Many friends who come to the clinic often ask me one question: why is it that after eating just a piece of icy watermelon or a few bites of spicy snack, the stomach begins to ache dully, then the belly starts rumbling, and finally they have to run to the toilet? Behind this, there is actually a deep understanding in traditional Chinese medicine of spleen and stomach function, constitutional bias, and dietary habits. Today, let us start with several common misconceptions and talk about this small problem that troubles many people.
Misconception One: Stomach pain and diarrhea simply mean the stomach is weak
Many people assume that diarrhea after eating something cold or spicy means the stomach is "too weak," so they desperately eat stomach-nourishing foods such as millet porridge and yam paste, yet the symptoms keep recurring. Why is that? According to traditional Chinese medicine theory, this is not only a stomach problem, but more likely a dysfunction of the spleen's transportation and transformation.
The Huangdi Neijing says: "The spleen governs transportation and transformation; the stomach governs receiving."
The stomach is responsible for receiving food, like a temporary warehouse; the spleen is responsible for transporting the refined essence from food to the whole body. If the yang qi of the spleen is insufficient and cannot warm and transform, even the best food will only stagnate in the intestines, becoming damp turbidity, and trigger diarrhea at the slightest stimulation. Clinically, these people often also have abdominal bloating after meals and fatigue of the limbs.
In the meridian theory of traditional Chinese medicine, one of the acupoints most closely related to the transportation and transformation function of the spleen and stomach is Zusanli. Zusanli, also known as Xialing and Sanli, is located on the anterior-lateral side of the lower leg, 3 cun below Dubi, one horizontal finger-breadth from the anterior crest of the tibia. It belongs to the Foot Yangming Stomach Meridian and is the He-Sea point of the Stomach Meridian and the lower He-Sea point of the stomach. The Lingshu says: "When pathogenic factors are in the spleen and stomach, there is muscle pain... all are regulated at Zusanli." This classical record shows that as early as more than two thousand years ago, the ancients already recognized the close connection between this acupoint and spleen-stomach function, which also provides a theoretical clue for later generations to understand why limb fatigue often accompanies failure of the spleen to transform and transport.
Misconception Two: Spicy harms the stomach, cold harms the spleen, and each affects only its own organ
Another common misunderstanding is to think that eating spicy food only harms the stomach and eating cold food only harms the spleen, with the two being unrelated. But traditional Chinese medicine holds that the spleen and stomach both belong to the middle jiao and are closely related, like a pair of partners. Pungent foods are hot in nature and easily consume stomach yin; raw and cold foods are cold in nature and easily damage spleen yang.
On the surface, the two are "one hot and one cold," but in reality both point to the same core: the balance of the spleen and stomach. For example, some people have stomach pain after eating spicy hot pot, which is actually heat pathogen scorching the stomach collaterals; while diarrhea after eating icy foods is cold pathogen trapping spleen yang. Clinically, one must first distinguish whether stomach yin deficiency predominates or spleen yang deficiency predominates, because the directions of regulation differ and cannot be generalized.
In the meridian theory of traditional Chinese medicine, Zhongwan is an important node where stomach qi gathers. Zhongwan, also known as Taicang and Weiwuan, is located on the upper abdomen, on the anterior midline, 4 cun above the umbilicus. It belongs to the Ren Mai and is the Front-Mu point of the stomach and the meeting point of the fu organs. The Nanjing records that "the fu organs meet at Zhongwan," indicating that Zhongwan is closely related to the function of the six fu organs, especially the stomach's receiving and transmitting. When people discuss stomach yin deficiency or spleen yang deficiency, Zhongwan is often used as an important reference in theoretical analysis, reflecting the pivotal position of the middle jiao in the overall balance of qi movement.
Misconception Three: Since the spleen and stomach are weak, one should eat more "stomach-nourishing" foods
Many friends, upon hearing that the spleen and stomach are deficient, immediately eat large amounts of "stomach-nourishing" foods such as red dates, longan, and glutinous rice, only to become more bloated. There is a key point here: the "nourishing" of the spleen and stomach is not simply supplementation, but rather "unblocking" and "transporting." If dampness or food stagnation is already present in the body, the more one supplements, the more severe the blockage becomes.
In clinical traditional Chinese medicine, for people who feel unwell after eating cold or spicy food, two situations are common. One belongs to spleen qi deficiency with cold, and eating warm foods such as ginger and Sichuan pepper may help improve it; the other belongs to stomach yin deficiency, which instead requires moistening foods such as lily bulb and ophiopogon to nourish it. If one does not distinguish the constitution and supplements blindly, the result may be the opposite. This explains why some people get worse the more they try to nourish themselves: the direction is wrong.
Misconception Four: Diarrhea is detoxification, so there is no need to worry
A friend once proudly said, "I get diarrhea when I eat spicy food, which means my body is detoxifying. That's a good thing!" This is actually a dangerous signal. Traditional Chinese medicine theory points out that normal excretion is the waste after body metabolism, whereas diarrhea after eating spicy or cold food is the intestines "protesting," belonging to functional disorder.
The Shanghan Lun says: "In Yangming disease, when the stomach is deficient and cold, water and grain are not separated, hence diarrhea occurs."
This sentence means that when the stomach is deficient and cold, food and fluids cannot be properly separated into clear and turbid, so they mix and descend, forming diarrhea. If this continues over time, not only will nutrient absorption be affected, but the normal intestinal flora and barrier function may also be damaged. Clinically, if some people also have bitter taste in the mouth and yellow greasy tongue coating, it may belong to a mixed cold-heat pattern, which should not be treated by simple warming and tonifying, and requires careful pattern identification by a licensed traditional Chinese medicine physician.
Misconception Five: Reacting badly to both cold and spicy food means the constitution is "too poor"
Some people feel that if they dare not eat anything, their constitution is too poor, so they desperately exercise and diet, only to make their stomach more uncomfortable. In fact, this does not necessarily mean the overall constitution is poor, but rather that the spleen and stomach, this "qi movement hub," has a problem. Traditional Chinese medicine emphasizes "the ascending and descending of qi movement": the spleen governs ascending the clear, and the stomach governs descending the turbid.
If qi movement is not smooth, cold foods cannot descend and spicy foods cannot ascend, resulting in pain and disorder. For example, people who work at a desk for long periods and are under great pressure easily develop liver depression attacking the spleen, leading to spleen-stomach qi stagnation, and this state is more likely to induce discomfort after eating cold or spicy food. In regulation, one should not only focus on the spleen and stomach themselves, but also soothe liver depression so that qi movement becomes smooth.
Tianshu is also an important reference for understanding the ascending and descending of spleen-stomach qi movement. Tianshu, also known as Changxi and Guhe, is located on the abdomen, level with the center of the umbilicus, 2 cun lateral to the anterior midline. It belongs to the Foot Yangming Stomach Meridian and is the Front-Mu point of the large intestine. The Zhenjiu Jiayijing records: "Abdominal distention and bowel rumbling, qi rushing up to the chest... Tianshu governs it." This literature suggests that Tianshu is closely related to the smooth movement of gastrointestinal qi, and in traditional Chinese medicine theory it is often used to explain various manifestations when middle jiao qi movement is disordered, such as abdominal fullness and rumbling sounds in the intestines.
Misconception Six: For stomach pain and diarrhea, one can only rely on antidiarrheal medication
Many people take antidiarrheal medication as soon as symptoms appear. The diarrhea stops temporarily, but the next time it happens just the same. Antidiarrheal medication only treats the branch, not the root problem of cold, heat, deficiency, or excess. In clinical traditional Chinese medicine, one must distinguish whether it is cold-damp type or damp-heat type: the former fears cold and has clear watery stool; the latter may be accompanied by burning in the anus and sticky stool.
If it is cold-damp type, drinking ginger brown sugar water may help relieve it; if it is damp-heat type, one needs to clear heat and drain dampness. If the direction is wrong, it may instead worsen the condition. In addition, this kind of problem is more common in people with long-term irregular diet and frequent late nights, and is often accompanied by spleen deficiency manifestations such as sallow complexion and teeth-marked tongue edges.
Misconception Seven: Since it is a chronic problem, one can only endure it and cannot improve it
Many people think this is an old problem and that it will pass if they just endure it. Actually, this is not the case. Traditional Chinese medicine holds that the spleen and stomach are the foundation of the acquired constitution and the source of qi, blood, and fluids. If not regulated for a long time, it may affect other zang-fu organs, for example causing palpitations, insomnia, or decreased immunity. Clinically, by adjusting dietary rhythm, avoiding raw, cold, greasy foods, and exercising appropriately, many people's symptoms gradually lessen.
More importantly, one should observe one's own dietary patterns. For example, if stomach pain occurs every time after eating icy foods, it indicates obvious middle jiao deficiency cold; if diarrhea occurs after eating spicy food, it may be internal accumulation of damp-heat. It is recommended to consult a licensed traditional Chinese medicine physician at a licensed medical institution and formulate an individualized plan according to one's constitution. After all, although people may all feel unwell after eating cold or spicy food, some need to warm the middle, some need to nourish yin, and others need to resolve dampness.
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If you find that you get stomach pain and diarrhea every time you eat something cold or spicy, you may wish to stop and think: this is actually the body reminding you that the balance of the spleen and stomach has been disrupted. Is it cold or heat? Is it deficiency or excess? Only when the direction is right is improvement possible. Have you made such observations recently?
Related Knowledge Q&A
What causes Misconception One?
Traditional Chinese medicine believes that Misconception One should be approached through holistic pattern identification, using the four diagnostic methods of inspection, auscultation and olfaction, inquiry, and palpation, and making a comprehensive judgment in combination with individual constitutional characteristics. It cannot be generalized. The specific direction of regulation must be determined by a licensed traditional Chinese medicine physician after an in-person consultation.
How long does Misconception Two take to improve?
The time required for improvement varies from person to person. Acute problems may improve after several treatments, while chronic constitutional conditioning is recommended to continue for 1-3 months. Traditional Chinese medicine emphasizes gradual progress and discourages rushing for quick results. The specific duration must be evaluated by a physician according to individual circumstances.
What should be noted in daily life for Misconception Three?
For daily care, it is recommended to maintain a regular routine, a balanced diet, moderate exercise, and emotional stability. Specific precautions should be flexibly adjusted according to individual constitution and seasonal changes. A licensed traditional Chinese medicine physician can be consulted for targeted advice.