Upper Abdominal Pain in Traditional Chinese Medicine
Understanding different upper abdominal pain patterns according to TCM theory
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Condition Categories
Upper abdominal pain is a common symptom that affects the area above the navel, often reflecting disorders in the upper digestive tract. This discomfort can range from mild to severe and may manifest in various forms, such as epigastric pain, a burning sensation, or a sharp ache in the hypochondriac region. The pain may be intermittent, worsen with pressure, or sometimes alleviate with vomiting, indicating diverse underlying conditions.
Traditional Chinese Medicine (TCM) interprets upper abdominal pain through the lens of Qi (energy) flow, organ health, and the balance of Yin and Yang. Unlike Western medicine, which often attributes pain to specific organ pathologies, TCM considers a broader spectrum of imbalances across the body's energy pathways.
Identifying the correct disharmony pattern is crucial for effective treatment, as TCM believes that each symptom, including pain, is a signal of an underlying imbalance.
TCM Patterns for Upper Abdominal Pain
Heat
Causes: Epigastric pain, Abdominal and epigastric pain, Burning abdominal pain, Burning epigastric pain, Intermittent epigastric pain
Damp-Heat in the Stomach
Epigastric pain
Along with: Upper abdominal pain, Upper abdominal fullness, Feeling of heaviness, Face pain, Congested nose, Thick nasal discharge, Dry mouth without desire to drink, Nausea, Feeling of heat, Dull yellow complexion, Sticky taste in the mouth
Phlegm-Heat in the Lungs
Epigastric pain
Along with: Coughing, Shortness of breath, Wheezing, Stifling sensation in the chest, Sputum, Feeling of heat, Thirst, Head and body heaviness, Dizziness, Copious thick yellow sputum
Damp-Heat invading the Spleen
Abdominal and epigastric pain
Along with: Loss of appetite, Feeling of heaviness, Dry mouth without desire to drink, Nausea or vomiting, Malodorous diarrhea, Anal burning, Feeling of heat, Scanty and dark urine, Low grade fever, Dull headache, Dull yellow complexion, Yellow sclera, Oily sweat, Itchy rashes, Bitter taste in the mouth, Upper abdominal fullness, Upper abdominal pain
Heat in Lessor Yang
Burning abdominal pain
Along with: Fever, Bitter taste in the mouth, Abdominal pain, Diarrhea, Sticky taste in the mouth, Malodorous diarrhea, Anal irritation, Upper abdominal burning pain, Tenesmus
Stomach Heat or Fire
Burning epigastric pain
Along with: Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth, Mouth ulcers, Acid reflux, Nausea, Vomiting after eating, Excessive hunger, Bad breath, Feeling of heat, Acne
Liver Qi Stagnation that transforms into Heat
Intermittent epigastric pain
Along with: Intermittent upper abdominal pain, Hernia-Related pain, Dysmenorrhea exacerbated by hot food or drinks, Irritability, Bitter taste in the mouth, Peptic ulcer, Chronic gastritis, Hepatitis, Cholecystitis
Qi Stagnation
Causes: Epigastric pain, Epigastic pain, Intermittent epigastric pain
Stomach Qi Stagnation
Epigastric pain
Along with: Upper abdominal pain, Upper abdominal distension, Belching, Nausea, Vomit, Hiccups, Irritability
Liver Qi Stagnation
Epigastic pain
Along with: Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia, Depression, Mood swings, Irregular periods, Globus sensation, Pre menstrual breast distension, Pre menstrual tension, Anxiety, Anger, Melasma
Liver Qi Stagnation that transforms into Heat
Intermittent epigastric pain
Along with: Intermittent upper abdominal pain, Hernia-Related pain, Dysmenorrhea exacerbated by hot food or drinks, Irritability, Bitter taste in the mouth, Peptic ulcer, Chronic gastritis, Hepatitis, Cholecystitis
Phlegm
Causes: Epigastric pain
Phlegm in Kidneys or Gallbladder
Epigastric pain
Along with: Frequent and urgent urination, Urinary dysfunction, Hematuria
Phlegm-Heat in the Lungs
Epigastric pain
Along with: Coughing, Shortness of breath, Wheezing, Stifling sensation in the chest, Sputum, Feeling of heat, Thirst, Head and body heaviness, Dizziness, Copious thick yellow sputum
Dampness
Causes: Epigastric pain, Abdominal and epigastric pain
Damp-Heat in the Stomach
Epigastric pain
Along with: Upper abdominal pain, Upper abdominal fullness, Feeling of heaviness, Face pain, Congested nose, Thick nasal discharge, Dry mouth without desire to drink, Nausea, Feeling of heat, Dull yellow complexion, Sticky taste in the mouth
Damp-Heat invading the Spleen
Abdominal and epigastric pain
Along with: Loss of appetite, Feeling of heaviness, Dry mouth without desire to drink, Nausea or vomiting, Malodorous diarrhea, Anal burning, Feeling of heat, Scanty and dark urine, Low grade fever, Dull headache, Dull yellow complexion, Yellow sclera, Oily sweat, Itchy rashes, Bitter taste in the mouth, Upper abdominal fullness, Upper abdominal pain
Qi Rebellion
Causes: Epigastric pain
Rebellious Liver Qi invading the Stomach
Epigastric pain
Along with: Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression, Acid reflux, Hiccups, Belching, Nausea or vomiting, Sighing, Weak limbs
Yin Deficiency
Causes: Epigastric pain, Epigastic pain
Stomach Yin Deficiency
Epigastric pain, Epigastic pain
Along with: Loss of appetite, Preference for sipping, Slight abdominal distension after eating
Blood Stasis
Causes: Epigastric pain
Stomach Blood Stagnation
Epigastric pain
Along with: Nocturnal epigastric pain, Abdominal pain worsened by pressure, Nausea or vomiting, Potential vomiting of blood, Hematochezia
Yin Excess
Causes: Epigastric pain worsen by pressure
Yin Excess
Epigastric pain worsen by pressure
Along with: Absence of thirst, Slow and forceful movement, Polyuria, Feeling of chest oppression, Nausea, Excessive vaginal discharge, Loss of appetite, Pain relieved by heat, Chills, Cold extremities, Pale urine
Cold
Causes: Severe epigastric pain
Cold invading the Stomach
Severe epigastric pain
Along with: Severe upper abdominal pain, Chills, Cold extremities, Desire for hot beverages and foods, Vomiting clear liquid, Nausea, Feeling worse after drinking cold drinks
Herbal Formulas for Upper Abdominal Pain
Traditional Chinese Medicine formulas used to address upper abdominal pain
Lian Po Yin
Addresses these upper abdominal pain patterns:
Main Actions
- Clears Heat
- Transforms Dampness
- Regulates Qi
- Harmonizes the Middle Burner
Addresses These Upper Abdominal Pain Pattern Variations
Damp-Heat in the Stomach
How it manifests:
Epigastric pain
Accompanying symptoms:
Upper abdominal pain, Upper abdominal fullness, Feeling of heaviness, Face pain, Congested nose, Thick nasal discharge...
Damp-Heat invading the Spleen
How it manifests:
Abdominal and epigastric pain
Accompanying symptoms:
Loss of appetite, Feeling of heaviness, Dry mouth without desire to drink, Nausea or vomiting, Malodorous diarrhea, Anal burning...
Ban Xia Hou Pu Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Regulates the flow of Qi,
- Clears Phlegm
- Treats esophageal spasm
- Descends Rebellious Qi
- Dissipates clumps
- Relieves Stagnation
Addresses These Upper Abdominal Pain Pattern Variations
Rebellious Liver Qi invading the Stomach
How it manifests:
Epigastric pain
Accompanying symptoms:
Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression...
Stomach Qi Stagnation
How it manifests:
Epigastric pain
Accompanying symptoms:
Upper abdominal pain, Upper abdominal distension, Belching, Nausea, Vomit, Hiccups...
Ge Hua Jie Cheng San
Addresses these upper abdominal pain patterns:
Main Actions
- Separates and reduces alcohol-dampness
- Warms the Middle
- Strengthens the Spleen
Addresses These Upper Abdominal Pain Pattern Variations
Damp-Heat in the Stomach
How it manifests:
Epigastric pain
Accompanying symptoms:
Upper abdominal pain, Upper abdominal fullness, Feeling of heaviness, Face pain, Congested nose, Thick nasal discharge...
Xiao Xian Xiong Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Clears Heat
- Transforms Phlegm
- Expands the chest
- Dissipates clumps
Addresses These Upper Abdominal Pain Pattern Variations
Phlegm-Heat in the Lungs
How it manifests:
Epigastric pain
Accompanying symptoms:
Coughing, Shortness of breath, Wheezing, Stifling sensation in the chest, Sputum, Feeling of heat...
Jin Ling Zi San
Addresses these upper abdominal pain patterns:
Main Actions
- Moves Liver Blood and Liver Qi
- Drains Liver Heat or Fire
- Stops pain
Addresses These Upper Abdominal Pain Pattern Variations
Liver Qi Stagnation that transforms into Heat
How it manifests:
Intermittent epigastric pain
Accompanying symptoms:
Intermittent upper abdominal pain, Hernia-Related pain, Dysmenorrhea exacerbated by hot food or drinks, Irritability, Bitter taste in the mouth, Peptic ulcer...
Si Ni San
Addresses these upper abdominal pain patterns:
Main Actions
- Regulates Liver and Spleen
- Eliminates Internal Heat
Addresses These Upper Abdominal Pain Pattern Variations
Phlegm in Kidneys or Gallbladder
How it manifests:
Epigastric pain
Accompanying symptoms:
Frequent and urgent urination, Urinary dysfunction, Hematuria
Xuan Fu Dai Zhe Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Regulates the downward flow of Stomach Qi
- Expectorant, treats hiccups
Addresses These Upper Abdominal Pain Pattern Variations
Rebellious Liver Qi invading the Stomach
How it manifests:
Epigastric pain
Accompanying symptoms:
Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression...
Zuo Jin Wan
Addresses these upper abdominal pain patterns:
Main Actions
- Clears Liver Heat
- Directs Rebellious Qi downward
- Stops vomiting
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Qi Stagnation
How it manifests:
Epigastric pain
Accompanying symptoms:
Upper abdominal pain, Upper abdominal distension, Belching, Nausea, Vomit, Hiccups...
Mai Men Dong Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Nourishes the Stomach
- Generates Body Fluids
- Directs Rebellious Qi downward
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Yin Deficiency
How it manifests:
Epigastric pain, Epigastic pain
Accompanying symptoms:
Loss of appetite, Preference for sipping, Slight abdominal distension after eating
Xue Fu Zhu Yu Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Invigorates the Blood
- Dispels blood Stagnation
- Spreads the Liver Qi
- Unblocks the channels
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Blood Stagnation
How it manifests:
Epigastric pain
Accompanying symptoms:
Nocturnal epigastric pain, Abdominal pain worsened by pressure, Nausea or vomiting, Potential vomiting of blood, Hematochezia
Huang Qin Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Clears Heat
- Alleviates dysenteric disorders
- Stops pain
- Harmonizes the Middle Burner
Addresses These Upper Abdominal Pain Pattern Variations
Heat in Lessor Yang
How it manifests:
Burning abdominal pain
Accompanying symptoms:
Fever, Bitter taste in the mouth, Abdominal pain, Diarrhea, Sticky taste in the mouth, Malodorous diarrhea...
Wu Ling San
Addresses these upper abdominal pain patterns:
Main Actions
- Promotes urination,
- Warms the Yang
- Strengthens the Spleen
- Promotes Qi transformation function
- Drains Dampness
- Clears edema
Addresses These Upper Abdominal Pain Pattern Variations
Yin Excess
How it manifests:
Epigastric pain worsen by pressure
Accompanying symptoms:
Absence of thirst, Slow and forceful movement, Polyuria, Feeling of chest oppression, Nausea, Excessive vaginal discharge...
Liang Fu Wan
Addresses these upper abdominal pain patterns:
Main Actions
- Warms the Middle Burner
- Dispels Cold
- Promotes the movement of Qi
- Alleviates Pain
Addresses These Upper Abdominal Pain Pattern Variations
Cold invading the Stomach
How it manifests:
Severe epigastric pain
Accompanying symptoms:
Severe upper abdominal pain, Chills, Cold extremities, Desire for hot beverages and foods, Vomiting clear liquid, Nausea...
San Jin Pai Shi Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Discharge Gallstones
- Clear Damp-Heat and promote urination
- Circulate Qi and Blood and relieve painful urination
Addresses These Upper Abdominal Pain Pattern Variations
Phlegm in Kidneys or Gallbladder
How it manifests:
Epigastric pain
Accompanying symptoms:
Frequent and urgent urination, Urinary dysfunction, Hematuria
Si Mo Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Promotes the movement of Qi
- Directs rebellious Qi downward
- Expands the chest and dissipates clumping
Addresses These Upper Abdominal Pain Pattern Variations
Rebellious Liver Qi invading the Stomach
How it manifests:
Epigastric pain
Accompanying symptoms:
Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression...
Xiao Yao San
Addresses these upper abdominal pain patterns:
Main Actions
- Harmonizes the function of Liver and Spleen
- Relieves Liver Qi stagnation
- Nourishes the Blood
Addresses These Upper Abdominal Pain Pattern Variations
Liver Qi Stagnation
How it manifests:
Epigastic pain
Accompanying symptoms:
Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia...
Yi Wei Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Strengthen the Stomach
- Creates Body Fluids
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Yin Deficiency
How it manifests:
Epigastric pain, Epigastic pain
Accompanying symptoms:
Loss of appetite, Preference for sipping, Slight abdominal distension after eating
Tiao Wei Cheng Qi Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Removes Heat and Dryness in the Lower Burner
- Removes constipation
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Heat or Fire
How it manifests:
Burning epigastric pain
Accompanying symptoms:
Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth...
Wu Pi Yin
Addresses these upper abdominal pain patterns:
Main Actions
- Reduces edema, diuretic
- Regulates and strengthens Spleen Qi
Addresses These Upper Abdominal Pain Pattern Variations
Yin Excess
How it manifests:
Epigastric pain worsen by pressure
Accompanying symptoms:
Absence of thirst, Slow and forceful movement, Polyuria, Feeling of chest oppression, Nausea, Excessive vaginal discharge...
Huo Xiang Zheng Qi San
Addresses these upper abdominal pain patterns:
Main Actions
- Releases the Exterior
- Transforms Dampness
- Regulates Qi
- Harmonizes the Middle Burner
Addresses These Upper Abdominal Pain Pattern Variations
Cold invading the Stomach
How it manifests:
Severe epigastric pain
Accompanying symptoms:
Severe upper abdominal pain, Chills, Cold extremities, Desire for hot beverages and foods, Vomiting clear liquid, Nausea...
Ju Pi Zhu Ru Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Directs rebellious Qi downward
- Stops hiccup
- Augments Qi
- Clears heat
Addresses These Upper Abdominal Pain Pattern Variations
Rebellious Liver Qi invading the Stomach
How it manifests:
Epigastric pain
Accompanying symptoms:
Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression...
Jia Wei Xiao Yao San
Addresses these upper abdominal pain patterns:
Main Actions
- Clears Liver and Spleen Qi Stagnation
- Tonifies Spleen
- Clears Deficient Heat
- Nourishes the blood
Addresses These Upper Abdominal Pain Pattern Variations
Liver Qi Stagnation
How it manifests:
Epigastic pain
Accompanying symptoms:
Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia...
Shen Ling Bai Zhu San
Addresses these upper abdominal pain patterns:
Main Actions
- Augments the Qi
- Strengthens the Spleen
- Drains Dampness
- Stops diarrhea
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Yin Deficiency
How it manifests:
Epigastric pain, Epigastic pain
Accompanying symptoms:
Loss of appetite, Preference for sipping, Slight abdominal distension after eating
Qing Wei San
Addresses these upper abdominal pain patterns:
Main Actions
- Drains Stomach Fire
- Cools the Blood
- Nourishes the Yin
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Heat or Fire
How it manifests:
Burning epigastric pain
Accompanying symptoms:
Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth...
Wu Zhu Yu Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Warms and tonifies the Liver and Stomach
- Directs Rebellious Qi downward
- Stops vomiting
Addresses These Upper Abdominal Pain Pattern Variations
Cold invading the Stomach
How it manifests:
Severe epigastric pain
Accompanying symptoms:
Severe upper abdominal pain, Chills, Cold extremities, Desire for hot beverages and foods, Vomiting clear liquid, Nausea...
Ding Xiang Shi Di Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Augments the Qi
- Warms the Middle Burner
- Directs Rebellious Qi downward
- Stops hiccup
Addresses These Upper Abdominal Pain Pattern Variations
Rebellious Liver Qi invading the Stomach
How it manifests:
Epigastric pain
Accompanying symptoms:
Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression...
Yue Ju Wan
Addresses these upper abdominal pain patterns:
Main Actions
- Promotes the movement of Qi
- Releases all types of Stagnation (Qi, Blood, Phlegm, Fire, Food and Dampness)
Addresses These Upper Abdominal Pain Pattern Variations
Liver Qi Stagnation
How it manifests:
Epigastic pain
Accompanying symptoms:
Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia...
Xie Huang San
Addresses these upper abdominal pain patterns:
Main Actions
- Clears Stagnant Fire from the Spleen and Stomach
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Heat or Fire
How it manifests:
Burning epigastric pain
Accompanying symptoms:
Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth...
Chai Hu Shu Gan San
Addresses these upper abdominal pain patterns:
Main Actions
- Disperses Stagnant Liver Qi and Blood
- Alleviates pain
- Harmonizes Blood
Addresses These Upper Abdominal Pain Pattern Variations
Liver Qi Stagnation
How it manifests:
Epigastic pain
Accompanying symptoms:
Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia...
Fei Er Wan
Addresses these upper abdominal pain patterns:
Main Actions
- Kills parasites
- Reduces accumulation
- Strengthens the Spleen
- Clears Heat
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Heat or Fire
How it manifests:
Burning epigastric pain
Accompanying symptoms:
Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth...
Yi Guan Jian
Addresses these upper abdominal pain patterns:
Main Actions
- Enriches the Yin
- Spreads the Liver Qi
Addresses These Upper Abdominal Pain Pattern Variations
Liver Qi Stagnation
How it manifests:
Epigastic pain
Accompanying symptoms:
Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia...
Hua Ban Tang
Addresses these upper abdominal pain patterns:
Main Actions
- Clears Qi-level Heat
- Cools the Blood
Addresses These Upper Abdominal Pain Pattern Variations
Stomach Heat or Fire
How it manifests:
Burning epigastric pain
Accompanying symptoms:
Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth...