughout the body but especially to the upper and lower limbs to nourish muscles and bones. If this function the spleen and stomach is deficient the limbs will become flaccid and desensitized. The stomach is responsible for sending transformed food downwards to the duodenum (small intestine) to prevent stagnation of food in the stomach causing belching and possibly vomiting. The stomach is also the origin of fluids due to it’s digestion function witch depends on having fluids to digest.

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Abdominal Pain – Wei Wan Tang Abdominal Pain – Wei Wan Tang Pain in the area between the tip of the xyphoid process and the pubis symphysis (level of Ren 12) including appendicitis, gall stones, bladder disorders, hernia, pancreitus and indigestion. Pathogenesis: External Pathogen Invasion - Esp. Cold – invades digestive system blocking middle jiao yang Qi causing stagnation = pain Chronic Yang Deficiency - Spleen yang def. – deficient cold in middle jiao causes qi and blood stagnation = pain Diet - over consumption of pungent/hot foods creates internal damp heat in digestive system blocking Qi and blood = pain Food Retention - induces pain in the abdomen Differentiate: Appendicitis –pain on right side of abdomen Parasites -pain around and on naval Bladder Disorders -lower centre of abdomen Treatment: Excess = Purge Deficiency = tonify Cold = warming Heat = cooling Blood Stagnation = remove Qi & Food Stagnation = promoting Excess Cold acute severe abdominal pain with constipation, pain below hypochondriac region, cold hands/feet T– white coating P - wiry / tense Treatment: Warm up internal region, expel cold, induce bowel movements to relieve pain. Formula: Da Huang Fu Zi Tang Deficient Cold dull chronic abdominal pain, ameliorated by warmth and pressure, middle jiao yang def. symptoms (cold abdomen limbs, poor appetite, soft stool) T - Pale P – weak, thin Treatment: warm middle jiao, nourish spleen, harmonize middle jiao qi to relieve pain. Formula: Huang Qi Jian Zhong Tang Excess Heat acute distended severe pain, hot feverish feeling, constipation, thirsty (bloated after drinking) gas with possible fluid leakage while passing of, gas with odour, aggravated with pressure. T – red with dots, brown-yellow coating P - forceful, excessive Treatment: induce bowel movement to purge fire and relive pain. Formula: Cheng Qi Tang (base formula for excess heat) Qi Stagnation emotional stress (anger), fullness and moving pain which radiates to side of abdomen, pain relieved by passing of gas and belching, aggravated by emotional stress T – red P - wiry Treatment: regulate Qi and sooth liver to relieve pain Formula: Chai Hu Shi Gan Tang Blood Stasis (masses in abdomen) Fixed pain in the abdomen accompanied with stabbing pain and masses which do not move T - purple P – wiry, un-even Treatment: promote blood circulation and remove blood stasis Formula: Xiao Fu Zhu Yu Tang Food Retention pain in abdomen due to diet, pain ameliorated with bowel movement, aggravated by constipation, acid regurgitation, poor appetite T - thick greasy coating P – slippery Treatment: promote digestion, remove food retention to relieve pain Formula Bao He Wan (base formula for food retention) Acid Reflux – Tu Suan Top of the Document Acidic fluid up surging from Stomach, patient usually swallows back down Western Medicine: Gastric ulcer, gastritis (chronic), indigestion, hyper-hydro-cholorea Pathogenesis: Diet - sweet/greasy/hot & spicy or bad quality food Exterior pathogen invasion - cold invade mid. Jiao – def. yang Qi turns to turbid dampness causing acid. Emotion - liver attacks stomach – sour flavour - spleen creates damp/phlegm which creates acid Deficiency Middle Jiao -congenital dysfunction, retention of food, can’t transform or transport which creates acid Differentiate: Cold = warm middle jiao to harmonize Stomach Hot = relates with liver to soothe liver to harmonize Stomach COLD Acid regurgitation, frothy fluids, fullness in abdomen, belching, cold limbs, soft stools, fatigue, ameliorated by warm drinks T – pale, white coat P – deep, delayed Treatment: warm middle jiao, disperse cold to harmonize St. and reduce acid Formula Xiang Sha Liu Jun Zi Tang + Wu Zhu Yu HOT Frequent acid regurgitation with belching of old food, fullness in abdomen, dry mouth, thirsty, smelly stools, liver Qi stagnation symptoms T - red, yellow coat P – Wiry, slippery, rapid Treatment: Clear heat, sooth liver, descend St. Qi, (bitter/pungent) Formula Zuo Jin Wan Constipation – Bian Bi Top of the Document Dry, Difficult to pass stools Heat: external heat invasion, wrong treatments, prolong treatments, hidden heat, over consumption of alcohol …, …, … PI YUE: weak spleen and strong stomach (usually strong spleen and weak stomach), big appetite, spleen cannot transform / transport food, frequent urination but dry stools Liver Qi Stagnation: patient always sitting, parasites, post surgery Wind: related to lung but moves to L.I. blocking bowels, wind has drying function. Diet: over consumption of pungent / hot / spicy foods Accumulation of Phlegm: causes phlegm stagnation Qi Deficiency: needs Qi to push stool out (mainly spleen Qi) Blood Deficiency: blood is a fluid = dryness when deficient Yin Deficiency: lack of fluids = dryness in intestines Yang Deficiency: yang cannot move yin = yang cannot move / warm fluids Accumulation of Cold: injures yang Qi, cannot warm intestines to lubricate bowels, yin cold in intestine Heat Coconstipation with abdominal pain and fullness with heat signs (fever, yang ming heat symptoms, sweating …) T - red , yellow coat P - forceful, slippery Treatment: purge bowels to purge fire Formula Chen Qi Tang (base formula for Heat) Pi Yue Frequent urination with constipation, stomach heat symptoms, dry mouth, bad breath, hot sensation, sticky feeling in mouth, good appetite T - red, dry coat P - slippery, rapid Treatment: clear stomach heat, lubricate intestines, relieve constipation Formula Ma Zi Ren Wan Qi Stagnation Dry stools, want to pass stool but cannot, do not have the energy to push, frequent belching, fullness in abdomen and hypochondriac region. T - thin, greasy coat P - wiry Treatment: promote Qi circulation, remove Qi stagnation to promote bowel movements. Formula Liu Mo Tang Accumulation of Wind Numbness and tingling of limbs, wind symptoms T – normal, red P - floating, wiry, thin Treatment: eliminate wind to relive constipation Formula Xiao Xu Ming Tang Food Retention Poor diet history, food retention symptoms with constipation, fullness in stomach, belching, acid regurgitation, nautious, hard/distended abdomen T - thick coat P - slippery, wiry Treatment: promote digestion, regulate stomach Qi to relieve constipation. Formula Bao He Wan & Da Huang Phlegm Causing Constipation Hot type of dyspnea and asthma, cough with phlegm, fullness in chest, steaming head syndrome (sweating on head) T - red, yellow coat P - slippery, rapid Treatment: eliminate phlegm and promote lung function, disperse lung Qi. Formula Yue Bi (Bei) Jia Ban Xia Tang Qi Deficiency Feels they have no force to push stool out, while passing stool sweating and shortness of breath present, general Qi deficiency present T – pale, puffy P - weak Treatment: nourish Qi to lubricate intestines and relieve constipation Formula Huang Qi Tang (spleen tonic) Blood Deficiency Sheep poop stools (rabbit like droppings – dark/hard), blood deficiency symptoms, dull yellow complexion, palpitations, dizzy, blurred vision. T - pale P - thin Treatment: nourish blood to lubricate intestines and relieve constipation Formula Run Chang Wan Yin Deficiency Yin deficiency symptoms with dry stools T - red, scanty coat P - thin, rapid Treatment: nourish yin, lubricate bowels to relieve constipation Formula Liu Wei Di Huang Wan Kidney Yang Deficiency Difficulty pushing stool out (Qi Def.) with yang deficiency signs (cold signs) T – pale, puffy P – deep, weak Treatment: warm up kidney yang to strengthen bowels. Formula Shen Qi Wan Wu Ren Wan (elderly) Stagnation of Cold Dry or not dry stool with difficulty passing, cold pain, fullness in abdomen ameliorated by warmth, lower back cold sensation T - white coat P - deep, delayed Treatment: expel cold to induce bowel movement Formula Ji Sheng Jian Diarrhea – Xie Xie Top of the Document Increased frequency of bowel movements with a consistency of soft stools, soft stools with undigested food, watery stools. Patient may also have abdominal pain with borbyrigmus. Diarrhea is usually due to disorder of the spleen’s transformation and transportation of fluid function in chronic cases but due to dampness in exterior or interior cases. If there is no dampness then there will be no diarrhea. Diarrhea is most common in summer and fall. Exterior Pathogen Invasion: Cold Dampness = attacks L.I. – acute – abdominal pain Summer Heat =complicated with damp – attacks SP&ST Poor Diet: Impairs spleen function = spleen Qi cannot ascend so transform and transporting function is impaired = Qi and fluids descend. Stress: Depress or Anger = attacks liver Worry = weaken spleen Qi Long Term Deficiency: Overworked for long period of time with a poor diet Elderly = general spleen yang deficiency Differentiate: Dysentry diarrhea with PUS and BLOOD and severe abdominal pain Cholera diarrhea accompanied with VOMITTING and severe abdominal pain. Severe -no appetite Mild - appetite Cold Dampness – Acute (cold/damp invades sp & st) Diarrhea: watery, thin Abdominal pain with borborygmus, fullness in abdomen, poor appetite T - white coat (exterior invasion) P - floating (exterior invasion) T - white greasy (int. cold damp) P - soft (int. cold damp) Treatment: aromatic herbs to transform dampness, expel cold and relieve diarrhea Formula Ext. wind cold – Huo Xiang Zheng Qi San Int. cold damp – Ping Wei San Damp Heat – Acute Diarrhea: yellow, stinky Unfinished feeling after passing stool with burning in anus, fever, thirst, dysphoria, scanty-dark urine T - red body, yellow greasy coat P - slippery/soft, rapid Treatment: clear heat from Large Intestine, eliminate dampness to stop diarrhea Formula Ge Gen Qin Lian Tang Poor/Irregular Diet – Acute Diarrhea: rotten egg smell Food stagnates in stomach and intestines, starts with borbrigimus and abdominal pain, no appetite, pain ameliorated by passing of stool, belching T - thick greasy coating P - slippery Treatment: remove food retention to treat diarrhea Formula Bao He Wan Spleen Qi Deficiency - Chronic Diarrhea: undigested food in soft stools Patient always has soft stools, poor appetite, bloating after meals, patient has sensitive stomach to certain foods (ie. Greasy / spicy) dull yellow complexion, fatigue T - pale, white coat P - weak Treatment: nourish spleen to invigorate spleen function to stop diarrhea Formula Shen Ling Bai Zhu San Bu Zhong Yi Qi Tang – with prolapse of anus Tong Xie Yao Fang – with abdominal pain and explosive diarrhea Kidney Deficiency – Chronic Diarrhea: early morning diarrhea Abdominal pain with borbrygima, ameliorated by passing of stool, general kidney yang deficiency symptoms T - pale, white coat P - deep, thin Treatment: warm up spleen and kidney yang to consolidate bowels Formula Si Shen Wan Zhen Ren Yang Zang Tang Water Retention in Intestines – Chronic Diarrhea: watery, frothy diarrhea Dysfunction of in testiness, water retained, always has borborygmi, emaciation, bloated abdomen, scanty urine, thirsty T – pale, swollen, teeth marks P - soft, slippery Treatment: invigorate spleen function to eliminate dampness Formula Ling Gui Zhu Gan Tang Blood Stasis – Chronic (chronic illness = blood stasis) Fixed stabbing pain in abdomen, unfinished feeling after bowel movement, dry mouth, no desire to drink T - purple spots P - wiry, uneven Treatment: promote blood circulation, remove blood stasis to harmonize nutrient level and remove diarrhea Formula Xiao Fu Zhu Yu Tang Dysphagia – Ye Ge Top of the Document Difficult swallowing, vomiting after eating (severe case). Starts with stagnated feeling in throat, may have pain behind sternum when eating. Usually occurs in middle aged men. Western Medicine Possible tumor, cardiac spasms … … Excessive or complicated deficiency, actual stagnation of QI, FIRE, PHLEGM or BLOOD STASIS Treatment: Remove stagnation, promote Qi/Blood circulation or purge fire. Emotion -unbalanced lifestyle causes dysfunction of liver & spleen creating Qi stagnation and phlegm accumulation. Long term = blood stasis Diet -over consumption of hot and spicy , greasy and sweet foods causing Qi & Phlegm stagnation Ext. Pathogens -cold or hot invades digestive system blocking digestive tract. Deficiency -chronic illness = deficiency of kidneys Kidney yin deficiency = whole body dryness, digestive tract not lubed Kidney yang deficiency = ming men fire deficiency Can’t warm middle jiao to transform and transport phlegm – phlegm stagnates in digestive tract = Ye Ge Differentiate: Plum Pit in throat (Mei He Qi) – no trouble swallowing & no vomiting. Upset stomach (Fan Wei) – delayed vomiting (vomit hours after eating) Vomiting – no swallowing difficulty Guan Ge – retention of urine with vomiting, no bowel movement. Hiccup – Qi up surging only causes noise, no pain Stagnated Qi & Phlegm Swallowing difficult with fullness or pain behind sternum, belching, hiccup, nautious, vomit of phlegm fluids, EMACIATION, dry throat, dry mouth. T – red with fissures, greasy coat P – wiry, slippery Treatment: Eliminate phlegm, promote Qi circulation, lubricate dryness Formula Qi Gu San Fluid Deficiency with Stagnated Dry Heat Heat injures body fluid, can’t lubricate intestines, severe swallowing difficulty-painful, can swallow fluid but not dry food, vomit after eating, vomit sticky phlegm, burning pain behind sternum, emaciation, St. yin def. Symptoms-burning pain in St. like cold drink, night sweat, dry stools T – deep fissures P –thin/wiry, rapid Treatment: Nourish fluid, clear dry heat to dissolve stagnation Formula Sha Shen Mai men Dong Tang Phlegm & Blood Stasis Severe – vomit after water, swallowing difficulty, pain in chest, vomit dark brown fluid, dry dark stools, emaciation, dark grey complexion T – dark purple, dry P – thin, uneven Treatment: Remove blood stasis, dissolve hardness, nourish yin & blood Formula Tong You Tang LATER STAGE Deficient Qi & Yang Pale/dull complexion, fatigued, short of breath, painful swallowing, edema (ankles), bloated abdomen, vomiting T – pale, purple, swollen P – deep, thin Treatment: Nourish Qi & Yang – rescue yang Formula Shen Fu tang Hiccup – E Ni Top of the Document Sudden Qi up surging to the throat, caused by Stomach Qi attacking the diaphragm. Western Medicine: Kidney Disorders with hiccup is Bad News Irregular Diet -eating too fast–too cold–too much =impairs ST,Qi cannot descend -eating too pungent = dry heat in ST. Emotion -Liver Qi Stagnation – anger turns to fire – creates phlegm – damages Spleen – effects Stomach -Usually Hiccups accompanied with Cough. SP./KD. Yang Def. -Qi also deficient – spleen looses clearing and descending turbid Qi function – Chronic diarrhea ST. Yin Def. -Lack of fluids – deficient fire in Stomach, fire goes upward causing hiccups Differentiate: Hiccup - comes from throat, comes suddenly Nausea - comes from stomach, doesn’t come suddenly Belching - gas released from stomach, ameliorated by belch, may be accompanied with acid regurgitation and abdominal distention. loud = excess weak = deficient cold =deep sound heat = loud & short Cold in Stomach – Excess Hiccup – deep sound, aggravated by cold Diet of cold food, exterior cold invasion, cold pathogens block stomach Qi, stomach looses it’s harmony and it’s descending function, cold sensation in abdomen. T – white coat P – delayed , slow Treatment: Warm up middle Jiao, expel cold, descend stomach Qi Formula Ding Xiang San Stomach Fire – Excess Hiccup – loud, strong, short (explosive) Diet of hot/spicy, excess alcohol, excess yang tonics, heat signs of thirst, desires cold dri