An old saying goes: "When the belly aches, squat at the toilet, and you come out feeling light as a feather." This sounds like a joke, but upon closer thought, it contains the plain observations of traditional Chinese medicine regarding "qi movement" and "damp turbidity." The older generation often refers to this phenomenon of stomachache, rushing to the toilet, and feeling relieved afterward as "an unsettled stomach" or "borborygmus with abdominal pain." From a TCM perspective, this is not simply "eating something bad," but rather a small "conflict" among qi and blood, water and dampness, and cold and heat within the body. Once the conflict subsides, one naturally feels comfortable. But why is it that "it gets better right after going"? Behind this lies the delicate balance among the viscera.
I. This Stomachache—Where Exactly Is the "Alarm" Coming From?
TCM teaches that "where there is obstruction, there is pain; where there is no nourishment, there is pain." When stomachache comes with an urgent need to defecate and relief follows after going, the root of this pain mostly lies in "qi movement obstruction" or "internal retention of damp turbidity." When the qi movement in the intestines is blocked, or when water-dampness, food stagnation, and other "turbid substances" linger, the body sends out an "alarm"—pain. Defecation, precisely by expelling these "turbid substances," clears the blockage, and the pain naturally subsides. Clinically, this presentation is commonly seen in people with spleen qi deficiency, liver qi stagnation, or cold-dampness encumbering the spleen. But even with the same stomachache, some feel pain around the navel, while others feel it in the left lower abdomen; some have loose stools, while others have sticky, unsatisfactory ones. This requires careful differentiation.
1. Spleen Deficiency with Excessive Dampness Pattern: The Belly Feels Like It's Stuffed with "a Ball of Wet Cotton"
The pain in this group tends to be a dull, vague ache, with an unfixed location, mostly around the navel or in the lower abdomen. During the pain, there is always a gurgling sound in the intestines, as if water were moving. The stool is usually unformed, either loose or sticky, and the pain noticeably lessens after defecation, though it may recur before long. TCM theory holds that the spleen governs the transportation and transformation of water-dampness. When spleen qi is deficient, the transportation and transformation of water-dampness becomes impaired, and it lingers in the intestines, forming "damp turbidity." Damp turbidity obstructs qi movement, which triggers pain. From the perspective of the meridians, the Zusanli point of the Foot Yangming Stomach Meridian, located on the anterior-lateral aspect of the lower leg, 3 cun below Dubi, one finger-breadth lateral to the anterior crest of the tibia, is the He-Sea point of the Stomach Meridian and the lower He-Sea point of the Stomach. The Lingshu states: "When pathogenic factors are in the spleen and stomach, the disease manifests as muscle pain... all are regulated through Zusanli." The spleen and stomach are internally-externally related, and this point is often regarded as an important window for observing the transportation and transformation function of the spleen and stomach. These individuals often also present with poor appetite, abdominal distension after meals, heaviness and fatigue of the body, and a white, greasy tongue coating. For care, gentle regulation is appropriate. One may appropriately consume some spleen-fortifying, dampness-draining food ingredients, such as Chinese yam, Poria, lotus seed, and Job's tears, either as congee or in soup. However, it should be noted that these ingredients must be selected according to one's constitution under the guidance of a licensed TCM practitioner, and should not be consumed in large amounts on one's own. At the same time, avoid raw, cold, greasy, and sweet-cloying foods to prevent aggravating dampness.
2. Liver Qi Stagnation Pattern: Stomachache Is Related to "Getting Angry"
The pain in this group is often closely related to emotional fluctuations. When work pressure is high, when one feels gloomy, or when one tends to brood in silence, the belly easily aches, there is an urgent need to go to the toilet, and it gets better after going. The pain is mostly distending or migratory, with an unfixed location, sometimes in the left abdomen, sometimes in the right. The stool may be normal, or may tend toward dryness or looseness, but the pain decreases immediately after defecation. TCM theory holds that the liver governs free coursing and regulates the qi movement of the whole body. If liver qi becomes stagnated and qi movement is not smooth, it will "invade the spleen transversely," affecting the normal peristalsis of the intestines and causing qi stagnation abdominal pain. Among the human meridians, the Taichong point of the Foot Jueyin Liver Meridian, located in the depression anterior to the junction of the first and second metatarsal bones on the dorsum of the foot, is the Yuan-Source point of the Liver Meridian. "Yuan" carries the meaning of origin, and the abundance or decline, stagnation or free flow of liver meridian qi and blood is often reflected at this point, which mutually corroborates the theory that the liver governs free coursing and regulates qi movement. These individuals often also present with distension and fullness in the chest and hypochondrium, sighing, low mood or irritability, and poor sleep. For care, the emphasis is on coursing the liver and rectifying qi. One may appropriately drink some flower teas, such as rose, finger citron, and aged tangerine peel, which help soothe the emotions. However, note that these teas cannot replace treatment and must be used after pattern differentiation by a licensed TCM practitioner. In daily life, maintaining a cheerful mood, avoiding excessive worry, and engaging in appropriate exercise such as walking and yoga can help relieve qi stagnation.
3. Cold-Dampness Coagulation and Stagnation Pattern: Stomachache with Aversion to Cold, Relieved by Drinking Warm Water
The pain in this group is mostly cold pain or colicky pain, with a fixed location, mostly around the navel. During the pain, the abdomen feels cold, and the person likes to press a hot water bottle against it, or drink some warm ginger water or brown sugar water, after which the pain eases. The stool is loose, even watery, and the pain lessens after defecation, but may recur. TCM theory holds that cold nature is coagulating and stagnating, while dampness is heavy and turbid. When the pathogenic factors of cold and dampness invade the intestines, they cause qi and blood to coagulate and stagnate, and where there is obstruction, there is pain. These individuals often also present with aversion to cold, cold hands and feet, a white, slippery tongue coating, and a bland taste in the mouth without thirst. For care, the emphasis should be on warming the middle and dispersing cold. One may appropriately consume some warm-natured food ingredients, such as ginger, cinnamon, and fennel, boiled in water or used in soup. However, note that these ingredients should not be used in excess and must be used under the guidance of a licensed TCM practitioner. At the same time, avoid raw, cold, and cooling foods, such as cold drinks, watermelon, and crab, and keep the abdomen warm.
II. Why Does It Get Better After Going to the Toilet? Behind This Is the Outlet for "Turbid Qi"
The Huangdi Neijing states: "The large intestine is the official of transmission, where transformation and excretion emerge." The intestines are the passage for transmitting waste and expelling turbid substances. In TCM meridian theory, the Tianshu point of the Foot Yangming Stomach Meridian, located 2 cun lateral to the umbilicus, is the Front-Mu point of the large intestine, directly corresponding to the transforming and transmitting function of the intestines. The Zhenjiu Jiayijing records: "For abdominal distension and borborygmus, qi rushing upward to the chest, inability to stand for long, and cutting pain in the abdomen with gurgling sounds, Tianshu governs it." This precisely reflects TCM's understanding of the connection between intestinal qi movement and body-surface acupoints. When there is damp turbidity, food stagnation, or qi stagnation in the body, these "turbid substances" obstruct the intestines and trigger pain. Defecation is precisely the body's self-regulation, restoring the free passage of the intestines by expelling these "turbid substances." Therefore, it gets better after going to the toilet—this is the body telling us: the turbid qi has emerged, and the qi movement is now free. But the problem is that if this kind of stomachache recurs repeatedly, it indicates that the internal environment of the body has gone wrong—such as spleen deficiency, liver stagnation, or cold-dampness—and requires fundamental regulation, rather than merely relying on "squatting at the toilet" each time for relief.
Clinically, if some individuals simultaneously present with blood in the stool, mucus in the stool, unexplained weight loss, or being awakened by pain at night, these may belong to more complex conditions such as "intestinal abscess" or "abdominal masses," and should not be regulated simply as "stomachache with the urge to defecate." They should promptly consult a licensed TCM practitioner at a formal medical institution for pattern differentiation and treatment.