The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
Peptic ulcers factsheet
Possible causes and remedies:
Symptoms: Weak voice Loose stools Poor appetite and two other symptoms
Recommended formula: Si Jun Zi Tang
Phlegm-Dampness in the Middle-Burner
Symptoms: Nausea Vomiting Focal distention and two other symptoms
Recommended formula: Liu Jun Zi Tang
In Chinese Medicine, peptic ulcers can be associated with seventeen so-called "patterns of disharmony". Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted. It is not equivalent to the Western concept of "disease", as a matter of fact here peptic ulcers can be caused by seventeen different patterns.
To understand whether someone's peptic ulcers might be caused by a given pattern, one needs to look for signs and symptoms associated with the pattern beyond what one might typically experience from peptic ulcers alone. For instance when peptic ulcers is caused by the pattern Spleen Qi Deficiency, patients also experience symptoms such as pale complexion, weak voice, poor appetite and loose stools. Similarly, patients with Spleen Qi Deficiency typically exhibit soggy (Ru) or weak (Ruo) pulses as well as a pale tongue.
We've listed below a description of the seventeen patterns associated with peptic ulcers so that you can start to get an understanding of the various possibilities according to Chinese Medicine.
Once identified, patterns are often treated using herbal formulas. Drinking herbal infusions is the most common remedy in Chinese Medicine, together with acupuncture. Here we detail below seventeen formulas that can help treat the various patterns associated with peptic ulcers, depending on which pattern fits your profile.
The seventeen "patterns of disharmony" associated with peptic ulcers
The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine
Spleen Qi Deficiency
Pulse type(s): Soggy (Ru), Weak (Ruo)
Tongue color: Pale
Recommended herbal formula: Si Jun Zi Tang
Symptoms: Weak voice Loose stools Poor appetite Pale complexion Weakness in the limbs
Peptic ulcers might be due to Spleen Qi Deficiency if the condition is paired with typical pattern symptoms such as pale complexion, weak voice, poor appetite and loose stools. Similarly, patients with Spleen Qi Deficiency typically exhibit soggy (Ru) or weak (Ruo) pulses as well as a pale tongue.
The Triple Burner is a so-called "Fu" Organ. Learn more about the Triple Burner in Chinese Medicine
Phlegm-Dampness in the Middle-Burner
Recommended herbal formula: Liu Jun Zi Tang
Symptoms: Nausea Vomiting Focal distention Coughing of copious thin and white sputum Stifling sensation in the chest and epigastrium
Peptic ulcers might be due to Phlegm-Dampness in the Middle-Burner if the condition is paired with typical pattern symptoms such as nausea, vomiting, stifling sensation in the chest and epigastrium and focal distention.
The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine
Blood Deficiency with disharmony of Liver and Spleen
Pulse type(s): Empty (Xu), Wiry (Xian)
Tongue color: Pale
Recommended herbal formula: Xiao Yao San
Symptoms: Anemia Vertigo Dizziness Headaches Dry mouth Chest pain Dry throat Leukorrhea Poor appetite Chest fullness Breast distention Irregular menstruation Alternating fever and chills
Peptic ulcers might be due to Blood Deficiency with disharmony of Liver and Spleen if the condition is paired with typical pattern symptoms such as chest fullness, chest pain, anemia and dizziness. Similarly, patients with Blood Deficiency with disharmony of Liver and Spleen typically exhibit empty (Xu) or wiry (Xian) pulses as well as a pale tongue.
Read more about Blood Deficiency with disharmony of Liver and Spleen here
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Liver Qi Stagnation
Pulse type(s): Wiry (Xian)
Recommended herbal formula: Chai Hu Shu Gan San
Symptoms: Belching Flank pain Irritability Suppressed emotions Feelings of frustration Alternating fever and chills Abdominal distention and fullness Stifling sensation in the chest causing one to have deep sighs
Peptic ulcers might be due to Liver Qi Stagnation if the condition is paired with typical pattern symptoms such as flank pain, stifling sensation in the chest causing one to have deep sighs, suppressed emotions and feelings of frustration. Similarly, patients with Liver Qi Stagnation typically exhibit wiry (Xian) pulses.
Crow-Dipper Rhizomes (Ban Xia) is the key herb for Er Chen Tang, a formula used for Damp-Cold Phlegm
Damp-Cold Phlegm
Pulse type(s): Slippery (Hua)
Tongue coating: Thick white coating
Recommended herbal formula: Er Chen Tang
Symptoms: Nausea Vomiting Dizziness Palpitations Focal distention Coughing with copious white sputum Stifling sensation in the chest and epigastrium
Peptic ulcers might be due to Damp-Cold Phlegm if the condition is paired with typical pattern symptoms such as nausea, vomiting, stifling sensation in the chest and epigastrium and palpitations. Similarly, patients with Damp-Cold Phlegm typically exhibit slippery (Hua) pulses as well as a tongue with thick white coating.
The Bladder is a so-called "Fu" Organ. Learn more about the Bladder in Chinese Medicine
Qi Stagnation in Gallbladder and Stomach with Phlegm Heat
Pulse type(s): Slippery (Hua), Wiry (Xian)
Tongue coating: Yellow coating
Recommended herbal formula: Wen Dan Tang
Symptoms: Anxiety Palpitations Slight thirst Nausea or vomiting Dizziness or vertigo Bitter taste in the mouth Indeterminate gnawing hunger Focal distention of the chest Coughing of copious thick yellow sputum Dream disturbed sleep with strange or unusual dreams
Peptic ulcers might be due to Qi Stagnation in Gallbladder and Stomach with Phlegm Heat if the condition is paired with typical pattern symptoms such as nausea or vomiting, dizziness or vertigo, dream disturbed sleep with strange or unusual dreams and palpitations. Similarly, patients with Qi Stagnation in Gallbladder and Stomach with Phlegm Heat typically exhibit slippery (Hua) or wiry (Xian) pulses as well as a tongue with yellow coating.
Read more about Qi Stagnation in Gallbladder and Stomach with Phlegm Heat here
The Lungs is a so-called "Zang" Organ. Learn more about the Lungs in Chinese Medicine
Phlegm Heat in the Lungs
Pulse type(s): Rapid (Shu), Slippery (Hua)
Tongue coating: Sticky coating, Yellow coating
Tongue shape: Swollen
Recommended herbal formula: Xiao Xian Xiong Tang
Symptoms: Clump Phlegm Chest pain Constipation Epigastric pain Clumping in the chest Bitter taste in the mouth Epigastric focal distention Focal distention of the chest Coughing of copious thick yellow sputum
Peptic ulcers might be due to Phlegm Heat in the Lungs if the condition is paired with typical pattern symptoms such as constipation, bitter taste in the mouth, coughing of copious thick yellow sputum and chest pain. Similarly, patients with Phlegm Heat in the Lungs typically exhibit rapid (Shu) or slippery (Hua) pulses as well as a tongue with sticky coating, yellow coating.
Atractylodes Rhizomes (Bai Zhu) is the key herb for Yue Ju Wan, a formula used for Qi Stagnation
Qi Stagnation
Pulse type(s): Wiry (Xian)
Tongue coating: Thin white coating
Tongue color: Normal (light red)
Recommended herbal formula: Yue Ju Wan
Symptoms: Belching Vomiting Acid reflux Indigestion Poor appetite Fixed pain in the hypochondria Mild coughing with copious sputum Stifling sensation in the chest and abdomen
Peptic ulcers might be due to Qi Stagnation if the condition is paired with typical pattern symptoms such as stifling sensation in the chest and abdomen, fixed pain in the hypochondria, belching and vomiting. Similarly, patients with Qi Stagnation typically exhibit wiry (Xian) pulses as well as a normal (light red) tongue with thin white coating.
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Lung Qi Deficiency and Liver Qi Stagnation
Pulse type(s): Empty (Xu), Tight (Jin)
Tongue coating: Thin white coating
Tongue color: Normal (light red), Pale
Recommended herbal formula: Xiao Chai Hu Tang
Symptoms: Coughing Dizziness Headaches Depression Moving pain Listlessness Hypochondrium fullness
Peptic ulcers might be due to Lung Qi Deficiency and Liver Qi Stagnation if the condition is paired with typical pattern symptoms such as coughing, hypochondrium fullness, dizziness and headaches. Similarly, patients with Lung Qi Deficiency and Liver Qi Stagnation typically exhibit empty (Xu) or tight (Jin) pulses as well as a normal (light red), pale tongue with thin white coating.
Read more about Lung Qi Deficiency and Liver Qi Stagnation here
The Triple Burner is a so-called "Fu" Organ. Learn more about the Triple Burner in Chinese Medicine
Phlegm-Heat in the Middle Burner
Pulse type(s): Rapid (Shu), Wiry (Xian)
Tongue coating: Yellow coating
Tongue color: Red tip
Recommended herbal formula: Ban Xia Xie Xin Tang
Symptoms: Poor appetite Abdominal fullness Dry heaves or vomiting Borborygmi with diarrhea Epigastric focal distention
Peptic ulcers might be due to Phlegm-Heat in the Middle Burner if the condition is paired with typical pattern symptoms such as epigastric focal distention, abdominal fullness, dry heaves or vomiting and borborygmi with diarrhea. Similarly, patients with Phlegm-Heat in the Middle Burner typically exhibit rapid (Shu) or wiry (Xian) pulses as well as a red tip tongue with yellow coating.
The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine
Stomach Qi Deficiency with Phelgm
Pulse type(s): Empty (Xu), Wiry (Xian)
Tongue coating: Thick white coating
Recommended herbal formula: Xuan Fu Dai Zhe Tang
Symptoms: Hiccuping Regurgitation Nausea or vomiting Unremitting belching Hard epigastric focal distention
Peptic ulcers might be due to Stomach Qi Deficiency with Phelgm if the condition is paired with typical pattern symptoms such as unremitting belching, hiccuping, regurgitation and nausea or vomiting. Similarly, patients with Stomach Qi Deficiency with Phelgm typically exhibit empty (Xu) or wiry (Xian) pulses as well as a tongue with thick white coating.
Ephedra (Ma Huang) is the key herb for Xiao Qing Long Tang, a formula used for Phlegm-Fluids above the diaphragm
Phlegm-Fluids above the diaphragm
Pulse type(s): Tight (Jin), Floating (Fu)
Tongue coating: Thick white coating
Tongue shape: Swollen
Recommended herbal formula: Xiao Qing Long Tang
Symptoms: Wheezing No thirst Absence of sweating Generalized body pain Alternating fever and chills General sensation of heaviness Stifling sensation in the chest Coughing of copious thin and white sputum
Peptic ulcers might be due to Phlegm-Fluids above the diaphragm if the condition is paired with typical pattern symptoms such as alternating fever and chills, absence of sweating, wheezing and stifling sensation in the chest. Similarly, patients with Phlegm-Fluids above the diaphragm typically exhibit tight (Jin) or floating (Fu) pulses as well as a tongue with thick white coating.
The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine
Heart and Spleen Deficiency
Pulse type(s): Fine (Xi)
Tongue coating: Thin white coating
Tongue color: Pale
Recommended herbal formula: Gui Pi Tang
Symptoms: Fatigue Anxiety Insomnia Menorrhagia Palpitations Forgetfulness Poor appetite Pale complexion Abnormal uterine bleeding
Peptic ulcers might be due to Heart and Spleen Deficiency if the condition is paired with typical pattern symptoms such as forgetfulness, palpitations, insomnia and fatigue. Similarly, patients with Heart and Spleen Deficiency typically exhibit fine (Xi) pulses as well as a pale tongue with thin white coating.
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Liver Qi Stagnation that transforms into Heat
Pulse type(s): Rapid (Shu), Wiry (Xian)
Tongue coating: Yellow coating
Tongue color: Red
Recommended herbal formula: Jin Ling Zi San
Symptoms: Hernial pain Irritability Bitter taste in the mouth Intermittent epigastric pain Painful periods that get worse with hot food or drinks
Peptic ulcers might be due to Liver Qi Stagnation that transforms into Heat if the condition is paired with typical pattern symptoms such as intermittent epigastric pain, hernial pain, painful periods that get worse with hot food or drinks and irritability. Similarly, patients with Liver Qi Stagnation that transforms into Heat typically exhibit rapid (Shu) or wiry (Xian) pulses as well as a red tongue with yellow coating.
Read more about Liver Qi Stagnation that transforms into Heat here
The Lungs is a so-called "Zang" Organ. Learn more about the Lungs in Chinese Medicine
Lung Yin Deficiency
Pulse type(s): Rapid (Shu), Empty (Xu), Floating (Fu)
Tongue coating: Complete absence of coating
Tongue color: Red
Recommended herbal formulas: Yang Yin Qing Fei Tang, Mai Men Dong Tang
Symptoms: Insomnia Dry cough Dry mouth Tiredness Weak voice Dry throat Malar flush Night sweats Hot palms and soles Thin body lacking strength
Exterior Heat and Dryness can invade the Lungs and exhausts the Body Fluids. If it is not dealt with for a long time, it leads to Lung Yin Deficiency. Other factors can cause this pattern such as the Deficiency of Kidneys or Stomach Yin as well as prolonged Lung Qi Deficiency due to excessive smoking or use of voice. Emotional stress such as sadness and grief may also deplete Lung Qi and Yin.
Empty Heat symptoms appear if the Lung Yin Deficiency condition is not treated for a while. Patients can feel malar flush, low-grade fever as well as Heat in the palms and chest, especially in the evenings.
The treatment principle is to tonify Lung Yin, nourish Body Fluids and clear Empty Heat if it is needed.
The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine
Stomach Yin Deficiency
Pulse type(s): Empty (Xu), Floating (Fu)
Tongue coating: Partial absence of coating
Tongue color: Red
Recommended herbal formulas: Mai Men Dong Tang, Yi Wei Tang
Symptoms: Thirst Retching Dry mouth Hiccuping Dry throat Dry stools Constipation Poor appetite Slight thirst Bleeding gums Epigastic pain Epigastric pain Feeling of hunger Feeling of fullness Hot palms and soles Feeling of heat in the afternoon
The Stomach is responsible for receiving foods and drinks, ripening them and sending them to the Spleen for further digestion. Therefore, the Stomach is the origin of Body Fluids. It is also an Organ that likes Cold and Dampness which are both Yin characteristics. Stomach Yin Deficiency harms the Organ's functions and cause Dryness and Heat. As a result, symptoms such as thirst, dry stools, dry mouth and dry throat appear.
However, this is just Empty Heat due to lacking of Yin (and not the Excess of Yang), so the feeling of Heat often only happens in the afternoons or evenings. The patients experiences thirst or hunger but there is no desire to drink or eat, or they only drink in small sips. They also prefer warm liquids and their appetite is poor. Due to lack of Body Fluids, there is constipation with dry stools. Retching and hiccups may occur as Stomach's Qi downward function is impaired.
Unbalanced diet and bad eating habits are the major reasons for this pattern. The patients may often consume spicy and acrid foods, which deplete Stomach Fluids and Yin. Prolonged irregular eating habits also have similar negative impact, such as eating on the run, skipping meals, eating while working, having late meals or working right after eating. Finally chronic Stomach disease can also be a cause. In additional to above reasons, a high fever during an infectious disease or overconsumption of antibiotics can also lead to an acute Stomach Yin Deficiency.
The treatment principle is to nourish Stomach Yin and Body Fluids.
Poria-Cocos Mushrooms (Fu Ling) is the key herb for Ling Gui Zhu Gan Tang, a formula used for Phlegm-Fluids in the hypochondrium
Phlegm-Fluids in the hypochondrium
Pulse type(s): Slippery (Hua), Soggy (Ru), Wiry (Xian)
Tongue coating: Thick white coating
Tongue color: Pale
Tongue shape: Swollen
Recommended herbal formula: Ling Gui Zhu Gan Tang
Symptoms: Palpitations Dizziness or vertigo
Peptic ulcers might be due to Phlegm-Fluids in the hypochondrium if the condition is paired with typical pattern symptoms such as palpitations and dizziness or vertigo. Similarly, patients with Phlegm-Fluids in the hypochondrium typically exhibit slippery (Hua), soggy (Ru) or wiry (Xian) pulses as well as a pale tongue with thick white coating.
The seventeen herbal formulas that might help with peptic ulcers
Liu Jun Zi Tang
Source date: 1107
Number of ingredients: 6 herbs
Key actions: Tonifies Qi. Strengthens the Spleen and Stomach. Clears Phlegm and mucus. Promotes appetite.
Why might Liu Jun Zi Tang help with peptic ulcers?
Because it is a formula often recommended to help with the patterns Spleen Qi Deficiency and Phlegm-Dampness in the Middle-Burner which are sometimes associated with peptic ulcers. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Mai Men Dong Tang
Source date: 220 AD
Number of ingredients: 6 herbs
Key actions: Nourishes the Stomach. Generates Body Fluids. Directs Rebellious Qi downward.
Why might Mai Men Dong Tang help with peptic ulcers?
Because it is a formula often recommended to help with the patterns Lung Yin Deficiency and Stomach Yin Deficiency which are sometimes associated with peptic ulcers. If any of these patterns look like something you might suffer from, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Si Jun Zi Tang
Source date: 1107 AD
Number of ingredients: 4 herbs
Key actions: Tonifies Qi. Strengthens the Spleen and Stomach.
Why might Si Jun Zi Tang help with peptic ulcers?
Because it is a formula often recommended to help treat Spleen Qi Deficiency, a pattern sometimes associated with peptic ulcers. If it looks like you might suffer from Spleen Qi Deficiency, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Xiao Yao San
Source date: 1107 AD
Number of ingredients: 6 herbs
Key actions: Harmonizes the function of Liver and Spleen. Relieves Liver Qi stagnation. Nourishes the Blood.
Why might Xiao Yao San help with peptic ulcers?
Because it is a formula often recommended to help treat Blood Deficiency with disharmony of Liver and Spleen, a pattern sometimes associated with peptic ulcers. If it looks like you might suffer from Blood Deficiency with disharmony of Liver and Spleen, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Chai Hu Shu Gan San
Source date: 1602
Number of ingredients: 7 herbs
Key actions: Disperses Stagnant Liver Qi and Blood. Alleviates pain. Harmonizes Blood.
Why might Chai Hu Shu Gan San help with peptic ulcers?
Because it is a formula often recommended to help treat Liver Qi Stagnation, a pattern sometimes associated with peptic ulcers. If it looks like you might suffer from Liver Qi Stagnation, this formula might help (although please seek confirmation with a professional practitioner beforehand).
Symptoms related to peptic ulcers
Poor appetite Palpitations Vomiting Dizziness Dry mouth Dry throat Alternating fever and chills Bitter taste in the mouth Pale complexion Weak voice
