Chronic Gastritis
胃脘痛 · wèi wǎn tòng+9 other namesHide other names
Also known as: Long-lasting Inflammation Of The Stomach Lining, Persistent Gastritis, Chronic Hemorrhagic Gastritis, Chronic Gastritis With Hemorrhage, Long-lasting Stomach Inflammation With Bleeding, Persistent Bleeding Gastritis, Chronic Gastritis with Malabsorption, Chronic Gastritis with Nausea, Chronic Superficial Gastritis
The type of stomach pain you have - whether it's bloating after stress, a dull ache that craves warmth, or a burning dryness - tells your TCM practitioner exactly which organ system needs rebalancing, and most people see significant relief within 4-8 weeks of targeted treatment.
About this page · what it is and isn't
What this is. A plain-English synthesis of how classical TCM and modern clinical research describe chronic gastritis. Patterns and herbs come from canonical TCM sources; clinical claims are cited in the Evidence section.
What it isn't. A diagnosis. Me&Qi is an editorial team, not a licensed clinic. The pattern quiz is a thinking tool — pulse and tongue still need a person in the room. Anything in the Safety section should send you to a doctor, not a herb.
Last reviewed Jun 2026.
Educational content about Traditional Chinese Medicine — not medical advice. See a qualified practitioner for diagnosis and treatment.
Chronic gastritis isn't a single condition in TCM - it's a family of six distinct patterns, each with its own cause, its own characteristic pain, and its own treatment. Stress-related bloating that radiates to the ribs points to Liver Qi invading the Stomach, while a dull ache that craves warmth signals a deficiency of digestive fire. A gnawing, burning pain with a dry mouth reveals depleted stomach fluids, and a heavy, bloated feeling with a thick tongue coating suggests Damp-Heat clogging the middle.
This page walks you through each pattern so you can understand what your symptoms are telling you.
Chronic gastritis is long-lasting inflammation of the stomach lining. It can cause upper abdominal pain, bloating, nausea, a feeling of fullness after eating, and indigestion. The most common causes are infection with Helicobacter pylori bacteria, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), heavy alcohol use, or autoimmune reactions. Diagnosis is usually made by endoscopy with biopsy, which allows doctors to see the inflammation and test for H. pylori.
Conventional treatments
Standard treatment focuses on reducing stomach acid and eliminating H. pylori if present. Proton pump inhibitors (PPIs) like omeprazole, H2 blockers like famotidine, and antacids are commonly prescribed to allow the stomach lining to heal. If H. pylori is found, a course of antibiotics combined with acid-suppressing medication is used. Lifestyle changes such as avoiding trigger foods, reducing alcohol, and managing stress are also recommended.
Where conventional treatment falls short
While acid-suppressing medications can relieve symptoms and promote healing, they do not address the underlying imbalances that made the stomach vulnerable in the first place. Long-term PPI use carries risks including nutrient malabsorption, increased susceptibility to gut infections, and rebound acid hypersecretion when stopping. Moreover, the conventional approach treats all chronic gastritis as fundamentally the same - a problem of too much acid or inflammation - without distinguishing between the different constitutional patterns that TCM recognizes, which may require opposite strategies such as warming or cooling.
How TCM understands chronic gastritis
TCM sees the stomach as a cauldron that receives food and 'cooks' it with digestive fire, then sends the processed essence downward. The Spleen helps transform and transport nutrients, while the Liver ensures that Qi flows smoothly in all directions. Chronic gastritis develops when one or more of these functions break down - either because something is blocking the flow (excess) or because the digestive fire or nourishing fluids are insufficient (deficiency).
When emotional stress disrupts the Liver's smooth flow, stagnant Qi can push sideways into the Stomach, causing bloating, belching, and pain that radiates to the ribs - a pattern called Liver Qi Stagnation invading the Stomach. This is one of the most common TCM patterns for chronic gastritis in our modern, high-stress world.
If the Spleen's warming energy - its Yang - becomes depleted through poor diet, overwork, or chronic illness, the digestive fire grows weak and cold. The result is a dull, persistent ache that feels better with warmth and gentle pressure, often accompanied by fatigue and loose stools. This is Spleen Yang Deficiency.
Other patterns include Stomach Yin Deficiency, where the protective fluids that line the stomach dry up, creating a gnawing, burning pain with a dry mouth; Damp-Heat in the Stomach, where heavy, greasy foods create a sticky, inflammatory mixture that causes bloating, nausea, and a thick yellow tongue coating; and Blood Stagnation, where long-standing inflammation leads to fixed, stabbing pain. Even acute cold invasion can trigger sudden cramping. Each pattern has its own distinct tongue and pulse signs, which is why a TCM practitioner will always examine your tongue and feel your pulse - they reveal the underlying imbalance that the pain alone cannot.
「寒气客于肠胃之间，膜原之下，血不得散，小络急引故痛。」
"When cold Qi lodges between the stomach and intestines, beneath the membranes, the blood cannot disperse and the small collaterals contract, causing pain. This is the classic description of cold-induced epigastric pain."
How a TCM practitioner diagnoses chronic gastritis
Inside the consultation
A TCM practitioner begins by listening carefully to the story of your stomach pain - when it started, what makes it worse or better, and exactly how it feels. The quality of the pain, accompanying sensations, and emotional triggers are the first clues that point toward one pattern rather than another.
If stress or frustration brings on a bloating, distending pain that radiates to the ribs, along with frequent sighing and belching, that points to Liver Qi Stagnation invading the Stomach. The tongue edges may be slightly red with a thin white coat, and the pulse feels wiry like a guitar string.
When the pain is a dull ache that feels better after a warm meal or gentle pressure, and you feel constantly tired with loose stools, Spleen Yang Deficiency is likely. The tongue looks pale and puffy with a thin white coating, and the pulse is deep and weak. Craving warmth and disliking cold reinforce this picture.
A gnawing or burning pain with a dry mouth and a sensation of heat, especially after spicy or drying foods, suggests Stomach Yin Deficiency. The tongue is red with little or no coating - almost peeled - and the pulse is thin and rapid. This pain feels like a low-grade fire rather than a sharp spasm.
Damp-Heat in the Stomach produces a heavy, full sensation in the upper abdomen, nausea, a bitter taste, and a greasy yellow tongue coating. The pulse is slippery and rapid. This pattern often follows rich, greasy foods or alcohol, and the discomfort feels more like stuffiness than sharp pain.
A fixed, stabbing pain that doesn't move and worsens at night is the hallmark of Stomach Blood Stagnation. The tongue may show purple spots or a dusky hue, and the pulse is choppy. This often develops after long-standing Qi stagnation or inflammation, and the pain is more intense and localized.
Sudden, cramping pain triggered by cold weather or cold drinks, and quickly relieved by a hot water bottle, signals Cold invading the Stomach. The tongue is pale with a thin white coat, and the pulse is tight or deep and slow. This acute flare can happen even with chronic gastritis.
TCM Patterns for Chronic Gastritis
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same chronic gastritis can come from several different patterns, each treated differently. The quickest way to find yours is the quiz below.
Find your pattern
Tap any sign that fits how yours feels.
- 1Your signs
- 2What makes it worse
- 3What helps
Which signs match your experience?
It is common to see bits of yourself in several patterns. For example, stress-related bloating from Liver Qi Stagnation often combines with fatigue and loose stools from Spleen Yang Deficiency, or with a burning sensation from Stomach Yin Deficiency. These overlaps are normal because chronic gastritis frequently involves a mix of stagnation and deficiency.
To clarify which pattern is dominant, notice what triggers your pain and what brings relief. Pain that flares with emotional upset and eases with belching leans toward Liver Qi stagnation. If warmth and pressure help, think Spleen Yang Deficiency. If cold drinks soothe a burning ache, consider Stomach Yin Deficiency. These details guide both your understanding and your practitioner's diagnosis.
Because tongue and pulse diagnosis are essential to distinguish patterns that can feel similar - like Damp-Heat and Stomach Yin Deficiency both causing a hot sensation - seeing a professional is wise. Also, if you have fixed, stabbing pain that doesn't change, or notice dark stools, seek care promptly, as these may indicate Blood Stagnation or a more serious condition.
Self-care like adjusting diet and managing stress supports any pattern, but a TCM practitioner can design a precise treatment plan with herbs, acupuncture, and lifestyle advice tailored to your unique pattern. If pain is severe, persistent, or accompanied by weight loss, always consult a doctor first.
Liver Qi Stagnation invading the Stomach
Spleen Yang Deficiency
Stomach Yin Deficiency
Damp-Heat in the Stomach
Stomach Blood Stagnation
Cold invading the Stomach
Treatment
Four ways to address chronic gastritis in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for chronic gastritis
9 formulas across the patterns above. The right one depends on your pattern — start with the quiz if you're unsure which fits.
A classical formula for people experiencing rib-side or chest pain, emotional frustration, irritability, sighing, and bloating caused by stagnation of Liver Qi. It works by smoothing the flow of Liver Qi, relieving tension, and gently moving blood to stop pain. It is one of the most widely used formulas for stress-related digestive and emotional complaints.
A warming, strengthening formula for people with chronic weakness, fatigue, and digestive discomfort marked by abdominal cramping, poor appetite, and spontaneous sweating. It gently rebuilds the body's core digestive strength and Qi, making it especially well suited for long-standing stomach problems with cold sensitivity and general exhaustion.
A classical warming formula used to strengthen the digestive system when it has become weakened by internal cold. It addresses symptoms like watery diarrhea, nausea, abdominal pain relieved by warmth and pressure, poor appetite, and a general feeling of coldness. It works by warming the core of the body and restoring the Spleen and Stomach's ability to process food and fluids.
A gentle formula designed to replenish the fluids of the Stomach when they have been depleted by heat or chronic illness. It is commonly used for dry mouth and throat, poor appetite despite feeling hungry, and a red tongue with little coating. The formula uses sweet, cooling, moistening herbs to restore the Stomach's natural lubrication and digestive function.
A remarkably simple two-herb classical formula used to relieve muscle cramps, spasms, and cramping pain throughout the body. It works by nourishing the Blood and Yin fluids that keep muscles and tendons supple, while directly relaxing tense, spasming tissues. Originally created to treat leg cramps so effectively that it earned the nickname 'Cast Away the Walking Stick Decoction.'
A classical formula used to clear Heat and resolve Phlegm that is disturbing the mind and digestive system. It is commonly used for insomnia, restlessness, nausea, and a bitter taste in the mouth caused by the accumulation of Phlegm-Heat in the Gallbladder and Stomach. Think of it as a formula that calms both an agitated mind and an upset stomach by addressing the underlying combination of inflammatory Heat and sticky Phlegm.
A remarkably simple two-herb powder used to relieve pain caused by blood stagnation. It is most often used for stabbing chest or abdominal pain, painful periods, and postpartum pain from retained blood clots. The name 'Sudden Smile' reflects how quickly and unexpectedly the pain resolves after taking it.
A simple three-herb formula used to relieve chest and stomach pain caused by poor blood circulation and stagnant Qi. It works by promoting blood flow and easing Qi movement in the chest and abdomen. The source text notes it is especially effective for women.
A simple two-herb classical formula used to warm the stomach and move stagnant Qi, relieving cold-type stomach pain, bloating, acid regurgitation, and menstrual cramps. It is especially suited to pain that feels better with warmth and is triggered by cold exposure or emotional stress.
Excess patterns like Liver Qi Stagnation or Damp-Heat often respond within 2-4 weeks of herbal treatment and acupuncture. Deficiency patterns such as Spleen Yang Deficiency or Stomach Yin Deficiency may require 3-6 months to rebuild the digestive fire or nourish fluids. Blood stasis and cold invasion patterns fall in between, often showing improvement in 4-8 weeks. Chronic cases that have been present for years may take longer, but steady progress is the norm.
Treatment principles
TCM treatment of chronic gastritis always aims to harmonize the Stomach and restore the proper downward movement of Qi. The specific method depends on the pattern: moving Liver Qi to relieve stress-related bloating, warming Spleen Yang to strengthen digestive fire, nourishing Stomach Yin to moisten a dry stomach, clearing Damp-Heat to resolve inflammation, invigorating Blood to dissolve stasis, or dispersing Cold to stop cramps. Acupuncture points like Zusanli ST-36 and Zhongwan REN-12 are used across many patterns to regulate stomach function, while herbs are tailored precisely to the individual's tongue and pulse picture.
What to expect from treatment
Most patients begin with weekly acupuncture sessions and a daily herbal formula in the form of powders, pills, or teas. You may notice improvement in bloating, pain, and digestion within the first few weeks, but full resolution often takes several months, especially for chronic deficiency patterns. Your practitioner will monitor your tongue and pulse at each visit and adjust the formula as your condition evolves. Consistency is key - missing doses or sessions can slow progress.
General dietary guidance
Eat warm, well-cooked foods and avoid cold, raw, greasy, spicy, or deep-fried items that burden the digestive system. Favour easily digestible grains like rice congee, steamed vegetables, and small amounts of lean protein. Chew thoroughly and eat at regular times without rushing. Avoid alcohol, coffee, and strong tea until your stomach heals. Drinking warm water or mild herbal teas between meals can also support digestion.
Combining TCM with conventional treatment
TCM can be safely combined with conventional gastritis treatment. Herbal formulas can generally be taken alongside PPIs or antacids, but should be spaced at least one hour apart. If you are taking antibiotics for H. pylori, inform your TCM practitioner - some herbs may enhance antibiotic effectiveness, while others may interfere. Never stop prescribed medication abruptly; work with your doctor to taper if symptoms improve. Always bring a full list of medications to your TCM consultation.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Safety & special considerations
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Vomiting blood or material that looks like coffee grounds — This may indicate bleeding in the stomach.
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Black, tarry stools — A sign of digested blood from an upper digestive bleed.
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Sudden, severe abdominal pain that doesn't let up — Could indicate a perforated ulcer or other emergency.
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Unexplained weight loss — May signal a more serious underlying condition.
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Difficulty swallowing or feeling that food gets stuck — Requires investigation to rule out obstruction.
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Pain that wakes you from sleep or is not relieved by any position — Could indicate a serious problem.
Audience-specific guidance — open what applies to you
During pregnancy, the growing fetus presses upward, often aggravating Stomach Qi rebellion and making acid reflux and epigastric distention more pronounced. Liver Qi stagnation invading the Stomach is a common pattern, as emotional sensitivity increases. However, the classic formula Chai Hu Shu Gan San should be used with caution because Chai Hu (Bupleurum) in large doses may have uterine-stimulating effects. A practitioner will modify the formula, often reducing Chai Hu or substituting with milder liver-soothing herbs.
Acupuncture is a preferred treatment during pregnancy for chronic gastritis, as it avoids herbal risks entirely. Points such as Neiguan PC-6 and Zusanli ST-36 are safe and effective for calming rebellious Stomach Qi. Abdominal points like Zhongwan REN-12 should be needled shallowly or avoided after the first trimester. Always inform your practitioner of your pregnancy so they can tailor the treatment safely.
Most TCM herbs used for chronic gastritis are compatible with breastfeeding, but bitter-cold herbs like Huang Lian (Coptis) can pass into breast milk and potentially cause infant diarrhoea or colic. For patterns like Damp-Heat in the Stomach that might call for such herbs, a practitioner will either reduce the dose, combine them with warming herbs to balance the effect, or favour acupuncture and dietary therapy instead.
Formulas that strengthen the Spleen and Stomach, such as those containing Bai Zhu (Atractylodes) or Huang Qi (Astragalus), are generally safe and may even support milk supply by boosting the mother’s Qi and Blood. Acupuncture remains an excellent option during breastfeeding, with no risk to the infant and the added benefit of helping manage the fatigue and stress common in the postpartum period.
Chronic gastritis is less common in children than in adults, but when it appears, Spleen deficiency patterns predominate. Children’s digestive systems are immature, making them prone to food stagnation and Spleen Qi deficiency. Symptoms may be vague - a child might complain of a tummy ache, refuse food, or become irritable after meals - rather than describing classic burning or gnawing pain. A practitioner will rely heavily on tongue diagnosis (looking for a pale, puffy tongue with a white coat) and pulse (often weak in the right middle position).
Herbal dosages are significantly reduced, typically to one-quarter to one-half of the adult dose depending on the child’s age and weight. Gentle, food-based remedies like congee with Shan Yao (Chinese yam) and Yi Yi Ren (coix seed) are often used to strengthen the Spleen without overwhelming it. Acupuncture can be replaced with acupressure or pediatric tui na massage on points like Zusanli ST-36 and Neiguan PC-6 to avoid needle fear.
In the elderly, chronic gastritis almost always involves a deficiency component - most commonly Spleen Yang Deficiency or Stomach Yin Deficiency. The digestive fire naturally wanes with age, leading to a dull ache that craves warmth, or a dry, burning sensation from depleted fluids. Pure excess patterns like Liver Qi stagnation or Damp-Heat rarely appear alone; they are usually layered on top of a deficient foundation, requiring careful combination formulas that tonify and move without injuring the body’s reserves.
Herbal dosages are typically reduced to two-thirds of the standard adult dose, and formulas are monitored for interactions with Western medications. For instance, blood-moving herbs like Dan Shen (Salvia) can potentiate anticoagulants. Acupuncture is often better tolerated than herbs and carries no drug interaction risk. Treatment timelines are longer - the elderly body repairs more slowly - so patience and consistency are essential.
Evidence & references
Acupuncture for chronic gastritis has a moderate evidence base. A 2015 systematic review and meta-analysis concluded that acupuncture can significantly improve epigastric pain, bloating, and other symptoms compared to conventional medication, with few side effects. However, many included trials were small and of variable methodological quality, so the evidence is promising but not definitive.
Chinese herbal medicine, particularly formulas like Chai Hu Shu Gan San for Liver Qi stagnation and Huang Qi Jian Zhong Tang for Spleen Yang deficiency, has shown benefit in randomized controlled trials conducted in China. A 2016 systematic review of Chinese herbal medicine for chronic gastritis found that herbal treatments improved symptom scores and quality of life more than placebo or conventional prokinetics. The main limitation is that most studies are published in Chinese-language journals and have not been replicated in large, international trials. Overall, TCM offers a well-tolerated adjunct or alternative, especially for patients who do not respond fully to standard care.
Key clinical studies
This systematic review included 12 randomized controlled trials with over 1,000 participants. Acupuncture significantly improved overall symptoms, epigastric pain, and bloating compared to conventional medication. The effect was particularly notable for patients with Liver Qi stagnation pattern.
Acupuncture for chronic gastritis: a systematic review and meta-analysis
Li J, et al. Acupuncture for chronic gastritis: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2015;2015:849016.
In this randomized trial of 120 patients, the group receiving modified Chai Hu Shu Gan San showed significantly greater improvement in epigastric distention, belching, and rib-side pain than the control group receiving conventional prokinetics. The total effective rate was 91.7% in the herbal group.
Clinical observation on Chaihu Shugan San for chronic gastritis with Liver Qi stagnation
Zhang Y, et al. Clinical observation on Chaihu Shugan San for chronic gastritis with Liver Qi stagnation. Chin J Integr Med. 2010;16(5):430-433.
This meta-analysis of 28 RCTs involving over 2,500 patients found that Chinese herbal formulas were superior to placebo and conventional medication in improving global symptom scores and quality of life. Formulas targeting Spleen Qi deficiency and Liver Qi stagnation were the most studied.
Chinese herbal medicine for chronic gastritis: a systematic review and meta-analysis
Liang F, et al. Chinese herbal medicine for chronic gastritis: a systematic review and meta-analysis. PLoS One. 2016;11(11):e0166634.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「按之心下满痛者，此为实也，当下之，宜大柴胡汤。」
"If there is fullness and pain upon pressure below the heart [epigastrium], this is an excess condition and should be drained; Da Chai Hu Tang is appropriate. This illustrates the principle of treating excess-type epigastric pain by purging."
Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet), Chapter 10 (Fu Man Han Shan Su Shi Bing Mai Zheng Zhi)
Abdominal Fullness, Cold Hernia, and Food Stagnation Pulse Patterns and Treatment
Frequently asked questions
Common questions about using Traditional Chinese Medicine for chronic gastritis.
Yes. TCM has been treating stomach pain for thousands of years, and clinical studies show that acupuncture and Chinese herbs can reduce inflammation, regulate stomach acid, and improve symptoms. The key is matching the treatment to your specific pattern - a formula for Liver Qi stagnation won't help Spleen Yang deficiency, so a proper diagnosis is essential.
Many patients notice less bloating and pain within the first two weeks of treatment. However, true healing of the stomach lining and correction of the underlying imbalance takes time - usually 2 to 6 months depending on the pattern and how long you've had the condition. Your practitioner will adjust your herbs and acupuncture points as your symptoms change.
Yes. Diet plays a huge role in TCM treatment for chronic gastritis. In general, you'll be advised to eat warm, cooked foods and avoid cold, raw, greasy, or spicy items that stress the digestive system. Specific foods may be recommended based on your pattern - for example, ginger tea for cold patterns, or pear and tofu for heat patterns.
In most cases, yes. It's usually safe to take Chinese herbs alongside proton pump inhibitors or antacids, but they should be spaced at least one hour apart to avoid any interaction. Always tell both your doctor and your TCM practitioner about all medications and supplements you are using, especially if you are on antibiotics for H. pylori.
Acupuncture can be safely used for digestive issues during pregnancy by a qualified practitioner who avoids certain points. However, many Chinese herbs are contraindicated in pregnancy, so you should never self-prescribe. Always consult a TCM practitioner experienced in prenatal care and inform your obstetrician.
TCM aims to correct the root imbalance, not just mask symptoms. When treatment is completed and dietary and lifestyle habits are maintained, recurrence is less likely than with medications that only suppress acid. Some patients may need periodic 'tune-up' treatments during stressful periods, but the goal is lasting relief.
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