Diarrhea in Traditional Chinese Medicine

Understanding different diarrhea patterns according to TCM theory

Educational content Consult qualified practitioners for medical advice

Overview
What causes it 14 TCM patterns documented
How to recognize Symptoms specific to each diarrhea pattern
Classical remedies 78 herbal formulas documented

Traditional Chinese Medicine (TCM) interprets diarrhea as a symptom of imbalance within the body's internal systems, particularly concerning the Spleen and Stomach's functions. Unlike Western perspectives that often target the symptom directly, TCM seeks to understand the root cause, attributing diarrhea to factors such as Qi Deficiency, Dampness invasion, or Yang Deficiency.

This holistic approach emphasizes restoring harmony and balance through natural remedies, diet adjustments, and acupuncture, offering a nuanced understanding of health that transcends mere symptom management.

TCM Patterns for Diarrhea

Dampness

Heavy, sticky moisture that obstructs body functions and creates sluggishness

Causes: Diarrhea, Loose stools, Loose stools with foul smell

12 variations documented
Onset Gradual
Location Systemic, especially digestive
Features Heavy/foggy feeling • Sticky/turbid discharges • Poor appetite • Bloating

Dampness manifests as swelling, bloating, a feeling of heaviness in the head and limbs, and digestive issues. It's like having waterlogged tissues that make everything feel heavy and slow. Common signs include a thick, greasy tongue coating, sticky mouth sensation, and stools that are difficult to flush.

Damp-Cold
How it presents with diarrhea

Diarrhea

Along with: Mouth ulcers, White and watery sputum, Nasal discharge, Sneezing, Chills, Abdominal pain,

Traditional Herbal Formulas
Damp-Heat in the Large Intestine
How it presents with diarrhea

Diarrhea

Along with: Abdominal pain, Abdominal fullness, Hematochezia, Mucous in feces, Smelly stools, Anal burning,

Traditional Herbal Formulas
Exterior Cold with Interior Dampness in Summer
How it presents with diarrhea

Diarrhea

Along with: Chills with warm skin, Lack of sweating, Heavy sensation in the head, Headaches, Abdominal pain, Vomit,

Traditional Herbal Formulas
Damp-Heat
How it presents with diarrhea

Loose stools

Along with: Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst,

Traditional Herbal Formulas
Cold-Damp invading the Spleen
How it presents with diarrhea

Loose stools

Along with: Loss of appetite, Epigastric coldness, Head and body heaviness, Sweet taste in mouth, Absence of thirst, Diarrhea,

Traditional Herbal Formulas
Damp-Heat in Stomach and Spleen
How it presents with diarrhea

Loose stools

Along with: Head and body heaviness, Upper abdominal oppression, Nausea, Diarrhea, Fever not reduced by sweating

Damp-Phlegm in the Uterus
How it presents with diarrhea

Loose stools

Along with: Late menstruation, Amenorrhea, Scanty menstruation, Lower abdominal pain, Abdominal heaviness, Stifling sensation in the chest,

Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
How it presents with diarrhea

Loose stools

Along with: Upper abdominal oppression, Nausea, Loss of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink,

Traditional Herbal Formulas
Oedema
How it presents with diarrhea

Loose stools

Along with: Abdominal edema, Ankle edema, Facial edema, Foot edema, Oedema of hands, Leg edema,

Summer Heat with Dampness
How it presents with diarrhea

Loose stools

Along with: Fever, Aversion to cold, Excessive sweating, Headaches, Feeling of heaviness, Tight feeling in chest and stomach,

Damp-Heat invading the Spleen
How it presents with diarrhea

Loose stools with foul smell

Along with: Loss of appetite, Feeling of heaviness, Dry mouth without desire to drink, Nausea or vomiting, Malodorous diarrhea, Anal burning,

Traditional Herbal Formulas
Spleen Deficiency with Dampness
How it presents with diarrhea

Diarrhea, Loose stools

Along with: Edema, Feeling of heaviness, Urinary dysfunction, Glomerulonephritis, Kidney infection, Nephrotic syndrome,

Cold

Congeals body fluids, damages Yang Qi, and causes pain with fixed location

Causes: Diarrhea, Loose stools

11 variations documented
Onset Sudden
Location Can be local or systemic
Features Aversion to cold • Prefers warmth • Pain relieved by heat • Tight/contracted feeling

Cold is the predominant pathogenic factor of winter in Traditional Chinese Medicine. Cold represents an environmental pathogen that, when excessive, causes disease characterized by its cold, congealing, and contracting nature. While Cold is the main pathogen of winter, it can cause illness in any season through exposure to cold temperatures, getting caught in rain, sweating followed by wind exposure, or excessive air conditioning.

Cold in the Uterus
How it presents with diarrhea

Diarrhea, Loose stools

Along with: Loss of appetite, Generalized fatigue, General weakness, Thin vaginal discharge

Cold invading the Large Intestine
How it presents with diarrhea

Diarrhea

Along with: Abdominal pain, Chills, Abdominal cold sensation

Traditional Herbal Formulas
Damp-Cold
How it presents with diarrhea

Diarrhea

Along with: Mouth ulcers, White and watery sputum, Nasal discharge, Sneezing, Chills, Abdominal pain,

Traditional Herbal Formulas
Exterior Cold with Interior Dampness in Summer
How it presents with diarrhea

Diarrhea

Along with: Chills with warm skin, Lack of sweating, Heavy sensation in the head, Headaches, Abdominal pain, Vomit,

Traditional Herbal Formulas
Greater Yin stage
How it presents with diarrhea

Diarrhea

Along with: Loss of appetite, Vomit, Abdominal fullness, Chills, Absence of thirst, Generalized fatigue

Traditional Herbal Formulas
Lesser Yin Cold Transformation
How it presents with diarrhea

Diarrhea

Along with: Chills, Absence of thirst, Desire to lie down curled up, Apathy, Hypersomnia, Cold extremities,

Traditional Herbal Formulas
Small Intestine Deficient and Cold
How it presents with diarrhea

Diarrhea

Along with: Borborygmi, Abdominal pain relieved by pressure or eating, Craving for hot beverages, Pale and abudant urination, Cold extremities

Cold-Damp invading the Spleen
How it presents with diarrhea

Loose stools

Along with: Loss of appetite, Epigastric coldness, Head and body heaviness, Sweet taste in mouth, Absence of thirst, Diarrhea,

Traditional Herbal Formulas
Empty-Cold
How it presents with diarrhea

Loose stools

Along with: Chills, Cold extremities, Pale face, Absence of thirst, Apathy, Excessive sweating,

Exterior-Cold
How it presents with diarrhea

Loose stools

Along with: Aversion to cold, Fever, Body pain, Stiff neck, Lack of sweating, Absence of thirst,

Traditional Herbal Formulas
Large Intestine Cold
How it presents with diarrhea

Loose stools

Along with: Diarrhea, Abdominal pain, Borborygmi, Clear urination, Cold extremities

Traditional Herbal Formulas

Qi Deficiency

Insufficient vital energy causing fatigue, weakness, poor digestion, and reduced function of organs and protective systems

Causes: Loose stools, Diarrhea

10 variations documented
Onset Gradual
Location Systemic
Features Fatigue • Weak voice • Shortness of breath • Spontaneous sweating • Poor appetite

Qi Deficiency is a fundamental pattern in Traditional Chinese Medicine where the body's vital energy is insufficient to maintain normal physiological functions, leading to weakness, fatigue, and various organ dysfunctions.

Qi Deficiency
How it presents with diarrhea

Loose stools

Along with: General weakness, Weak voice, Generalized fatigue, Apathy, Dislike of speaking, Spontaneous sweat,

Spleen Qi Deficiency
How it presents with diarrhea

Loose stools

Along with: Slight abdominal distension after eating, General weakness, Desire to lie down, Slight abdominal pain, Excessive gas and flatulence, Bloated abdomen,

Qi and Blood Deficiency
How it presents with diarrhea

Loose stools

Along with: General weakness, Generalized fatigue, Weak voice, Pale face, Shortness of breath, Palpitations,

Traditional Herbal Formulas
Spleen and Lung Qi Deficiency
How it presents with diarrhea

Loose stools

Along with: Loss of appetite, Slight abdominal distension after eating, Generalized fatigue, General weakness, Pale face, Weak limbs,

Stomach and Spleen Qi Deficiency
How it presents with diarrhea

Loose stools

Along with: Loss of appetite, Slight abdominal distension after eating, Generalized fatigue, General weakness, Pale face, Weak limbs,

Stomach Qi Deficiency
How it presents with diarrhea

Loose stools

Along with: Morning fatigue

Traditional Herbal Formulas
Spleen Deficiency with Dampness
How it presents with diarrhea

Diarrhea, Loose stools

Along with: Edema, Feeling of heaviness, Urinary dysfunction, Glomerulonephritis, Kidney infection, Nephrotic syndrome,

Spleen and Stomach Qi Deficiency
How it presents with diarrhea

Diarrhea, Loose stools

Along with: Dizziness, Unsteadiness, Blurry vision, Deafness, Tinnitus, Shortness of breath,

Spleen Deficiency
How it presents with diarrhea

Loose stools

Along with: Sticky vaginal discharge, Generalized fatigue, Depression, Cold extremities, Diarrhea, White vaginal discharge,

Heart and Spleen Deficiency
How it presents with diarrhea

Loose stools

Along with: Palpitations, Insomnia, Loss of appetite, Generalized fatigue, Anxiety, Pale face,

Traditional Herbal Formulas

Yang Deficiency

Insufficient yang qi causing coldness, fatigue, and diminished physiological functions throughout the body

Causes: Diarrhea, Loose stools, Persistent diarrhea

8 variations documented
Onset Gradual
Location Systemic
Features Always cold • Fatigue • Pale face • Prefers warmth • Cold limbs

Yang Deficiency represents a fundamental weakness of the body's yang qi in Traditional Chinese Medicine. It manifests as an inability to warm the body, transform substances, and maintain normal physiological activities, resulting in various cold-type symptoms and functional decline.

Greater Yin stage
How it presents with diarrhea

Diarrhea

Along with: Loss of appetite, Vomit, Abdominal fullness, Chills, Absence of thirst, Generalized fatigue

Traditional Herbal Formulas
Kidney and Spleen Yang Deficiency
How it presents with diarrhea

Loose stools, Diarrhea

Along with: Lower back pain, Weak and cold knees, Back cold sensation, Chills, Weak legs, Bright pale face,

Traditional Herbal Formulas
Lesser Yin Cold Transformation
How it presents with diarrhea

Diarrhea

Along with: Chills, Absence of thirst, Desire to lie down curled up, Apathy, Hypersomnia, Cold extremities,

Traditional Herbal Formulas
Kidney Yang Deficiency
How it presents with diarrhea

Loose stools, Persistent diarrhea

Along with: Lower back pain, Dizziness, Tinnitus, Weak and cold knees, Lower back coldness, Chills,

Spleen Yang Deficiency
How it presents with diarrhea

Loose stools

Along with: Slight abdominal distension after eating, General weakness, Desire to lie down curled up, Pale face, Cold extremities, Chills,

Yang Deficiency or Empty Yang
How it presents with diarrhea

Loose stools

Along with: Chills, General cold feeling, Pale urine, Undigested food in stools, General weakness, Abdominal pain relieved by pressure and warmth,

Spleen or Kidney Yang Deficiency
How it presents with diarrhea

Loose stools

Along with: Abdominal pain that worsens with cold, Urinary dysfunction, Deep pain and heaviness in limbs, Dizziness, Heavy sensation in the head, Edema,

Traditional Herbal Formulas
Spleen and Kidney Yang Deficiency
How it presents with diarrhea

Loose stools

Along with: Pale face, Facial edema, Oedema of limbs, Abdominal distention, Cold extremities, Shortness of breath,

Traditional Herbal Formulas

Heat

Intense, ascending pathogenic force that consumes body fluids, disturbs the mind, and accelerates all physiological processes

Causes: Diarrhea, Loose stools with foul smell, Loose stools

6 variations documented
Onset Can be sudden
Location Can be local or systemic
Features Red face/eyes • Thirst for cold drinks • Restlessness • Yellow/dark secretions

Heat is a major pathogenic factor in Traditional Chinese Medicine that can arise from external invasion or internal generation. Heat has the characteristics of burning intensity, rising upward, consuming qi and fluids, and generating wind and disturbing blood. In TCM philosophy, normal physiological warmth is called "minor fire" (少火) which maintains life functions, while pathological heat is "major fire" (壮火) which damages the body.

Damp-Heat in the Large Intestine
How it presents with diarrhea

Diarrhea

Along with: Abdominal pain, Abdominal fullness, Hematochezia, Mucous in feces, Smelly stools, Anal burning,

Traditional Herbal Formulas
Heat in Lessor Yang
How it presents with diarrhea

Diarrhea, Loose stools with foul smell

Along with: Fever, Bitter taste in the mouth, Abdominal pain, Sticky taste in the mouth, Malodorous diarrhea, Anal irritation,

Traditional Herbal Formulas
Damp-Heat
How it presents with diarrhea

Loose stools

Along with: Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst,

Traditional Herbal Formulas
Damp-Heat in Stomach and Spleen
How it presents with diarrhea

Loose stools

Along with: Head and body heaviness, Upper abdominal oppression, Nausea, Diarrhea, Fever not reduced by sweating

Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
How it presents with diarrhea

Loose stools

Along with: Upper abdominal oppression, Nausea, Loss of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink,

Traditional Herbal Formulas
Damp-Heat invading the Spleen
How it presents with diarrhea

Loose stools with foul smell

Along with: Loss of appetite, Feeling of heaviness, Dry mouth without desire to drink, Nausea or vomiting, Malodorous diarrhea, Anal burning,

Traditional Herbal Formulas

Blood Deficiency

Insufficient blood to nourish the body, causing paleness, dizziness, and dryness throughout the system

Causes: Loose stools

4 variations documented
Onset Gradual
Location Systemic
Features Pale face/lips/nails • Blurred vision • Dizziness • Scanty menses • Numbness

Blood Deficiency represents a fundamental lack of blood volume or quality in the body, resulting in organs, tissues, and the mind being undernourished. In Traditional Chinese Medicine, blood not only refers to the red fluid in our vessels but encompasses the body's entire nourishing and moistening functions.

Qi and Blood Deficiency
How it presents with diarrhea

Loose stools

Along with: General weakness, Generalized fatigue, Weak voice, Pale face, Shortness of breath, Palpitations,

Traditional Herbal Formulas
Spleen and Heart Blood Deficiency
How it presents with diarrhea

Loose stools

Along with: Palpitations, Dizziness, Insomnia, Vivid dreaming, Poor memory, Anxiety,

Traditional Herbal Formulas
Spleen Blood Deficiency
How it presents with diarrhea

Loose stools

Along with: Loss of appetite, Generalized fatigue, General weakness, Pale face, Weak limbs, Diarrhea,

Traditional Herbal Formulas
Heart and Spleen Deficiency
How it presents with diarrhea

Loose stools

Along with: Palpitations, Insomnia, Loss of appetite, Generalized fatigue, Anxiety, Pale face,

Traditional Herbal Formulas

Phlegm

Thick, sticky pathological fluid that obstructs body functions and can manifest anywhere in the body

Causes: Loose stools

3 variations documented
Onset Gradual
Location Local or systemic
Features Nodules/lumps • Heavy sensation • Mucus/expectoration • Mental confusion (if affecting mind)

Phlegm is both a pathological product and a pathogenic factor in Traditional Chinese Medicine. It results from impaired fluid metabolism when the body's transformative functions fail, particularly affecting the Spleen, Lungs, and Kidneys. Classical texts emphasize that "the Spleen is the source of phlegm production, while the Lungs are the storage vessel for phlegm."

Damp-Phlegm in the Uterus
How it presents with diarrhea

Loose stools

Along with: Late menstruation, Amenorrhea, Scanty menstruation, Lower abdominal pain, Abdominal heaviness, Stifling sensation in the chest,

Oedema
How it presents with diarrhea

Loose stools

Along with: Abdominal edema, Ankle edema, Facial edema, Foot edema, Oedema of hands, Leg edema,

Phlegm-Fluids in the Stomach and Small intestine
How it presents with diarrhea

Loose stools

Along with: Abdominal distention, Vomiting clear liquid, Dry tongue, Dry mouth without desire to drink, Stomach splashing sound, Chest distension,

Qi Sinking

Weakened lifting force causing downward bearing sensations, organ prolapse, and inability to hold things in their proper position

Causes: Loose stools, Chronic diarrhoea

3 variations documented
Onset Gradual
Location Lower body/downward
Features Downward bearing feeling • Organ prolapse • Chronic diarrhea • Fatigue

Qi Sinking represents a progression from Spleen Qi deficiency in Traditional Chinese Medicine, where the spleen's essential lifting function fails, causing various downward symptoms and organ displacement.

Qi Collapsing or Qi Sinking
How it presents with diarrhea

Loose stools, Chronic diarrhoea

Along with: Uterine prolapse, Prolapsed bladder, Stomach prolapse, Nephroptosis, Anus prolapse, Bearing down sensation in abdomen,

Traditional Herbal Formulas
Spleen Qi Sinking
How it presents with diarrhea

Loose stools

Along with: Loss of appetite, Slight abdominal distension after eating

Traditional Herbal Formulas
Large Intestine collapse
How it presents with diarrhea

Chronic diarrhoea

Along with: Chronic diarrhea, Anus prolapse, Hemorrhoids, Generalized fatigue, Cold extremities, Loss of appetite,

Traditional Herbal Formulas

Qi Stagnation

Blocked or disrupted flow of vital energy causing distending pain, emotional distress, and symptoms that worsen with stress

Causes: Diarrhea, Loose stools

2 variations documented
Onset Gradual (can be sudden)
Location Can be local or systemic
Features Distending/moving pain • Emotional stress worsens • Sighing • Pain relieved by movement/burping

Qi Stagnation is a fundamental pathological pattern in Traditional Chinese Medicine where the smooth flow of vital energy becomes obstructed, creating areas of pressure, pain, and dysfunction throughout the body.

Liver Qi Stagnation
How it presents with diarrhea

Diarrhea

Along with: Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia,

Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
How it presents with diarrhea

Loose stools

Along with: Upper abdominal oppression, Nausea, Loss of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink,

Traditional Herbal Formulas

Summer Heat

Intense summer heat that rapidly depletes both energy and fluids

Causes: Diarrhea, Loose stools

2 variations documented
Onset Sudden
Location Systemic
Features Mostly summer season • Profuse sweating • Intense thirst • Possible fever

Summer-Heat (暑 Shǔ) is a unique pathogenic factor in Traditional Chinese Medicine that only occurs during summer. Unlike other disease-causing factors in TCM that can arise internally or externally, Summer-Heat always comes from the environment - specifically from exposure to intense summer heat and humidity.

Summer-Heat
How it presents with diarrhea

Diarrhea

Along with: Fever, Aversion to cold, Excessive sweating, Headaches, Feeling of heaviness, Upper abdominal discomfort,

Traditional Herbal Formulas
Summer Heat with Dampness
How it presents with diarrhea

Loose stools

Along with: Fever, Aversion to cold, Excessive sweating, Headaches, Feeling of heaviness, Tight feeling in chest and stomach,

Qi Rebellion

Qi flowing against its natural direction, typically surging upward when it should descend

Causes: Diarrhea

1 variation documented
Onset Sudden
Location Upper body/upward
Features Upward movement • Nausea/vomiting • Hiccups • Cough/asthma • Headache

Qi Rebellion represents a fundamental disruption in the body's energy flow, where qi moves against its proper direction - like water flowing uphill or smoke sinking downward. In Traditional Chinese Medicine, each organ has a natural directional flow for its qi, and when this flow reverses, it creates a cascade of symptoms that shoot upward through the body.

Rebellious Qi
How it presents with diarrhea

Diarrhea

Along with: Hiccups, Belching, Nausea, Vomit, Coughing, Asthma

Yang Collapse

Sudden, catastrophic loss of yang energy causing systemic shutdown with cold sweating, frozen extremities, and consciousness fading

Causes: Loose stools

1 variation documented
Onset Sudden
Location Systemic/Critical
Features Life-threatening • Cold extremities • Profuse cold sweat • Loss of consciousness

Yang Collapse represents the most critical yang deficiency pattern in Traditional Chinese Medicine - a life-threatening condition where the body's yang energy suddenly and massively depletes, leading to systemic functional failure.

Collapse of Yang
How it presents with diarrhea

Loose stools

Along with: Apathy, Chills, Cold extremities, Bright pale face, Sweating on forehead, Absence of thirst,

Traditional Herbal Formulas

Blood Stasis

Blood that is no longer flowing smoothly through the vessels

Causes: Loose stools

1 variation documented
Onset Gradual (trauma=sudden)
Location Often local, can be systemic
Features Fixed/stabbing pain • Purple/dark coloration • Masses/tumors • Pain worse at night

Blood Stasis represents blood that is no longer flowing smoothly through the vessels, either moving too slowly, pooling in certain areas, or congealing into clots. It's one of the most important pathological conditions in Traditional Chinese Medicine and can be both a result of disease and a cause of further illness.

Spleen and Liver Blood Deficiency
How it presents with diarrhea

Loose stools

Along with: Loss of appetite, Slight abdominal distension after eating, Generalized fatigue, General weakness, Dull pale complexion, Weak limbs,

Yin Excess

Pathological accumulation of cold, heavy substances causing stagnation, obstruction, and suppression of yang energy with internal cold manifestations

Causes: Loose stools

1 variation documented
Onset Gradual
Location Systemic
Features Pathological cold from internal Yin • Accumulation of cold fluids • Slow metabolism

Yin Excess represents patterns in Traditional Chinese Medicine where yin-natured pathological substances - cold, phlegm, dampness, and fluids - accumulate excessively in the body, overwhelming yang energy and causing obstruction, stagnation, and cold manifestations throughout the system.

Yin Excess
How it presents with diarrhea

Loose stools

Along with: Absence of thirst, Slow and forceful movement, Epigastric pain worsen by pressure, Polyuria, Feeling of chest oppression, Nausea,

Traditional Herbal Formulas

Herbal Formulas for Diarrhea

Traditional Chinese Medicine formulas used to address diarrhea

Bu Zhong Yi Qi Tang

Addresses these diarrhea patterns:

Qi Deficiency Qi Sinking Yang Deficiency

Gui Pi Tang

Addresses these diarrhea patterns:

Qi Deficiency Blood Deficiency Blood Stasis

Si Jun Zi Tang

Addresses these diarrhea patterns:

Qi Deficiency

Liu Jun Zi Tang

Addresses these diarrhea patterns:

Qi Deficiency Dampness

Wu Ling San

Addresses these diarrhea patterns:

Dampness Qi Deficiency Yang Deficiency Phlegm Yin Excess

Ping Wei San

Addresses these diarrhea patterns:

Dampness Cold Heat Qi Stagnation Phlegm

Shen Ling Bai Zhu San

Addresses these diarrhea patterns:

Cold Qi Deficiency

Yi Huang Tang

Addresses these diarrhea patterns:

Qi Deficiency Dampness Heat Yang Deficiency

Zhen Wu Tang

Addresses these diarrhea patterns:

Dampness Phlegm Yang Deficiency