Stomachache
AliasEpigastric pain
Traditional Chinese Medicine Definition
Stomach pain, also known as epigastric pain, belongs to the category of spleen-stomach diseases in traditional Chinese medicine. According to "Internal Medicine of Traditional Chinese Medicine", stomach pain refers to a condition caused by dysfunction of the spleen and stomach, stagnation of stomach Qi, or damage to the stomach collaterals, primarily manifested by pain in the epigastric region. Its characteristic feature is pain located in the epigastric region, with various pain qualities that may present as distending pain, stabbing pain, or dull pain, often accompanied by nausea, vomiting, and loss of appetite.
In TCM clinical practice, the core pathogenesis of stomach pain is dysfunction of the spleen and stomach, leading to stagnation of stomach Qi or damage to the stomach collaterals. Common triggers include improper diet, emotional distress, and overexertion. During syndrome differentiation, attention should be paid to distinguishing cold, heat, deficiency, and excess:
1. Cold pathogen attacking the stomach syndrome: Sudden stomach pain, aversion to cold with preference for warmth, pain relieved by warmth and aggravated by cold, bland taste without thirst.
2. Food stagnation syndrome: Epigastric distending pain that worsens with pressure, belching with foul odor and acid regurgitation, vomiting of undigested food, with pain relieved after vomiting.
3. Liver Qi attacking the stomach syndrome: Epigastric distending pain radiating to both hypochondria, frequent belching, often triggered by emotional factors.
4. Spleen-stomach deficiency-cold syndrome: Vague stomach pain, preference for warmth and pressure, pain on an empty stomach relieved by eating, fatigue and weakness.
5. Stomach Yin deficiency syndrome: Epigastric burning pain, discomfort resembling hunger, dry mouth and throat, dry stools.
Direction of regulation: In TCM clinical practice, treatment of stomach pain should follow the principle of syndrome differentiation, adopting corresponding methods based on different syndrome types. Cold pathogen attacking the stomach syndrome should be treated by warming the stomach and dispersing cold, regulating Qi and harmonizing the stomach to relieve pain; food stagnation syndrome should be treated by promoting digestion and removing stagnation, harmonizing the stomach to relieve pain; liver Qi attacking the stomach syndrome should be treated by soothing the liver and regulating Qi, harmonizing the stomach to relieve pain; spleen-stomach deficiency-cold syndrome should be treated by warming the middle and strengthening the spleen, harmonizing the stomach to relieve pain; stomach Yin deficiency syndrome should be treated by nourishing Yin and stomach, harmonizing the middle to relieve pain.
Common Syndrome Types and Key Points of Differentiation
Syndrome of Cold Pathogen Invading the Stomach
Main Manifestations: Sudden onset of stomachache with aversion to cold and preference for warmth, pain decreases with warmth and increases with cold, and a lack of thirst with a bland taste in the mouth.
Management Approach: Warm the Stomach and Disperse Cold, Harmonize Qi and Stomach to Alleviate Pain
Syndrome of Stagnation of Food and Drink
Main Manifestations: Stomach epigastric distension and pain that is resistant to pressure, belching with acid regurgitation, vomiting undigested food, pain decreases after vomiting.
Management Approach: digestive assistance, harmonize the stomach and relieve pain
Liver Qi attacking the Stomach Syndrome
Main Manifestations: Distension and pain in the epigastrium extending to both sides, frequent belching, and pain often caused by emotional factors.
Management Approach: regulate liver and Qi, harmonize the stomach and relieve pain
Spleen and Stomach Deficiency Cold Syndrome
Main Manifestations: Epigastric pain that is intermittent and relieved by warmth and pressure, pain on an empty stomach, relieved after eating, and fatigue with lack of energy
Management Approach: warming the middle-jiao, invigorating the spleen, harmonize the stomach and relieve pain
Insufficient Stomach Yin Syndrome
Main Manifestations: Burning pain in the epigastrium, feeling of hunger-like restlessness, dry mouth and throat, dry and hard stools
Management Approach: Nourish Yin and Stomach, Harmonize the Middle Jiao and Alleviate Pain
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
In clinical practice, patients with epigastric pain often have spleen-stomach weakness. During syndrome differentiation, attention should be paid to regulating the ascending and descending of the spleen and stomach, and nurturing the acquired foundation.
— Fan Li Traditional Chinese Medicine (TCM) Practitioner Assistant Physician
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This page is for the popular science of traditional Chinese medicine knowledge and does not constitute medical advice. Specific diagnosis should be completed by a licensed traditional Chinese medicine practitioner in person.
This article has been reviewed by licensed TCM physicians at Hangzhou Kezhentang TCM Clinic. It is for TCM popular science reference only and does not involve specific treatment plan recommendations.
References: Internal Medicine of TCM (13th Five-Year Plan Textbook), Diagnostic and Therapeutic Effectiveness Standards for TCM Diseases and Syndromes (ZY/T001.1-94), Classification and Codes of TCM Diseases and Syndromes (GB/T 15657-2021)