Upper Abdominal Pain in Traditional Chinese Medicine

Understanding different upper abdominal pain patterns according to TCM theory

Educational content Consult qualified practitioners for medical advice

Overview
What causes it 9 TCM patterns documented
How to recognize Symptoms specific to each upper abdominal pain pattern
Classical remedies 36 herbal formulas documented

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

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

Causes: Epigastric pain, Abdominal and epigastric pain, Burning abdominal pain, Burning epigastric pain, Intermittent epigastric pain

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 Stomach
How it presents with upper abdominal pain

Epigastric pain

Along with: Upper abdominal pain, Upper abdominal fullness, Feeling of heaviness, Face pain, Congested nose, Thick nasal discharge,

Traditional Herbal Formulas
Phlegm-Heat in the Lungs
How it presents with upper abdominal pain

Epigastric pain

Along with: Coughing, Shortness of breath, Wheezing, Stifling sensation in the chest, Sputum, Feeling of heat,

Traditional Herbal Formulas
Damp-Heat invading the Spleen
How it presents with upper abdominal pain

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,

Traditional Herbal Formulas
Heat in Lessor Yang
How it presents with upper abdominal pain

Burning abdominal pain

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

Traditional Herbal Formulas
Stomach Heat or Fire
How it presents with upper abdominal pain

Burning epigastric pain

Along with: Upper abdominal burning pain, Excessive thirst, Craving for cold beverages, Restlessness, Dry stools, Dry mouth,

Liver Qi Stagnation that transforms into Heat
How it presents with upper abdominal pain

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,

Traditional Herbal Formulas

Qi Stagnation

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

Causes: Epigastric pain, Epigastic pain, Intermittent epigastric pain

3 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.

Stomach Qi Stagnation
How it presents with upper abdominal pain

Epigastric pain

Along with: Upper abdominal pain, Upper abdominal distension, Belching, Nausea, Vomit, Hiccups,

Traditional Herbal Formulas
Liver Qi Stagnation
How it presents with upper abdominal pain

Epigastic pain

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

Liver Qi Stagnation that transforms into Heat
How it presents with upper abdominal pain

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,

Traditional Herbal Formulas

Phlegm

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

Causes: Epigastric pain

2 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."

Phlegm in Kidneys or Gallbladder
How it presents with upper abdominal pain

Epigastric pain

Along with: Frequent and urgent urination, Urinary dysfunction, Hematuria

Traditional Herbal Formulas
Phlegm-Heat in the Lungs
How it presents with upper abdominal pain

Epigastric pain

Along with: Coughing, Shortness of breath, Wheezing, Stifling sensation in the chest, Sputum, Feeling of heat,

Traditional Herbal Formulas

Dampness

Heavy, sticky moisture that obstructs body functions and creates sluggishness

Causes: Epigastric pain, Abdominal and epigastric pain

2 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-Heat in the Stomach
How it presents with upper abdominal pain

Epigastric pain

Along with: Upper abdominal pain, Upper abdominal fullness, Feeling of heaviness, Face pain, Congested nose, Thick nasal discharge,

Traditional Herbal Formulas
Damp-Heat invading the Spleen
How it presents with upper abdominal pain

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,

Traditional Herbal Formulas

Qi Rebellion

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

Causes: Epigastric pain

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 Liver Qi invading the Stomach
How it presents with upper abdominal pain

Epigastric pain

Along with: Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression,

Yin Deficiency

Depletion of cooling, moistening fluids causing dryness, false heat rising, and restless agitation throughout the body

Causes: Epigastric pain, Epigastic pain

1 variation documented
Onset Gradual
Location Systemic
Features Night sweats • Dry mouth/throat • Heat in afternoon/evening • Malar flush

Yin Deficiency represents a fundamental pattern in Traditional Chinese Medicine where the body's yin fluids - blood, essence, and body fluids - become depleted, losing their ability to cool, moisten, and anchor the yang energy, resulting in relative hyperactivity of yang and internal heat manifestations.

Stomach Yin Deficiency
How it presents with upper abdominal pain

Epigastric pain, Epigastic pain

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

Blood Stasis

Blood that is no longer flowing smoothly through the vessels

Causes: Epigastric pain

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.

Stomach Blood Stagnation
How it presents with upper abdominal pain

Epigastric pain

Along with: Nocturnal epigastric pain, Abdominal pain worsened by pressure, Nausea or vomiting, Potential vomiting of blood, Hematochezia

Traditional Herbal Formulas

Yin Excess

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

Causes: Epigastric pain worsen by pressure

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 upper abdominal pain

Epigastric pain worsen by pressure

Along with: Absence of thirst, Slow and forceful movement, Polyuria, Feeling of chest oppression, Nausea, Excessive vaginal discharge,

Traditional Herbal Formulas

Cold

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

Causes: Severe epigastric pain

1 variation 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 invading the Stomach
How it presents with upper abdominal pain

Severe epigastric pain

Along with: Severe upper abdominal pain, Chills, Cold extremities, Desire for hot beverages and foods, Vomiting clear liquid, Nausea,

Herbal Formulas for Upper Abdominal Pain

Traditional Chinese Medicine formulas used to address upper abdominal pain

Ban Xia Hou Pu Tang

Addresses these upper abdominal pain patterns:

Qi Rebellion Qi Stagnation

Lian Po Yin

Addresses these upper abdominal pain patterns:

Heat Dampness

Chai Hu Shu Gan San

Addresses these upper abdominal pain patterns:

Qi Stagnation

Ding Xiang Shi Di Tang

Addresses these upper abdominal pain patterns:

Qi Rebellion

Fei Er Wan

Addresses these upper abdominal pain patterns:

Heat

Ge Hua Jie Cheng San

Addresses these upper abdominal pain patterns:

Heat Dampness

Hua Ban Tang

Addresses these upper abdominal pain patterns:

Heat

Huang Qin Tang

Addresses these upper abdominal pain patterns:

Heat

Huo Xiang Zheng Qi San

Addresses these upper abdominal pain patterns:

Cold