Stomach Pain - Wei Tong
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Definition
A condition with frequent or sudden pains in the epigastrium as the main symptom is classified as a stomach pain syndrome. The pains can be distending, stabbing, dull or twisting. The can also be minor or severe.
Causes and Pathological Mechanisms
Cold evil invasion
- Cold freezes and causes Qi Stagnation – cold pain; cold evil stagnates and transform into Fire – hot pain.
Improper Diet injures the Stomach
- Overeating: indigestion and Stomach Qi fails to descend smoothly and causes Qi Stagnation
- Too much raw and cold food or cold invasion after food: cold gathers in the Stomach and causes Cold pain
- Rich and greasy food, spices and alcohol: Damp Heat blocks the stomach causing Stomach Qi Stagnation – hot pain
- Undigested food transforms into Heat – Stomach Qi Stagnation – hot pain
- Irregular eating: too hungry and too full for a long period, impairing the Spleen and Stomach impairment – Stomach Qi Stagnation - pain
- Anger impairs the Liver: Liver Qi fails to disperse. Liver Qi Stagnation invades the Stomach and causes obstruction. Liver Qi Stagnation transforms into Fire and invades the Stomach – hot pain. Qi Stagnation causes Blood Stasis – stabbing pain
- Worry and pensiveness impairs the Spleen and Stomach: weak earth abused by strong wood – dull and distending pain. Pensiveness leads to Qi Stagnation - pain
Weak Constitution and protracted illness
- Constitution weak Spleen and Stomach or protracted illness and overwork can impair the Spleen and Stomach – Middle Jiao deficient and Cold – dull pain. With cold evil invasion – cold pain
- Febrile diseases impairs Stomach Yin or Stomach Heat impairs Stomach Yin – pain
Patterns
- Symptoms: Pain: sudden onset of stomach pain, like warmth and dislike cold, warmth eases and cold aggravates. Not thirsty and prefers hot drinks.
- Tongue: Thin white coating
- Pulse: Wiry and Tight
- Treatment strategy: Warm the middle and expel cold
- Formula: Liang Fu Wan
- Acupoints:
Food Stagnation
- Symptoms: Pain: distending and full, eases after vomit. Eructation with foul smell and acid, vomit undigested food, no desire for food and sticky defecation.
- Tongue: Thick and greasy coating
- Pulse: Slippery
- Treatment strategy: Promote digestion to remove food stagnation
- Formula: Bao He Wan
- Acupoints:
- Symptoms: Pain: distending stomach pain radiating to hypochondriac region, full and stuffy epigastrium, related to emotion. Frequent eructation and difficulties in defecation (not smooth).
- Tongue: Thin with coating
- Pulse: Wiry
- Treatment strategy: Soothe liver, regulate qi and stomach
- Formula: Chai Hu Shu Gan San
- Acupoints:
- Symptoms: Pain: fixed pain, stabbing pain and pinching pain, refuse palpation, aggravated after food. With or without haematemesis and hematochezia.
- Tongue: Dull and purple tongue
- Pulse: Uneven
- Treatment strategy: Remove blood stasis, dredge collateral and regulate stomach qi
- Formula: Shi Xiao San and Huo Luo Xiao Ling Dan
- Acupoints:
Stomach Heat - Liver and Stomach Stagnated Heat
- Symptoms: Pain: stomach burning and pressing pain. Angry and irritable, acid regurgitation, noises in stomach, dry and bitter mouth.
- Tongue: Red with yellow coating
- Pulse: Wiry and Rapid
- Treatment strategy: Clear stomach heat, soothe liver and regulate qi
- Formula: Hua Gan Jian and Zuo Jin Wan
- Acupoints:
Stomach Heat - Damp Heat Blockage in the Middle Jiao
- Symptoms: Pain: stomach pain with hot sensation and noise in stomach. Dry and bitter mouth, thirsty but no desire for drink, dark urine, sticky defecation
- Tongue: Yellow and greasy coating
- Pulse: Slippery and Rapid
- Treatment strategy: Resolve damp-heat and regulate stomach qi
- Formula: Qing Zhong Tang
- Acupoints:
- Symptoms: Pain: stomach dull and burning pain. Dry mouth and throat or thirsty and dry feces.
- Tongue: Red or bright red with exfoliated coating
- Pulse: Thready and Wiry
- Treatment strategy: Nourish stomach yin
- Formula: Yi Guan Jian
- Acupoints:
Deficiency and Cold
- Symptoms: Pain: dull stomach pain, likes warmth and palpation and eased after food. Vomit clear water, poor appetite, lassitude and lack of shen, cool limbs and loose feces.
- Tongue: Pale tongue
- Pulse: Soft and Weak
- Treatment strategy: Warm the middle and tonify spleen
- Formula: Huang Qi Jian Zhong Tang and Li Zhong Tang
- Acupoints:
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