Gastritis
胃脘痛 · wèi wǎn tòng+11 other namesHide other names
Also known as: Gastric Inflammation, Inflamed Stomach, Inflammation Of The Stomach, Inflammatory Condition In The Stomach, Stomach Inflammation, Gastritis (acute and chronic), Alcoholic Gastritis, Gastric Erosion, Acid Reflux Gastritis, Gastroesophageal Reflux Gastritis, Acute Gastritis
Not all gastritis is the same. The stress-triggered pain that radiates to your ribs, the burning after spicy food, and the dull ache that improves with a hot water bottle are three different patterns - each with its own treatment. Most people see significant relief within a few weeks once the right pattern is identified.
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 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.
Gastritis isn't one condition in TCM - it's a family of six distinct patterns, each with its own cause, its own characteristic pain, and its own treatment. Some are triggered by stress, others by cold or dietary overload. TCM sees the stomach as a cooking pot that needs the right balance of fire and fluid; when that balance is off, pain follows. The patterns below explain why your gastritis feels the way it does and point to a targeted solution.
Gastritis is inflammation of the stomach lining, which can be acute or chronic. It may cause burning pain in the upper abdomen, nausea, bloating, and a feeling of fullness. Common causes include infection with Helicobacter pylori, regular use of non-steroidal anti-inflammatory drugs (NSAIDs), excessive alcohol, and severe stress. Diagnosis is usually made through endoscopy with biopsy, which can identify H. pylori and assess the degree of damage.
Conventional treatments
Standard treatment depends on the cause. For H. pylori-related gastritis, a combination of antibiotics and acid-suppressing drugs (proton pump inhibitors or PPIs) is used. For NSAID-induced gastritis, stopping the offending medication and taking PPIs or H2 blockers is typical. Antacids may provide quick symptom relief. Dietary changes, such as avoiding spicy or acidic foods, are also recommended.
Where conventional treatment falls short
While PPIs and H2 blockers effectively reduce stomach acid and allow the lining to heal, they do not address the underlying reasons why the stomach became vulnerable in the first place - such as stress, dietary habits, or constitutional weakness. Long-term PPI use has been associated with nutrient malabsorption, increased risk of infections, and rebound acid hypersecretion when stopped. Moreover, the conventional approach treats all gastritis as essentially the same condition, whereas TCM recognizes that a burning pain after spicy food, a dull ache that improves with warmth, and a stress-triggered bloating pain each require a fundamentally different treatment strategy.
How TCM understands gastritis
In TCM, the Stomach is the 'sea of grain and water' - it receives food and drink, ripens them with its yang fire, and sends the purified essence upward to the Spleen while pushing waste downward. For this to work smoothly, Stomach Qi must descend. Pain arises when something disrupts that downward flow, whether an external invader like Cold, an internal buildup like Damp-Heat, or a weakness in the Stomach's own energy.
The Liver plays a crucial role because it governs the smooth flow of Qi throughout the body. Emotional stress, frustration, or anger can cause Liver Qi to stagnate and then 'invade' the Stomach, reversing its normal downward direction and causing pain, belching, and distension that radiates to the ribs. This is why stress is such a common trigger for gastritis flares.
The Spleen is the Stomach's partner in digestion, transforming food into Qi and Blood. When the Spleen is weak - often from irregular eating or too many cold, raw foods - it fails to manage fluids, and dampness accumulates. This dampness can combine with heat from rich or spicy foods to create Damp-Heat, a sticky, hot condition that clogs the Stomach and causes a heavy, burning pain with nausea.
Not all gastritis is excess. Chronic gastritis often reflects a deficiency: either the warming Yang of the Stomach is depleted, leaving it cold and slow, or the cooling Yin fluids have dried up, leaving it dry and irritated. The first feels like a dull ache that loves warmth; the second like a gnawing, burning sensation with a dry mouth. These deficiency patterns take longer to develop and longer to heal.
Because one person's gastritis may be driven by Cold while another's by Damp-Heat or Liver Qi stagnation, TCM doesn't have a single 'gastritis formula.' Instead, treatment is tailored to the specific pattern. The tongue and pulse are essential tools for telling these patterns apart, which is why a professional diagnosis is so valuable.
「胃脘当心而痛」
"Pain in the epigastric region located just below the heart. This is one of the earliest classical descriptions of the condition now known as gastritis, linking it directly to the Stomach’s dysfunction."
How a TCM practitioner diagnoses gastritis
Inside the consultation
A TCM practitioner begins by asking what the pain actually feels like, what brings it on, and what makes it better or worse. The quality, location, and timing of the discomfort are the first clues that point toward one pattern rather than another. They then look at the tongue and feel the pulse to confirm which internal imbalance is driving the symptoms.
If the pain is sharp and cramping and clearly improves with warmth, Cold invading the Stomach is likely. This pattern often follows a sudden chill or cold drinks, and the tongue usually looks pale with a thin white coating, while the pulse feels tight and tense.
A stuffy, burning sensation in the upper abdomen, a bitter taste in the mouth, and a thick yellow greasy tongue coating point to Damp-Heat in the Stomach. This pattern is common after a period of rich, greasy, or spicy food and alcohol, and the pulse often feels rapid and slippery.
When the pain is linked to emotional stress and radiates toward the ribs, Liver Qi Stagnation invading the Stomach is the likely picture. Frequent belching, sighing, and a feeling of distension are typical, and the tongue may look normal or have a thin white coating while the pulse feels wiry, like a guitar string.
Epigastric fullness, sour regurgitation, and belching with a foul smell after overeating suggest Food Stagnation in the Stomach. The tongue coating is thick and greasy, and the pulse feels slippery. This pattern is usually acute and directly tied to a recent dietary indiscretion.
A dull, nagging ache that feels better with pressure and warmth, accompanied by fatigue and loose stools, indicates a deeper deficiency: Stomach Yang Deficient and Cold. The tongue is pale and puffy with a thin white coating, and the pulse is deep and weak, reflecting the lack of warming energy.
When the pain is more of a burning sensation, with a feeling of hunger but no real desire to eat, dry mouth, and a red tongue with little or no coating, Stomach Yin Deficiency is the pattern. The pulse is often thin and rapid, signaling that the stomach’s moistening fluids have been depleted over time.
TCM Patterns for Gastritis
In TCM, the aim is to address the root cause, not just the symptom — it calls that root cause a “pattern.” The same 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 very common to see a bit of yourself in more than one pattern, because these patterns are snapshots of a dynamic process rather than rigid boxes. A chronic deficiency pattern can easily be layered with an acute invasion of cold or a bout of food stagnation, creating a mixed picture.
To narrow things down, pay attention to which feature is strongest and what makes the pain better or worse. A sharp pain that eases with a hot water bottle leans strongly toward Cold or Yang Deficiency, while a burning discomfort that worsens with rich food points toward Damp-Heat or Yin Deficiency. Emotional triggers and rib-side pain make Liver involvement much more likely.
Because the tongue and pulse are so important for telling deficiency from excess-and because patterns can overlap in subtle ways-a professional diagnosis is really worthwhile before trying herbs or dietary changes. If the pain is severe, sudden, or accompanied by vomiting blood, black tarry stools, or unexplained weight loss, see a doctor promptly rather than self-treating.
Liver Qi Stagnation invading the Stomach
Damp-Heat in the Stomach
Cold invading the Stomach
Stomach Yin Deficiency
Treatment
Four ways to address gastritis in TCM — explore each, or take the quiz to see what fits you first.
Formulas traditionally used for gastritis
7 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 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 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.
A gentle, time-tested formula for the uncomfortable, heavy feeling after overeating or consuming rich, greasy foods. It helps break down accumulated food, relieves bloating, acid reflux, nausea, and belching, and restores normal digestive movement. Often described as 'digestive first aid' in Chinese medicine, it works by clearing the blockage rather than masking symptoms.
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.
Acute patterns like Cold Invasion or Food Stagnation often respond within days to a week of treatment. Chronic patterns, such as Stomach Yang Deficiency or Yin Deficiency, may require 4-8 weeks of consistent acupuncture and herbs to rebuild digestive function. Flare-ups triggered by emotional stress or dietary lapses can settle in 1-2 weeks with the right herbal formula.
Treatment principles
Across all patterns, the central goal is to harmonize the Stomach and restore the normal downward movement of Qi. For excess patterns - whether Cold, Food Stagnation, Damp-Heat, or Liver Qi invading the Stomach - treatment focuses on clearing the pathogen and removing the obstruction. For deficiency patterns, the approach shifts to warming and strengthening Yang or nourishing Yin fluids.
Because many chronic cases involve a mix of excess and deficiency, formulas are often carefully balanced to address both. Throughout treatment, protecting Stomach Qi is paramount, so herbs are chosen to be gentle and easy to digest.
What to expect from treatment
Most treatment plans combine weekly acupuncture sessions with a daily herbal formula. You may feel some relief right after the first acupuncture session, but herbs typically take a few days to build a noticeable effect. For acute gastritis, significant improvement is common within 1-2 weeks. For chronic conditions, expect gradual progress over 4-8 weeks.
Your practitioner will adjust your formula as your symptoms change. Dietary compliance is essential - sticking to recommended foods can speed healing considerably.
General dietary guidance
Regardless of your pattern, a few dietary principles apply to all gastritis types. Eat at regular times and chew thoroughly. Favor warm, cooked foods like soups, congee, and steamed vegetables, which are easy on the Stomach. Avoid raw, cold, and icy foods, as well as greasy, fried, and overly spicy dishes that generate dampness and heat.
Coffee, alcohol, and carbonated drinks can irritate the stomach lining and should be limited or eliminated. Small, frequent meals are often better tolerated than large ones. Once your pattern is identified, your practitioner will give you more specific food recommendations.
Combining TCM with conventional treatment
TCM treatment for gastritis can generally be used alongside conventional medications. If you are taking proton pump inhibitors, H2 blockers, or antacids, continue them as prescribed and inform both your TCM practitioner and your doctor. If you are on antibiotics for H. pylori, herbal formulas can support digestion and reduce side effects, but must be coordinated to avoid any interactions.
Certain herbs, such as Gan Cao (licorice root), can affect potassium levels or blood pressure if used in large amounts over a long period, so always provide a full medication list. Never stop or adjust prescription medications without consulting your prescribing physician.
*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 — May indicate active bleeding in the stomach.
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Black, tarry stools — A sign of upper gastrointestinal bleeding.
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Sudden, severe abdominal pain that is unlike any previous episode — Could signal a perforation or other emergency.
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Unexplained weight loss — May be a sign of a more serious underlying condition.
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Difficulty swallowing or feeling that food gets stuck — Requires investigation to rule out obstruction or stricture.
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Pain accompanied by fever and chills — Could indicate infection or a more serious inflammatory process.
Audience-specific guidance — open what applies to you
During pregnancy, Liver Qi stagnation and Stomach Yin deficiency become more common patterns for gastritis, as the growing fetus consumes Yin and blood while emotional shifts can constrain Liver Qi. Morning sickness can also deplete Stomach fluids, making the gnawing, burning pain of Yin deficiency more likely.
Herbal treatment must be cautious. Strong Qi-moving formulas like Chai Hu Shu Gan San are generally safe when properly modified, but herbs that strongly invigorate blood (e.g., Dan Shen, San Leng, E Zhu) and bitter-cold herbs like Huang Lian should be avoided or used only under expert guidance to prevent miscarriage. Warm, gentle herbs such as Sha Ren and Zi Su Geng can safely harmonize the Stomach. Acupuncture is an excellent first-line option, with points like Neiguan PC-6 and Zusanli ST-36 being safe and effective throughout pregnancy.
Most mild TCM formulas are compatible with breastfeeding, but bitter-cold herbs like Huang Lian and Da Huang can pass into breast milk and cause infant diarrhea or colic. For Damp-Heat pattern gastritis, milder alternatives such as Zhu Ru or Yi Yi Ren are preferred, or the formula can be used short-term while monitoring the infant.
Liver Qi stagnation formulas like Chai Hu Shu Gan San are generally considered safe during lactation, as the herbs are not highly concentrated in milk. Acupuncture remains a safe, effective option that avoids any herb transfer. If significant Heat or Dampness is present, dietary adjustments - reducing greasy and spicy foods - often provide substantial relief without the need for strong herbs.
In children, gastritis most often arises from Food Stagnation in the Stomach due to overeating or irregular meals, and from Cold invading the Stomach after consuming too many cold drinks or icy foods. The pain is usually acute, with a distended belly, sour belching, and a thick tongue coating. Children cannot always articulate their symptoms well, so observing their eating habits, bowel movements, and whether they clutch their stomach after meals is crucial.
Treatment relies heavily on dietary correction and gentle herbal formulas. Bao He Wan is the classic choice for food stagnation, but the dosage must be reduced to roughly one-quarter to one-half of the adult dose depending on age. Acupressure or gentle acupuncture at Zusanli ST-36 and Zhongwan REN-12 is well tolerated. Avoid strong, bitter herbs, and always address the root cause - often simply adjusting the child’s diet resolves the problem without prolonged treatment.
In older adults, chronic gastritis tends to shift toward deficiency patterns - Stomach Yang Deficiency and Stomach Yin Deficiency are far more common than excess patterns like Damp-Heat or Food Stagnation. The pain is typically dull, persistent, and worse with fatigue or cold, reflecting a gradual decline in the digestive fire and the stomach’s moistening fluids. The tongue is often pale and puffy or red and dry with little coating, and the pulse feels weak and deep.
Herbal dosages should be reduced, usually to about two-thirds of the standard adult dose, and warming or nourishing formulas like Huang Qi Jian Zhong Tang or Yi Wei Tang are favored. Polypharmacy is a real concern, so practitioners must check for interactions with conventional medications. Acupuncture and moxibustion are especially valuable in this population, as they are gentle, drug-free, and can be applied for longer courses without burdening the liver or kidneys. Treatment timelines are typically longer, and the focus is on gradual, sustained improvement rather than rapid resolution.
Evidence & references
Acupuncture has a moderate evidence base for chronic gastritis and functional dyspepsia. Several systematic reviews and meta-analyses, primarily from Chinese research groups, suggest that acupuncture can significantly reduce epigastric pain, bloating, and nausea, and may improve quality of life compared to conventional medication alone. The quality of trials is often limited by small sample sizes and methodological weaknesses, but the direction of effect is consistently positive.
Chinese herbal medicine has been studied extensively in China, with formulas like Chai Hu Shu Gan San and Huang Lian Wen Dan Tang showing promise for specific TCM patterns. Animal studies support anti-inflammatory and mucosal-protective effects. However, rigorous English-language randomized controlled trials remain scarce, and much of the evidence is published in Chinese journals. More high-quality, double-blind trials are needed to confirm these findings for an international audience.
Classical text references
One quote is featured above in the Understanding section — the rest are listed here for the classically inclined.
「心下痞，按之濡，其脉关上浮者，大黄黄连泻心汤主之。」
"When there is a glomus below the heart that feels soft on pressure and the pulse is floating at the guan position, Da Huang Huang Lian Xie Xin Tang governs. This passage describes epigastric fullness and discomfort, a key presentation of gastritis, and links it to Heat accumulation in the Stomach."
Jin Gui Yao Lue
Chapter on Abdominal Fullness, Cold and Glomus
「脾胃虚弱，饮食不消，则胃脘疼痛。」
"When the Spleen and Stomach are weak and food is not properly digested, epigastric pain arises. Li Dong-yuan emphasizes the central role of Spleen-Stomach deficiency in chronic gastritis, a view that still guides modern TCM treatment."
Pi Wei Lun (Treatise on the Spleen and Stomach)
Chapter on Stomach Pain
Frequently asked questions
Common questions about using Traditional Chinese Medicine for gastritis.
Treatment typically includes acupuncture, a customized herbal formula, and dietary guidance. Acupuncture points on the abdomen, legs, and arms help regulate Stomach Qi and calm the Liver. Herbal formulas are taken daily, usually as a tea or granules, to address the underlying pattern. Your practitioner will also advise on foods to avoid and those that support healing.
Yes, TCM can be safely combined with proton pump inhibitors or H2 blockers. Many patients begin TCM while still on these medications. As your symptoms improve, you can work with your prescribing doctor to slowly reduce the dose if appropriate. Never stop acid-suppressing drugs abruptly, as this can cause rebound acid production.
For acute gastritis, many people notice improvement within the first week of herbs and acupuncture. Chronic gastritis often takes longer - you may see gradual relief over 4-8 weeks. The timeline depends on the pattern: excess conditions like Food Stagnation clear quickly, while deficiency patterns require time to rebuild the stomach lining and digestive fire.
Dietary adjustments are an important part of TCM treatment, but they don't have to be extreme. The general rule is to eat warm, cooked foods, avoid raw and cold items, and steer clear of greasy, spicy, or overly sweet foods that create dampness. You'll also receive pattern-specific advice - for example, ginger tea for cold patterns or pear for dryness. Most patients find that once they feel better, they can gradually reintroduce a wider range of foods.
Yes, acupuncture is very safe when performed by a trained professional. The needles are hair-thin and cause minimal discomfort. For gastritis, points are often chosen on the abdomen, lower legs, and wrists. Some people feel immediate relaxation and a reduction in pain after a session.
TCM aims to resolve the underlying imbalance, not just mask the pain. When the pattern is fully corrected and dietary habits are maintained, recurrence is less likely. However, if you return to the same triggers - chronic stress, poor diet, overwork - the condition can reappear. Your practitioner will help you identify and manage your personal triggers.
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