Epigastric pain according to Chinese Medicine

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Epigastric pain can be the consequence of several so-called “patterns of disharmony” in Chinese Medicine.

Chinese Medicine sees the body as a system, not a sum of isolated parts. A "pattern" is when the system's harmony is disrupted, leading to symptoms or signs that something is wrong (like epigastric pain here). It is similar to the concept of disease in Western Medicine but not quite: a Western disease can often be explained by several Chinese patterns and vice-versa.

A pattern often manifests itself in a combination of symptoms that, at first glance, do not seem necessarily related to each others. For instance here epigastric pain is often associated with nausea, vomiting and vomiting of blood in the pattern “Stomach Blood Stagnation”. As you will see below, we have in record five patterns that can cause epigastric pain.

Once identified, patterns are treated using medicinal herbs, acupuncture, and other therapies. In the case of epigastric pain we’ve identified five herbal formulas that may help treat patterns behind the symptom.

We’ve also selected below the five medicinal herbs that we think are most likely to help treat epigastric pain.

The five "patterns of disharmony" that can cause epigastric pain

In Chinese Medicine epigastric pain is a symptom for 5 patterns that we have on record. Below is a small explanation for each of them with links for more details.

The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine

Stomach Blood Stagnation

Pulse type(s): Wiry (Xian)

Tongue color: Bluish-Purple

In addition to epigastric pain, other symptoms associated with Stomach Blood Stagnation include nausea, vomiting and vomiting of blood.

Stomach Blood Stagnation is often treated with Shi Xiao San, a herbal formula made of 2 herbs (including Cattail Pollen - Pu Huang - as a key herb). Shi Xiao San belongs to the category of "formulas that invigorate blood and dispel blood stagnation", which might be why it is often recommended for this pattern. Its main action as a formula is: "Invigorates Blood".

Read more about Stomach Blood Stagnation here

The Stomach is a so-called "Fu" Organ. Learn more about the Stomach in Chinese Medicine

Stomach Qi Stagnation

Pulse type(s): Wiry (Xian)

In addition to epigastric pain, other symptoms associated with Stomach Qi Stagnation include nausea, vomiting and irritability.

Stomach Qi Stagnation is often treated with Ban Xia Hou Pu Tang, a herbal formula made of 5 herbs (including Crow-Dipper Rhizomes - Ban Xia - as a key herb). Ban Xia Hou Pu Tang belongs to the category of "formulas that promote qi movement", which might be why it is often recommended for this pattern. Its main action as a formula is: "Regulates the flow of Qi, treats esophageal spasm".

Read more about Stomach Qi Stagnation here

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

Stomach Yin Deficiency causes Dryness and Heat, which harms the Organ's ability of receiving and ripening foods and drinks. It is the result of prolonged unbalanced diet and irregular eating habits.

In addition to epigastric pain, other symptoms associated with Stomach Yin Deficiency include poor appetite, constipation and dry stools.

Stomach Yin Deficiency is often treated with Mai Men Dong Tang, a herbal formula made of 6 herbs (including Dwarf Lilyturf Roots - Mai Dong - as a key herb). Mai Men Dong Tang belongs to the category of "formulas that enrich yin and moisten dryness", which might be why it is often recommended for this pattern. Its main action as a formula is: "Nourishes the Stomach".

Read more about Stomach Yin Deficiency here

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Rebellious Liver Qi invading the Stomach

Pulse type(s): Weak (Ruo), Wiry (Xian)

In addition to epigastric pain, other symptoms associated with Rebellious Liver Qi invading the Stomach include irritability, belching and sour regurgitation.

Rebellious Liver Qi invading the Stomach is often treated with Xuan Fu Dai Zhe Tang, a herbal formula made of 7 herbs (including Inula Flowers - Xuan Fu Hua - as a key herb). Xuan Fu Dai Zhe Tang belongs to the category of "formulas for a rebellious qi", which might be why it is often recommended for this pattern. Its main action as a formula is: "Regulates the downward flow of Stomach Qi".

Read more about Rebellious Liver Qi invading the Stomach here

The Spleen is a so-called "Zang" Organ. Learn more about the Spleen in Chinese Medicine

Damp-Heat invading the Spleen

Pulse type(s): Rapid (Shu), Slippery (Hua)

In addition to epigastric pain, other symptoms associated with Damp-Heat invading the Spleen include poor appetite, feeling of heat and feeling of heaviness.

Damp-Heat invading the Spleen is often treated with Lian Po Yin, a herbal formula made of 7 herbs (including Goldthread Rhizomes - Huang Lian - as a key herb). Lian Po Yin belongs to the category of "formulas that clear heat and expel dampness", which might be why it is often recommended for this pattern. Its main action as a formula is: "Clears Heat".

Read more about Damp-Heat invading the Spleen here

Five herbal formulas that might help with epigastric pain

Ge Xia Zhu Yu Tang

Source date: 1830 AD

Number of ingredients: 12 herbs

Key actions: Invigorates Blood. Eliminates Blood Stagnation below the diaphragm. Stops pain. Promotes Qi movement.

Why might Ge Xia Zhu Yu Tang help with epigastric pain?

Because it is a formula often recommended to treat the pattern 'Stomach Blood Stagnation' of which epigastric pain is a symptom.

Other symptoms characteristic of Stomach Blood Stagnation include nausea, vomiting and vomiting of blood.

Read more about Ge Xia Zhu Yu Tang here

Zuo Jin Wan

Source date: 1481 AD

Number of ingredients: 2 herbs

Key actions: Clears Liver Heat. Directs Rebellious Qi downward. Stops vomiting.

Why might Zuo Jin Wan help with epigastric pain?

Because it is a formula often recommended to treat the pattern 'Stomach Qi Stagnation' of which epigastric pain is a symptom.

Other symptoms characteristic of Stomach Qi Stagnation include nausea, vomiting and irritability.

Read more about Zuo Jin Wan here

Shen Ling Bai Zhu San

Source date: 1107 AD

Number of ingredients: 10 herbs

Key actions: Augments the Qi. Strengthens the Spleen. Leaches out Dampness. Stops diarrhea.

Why might Shen Ling Bai Zhu San help with epigastric pain?

Because it is a formula often recommended to treat the pattern 'Stomach Yin Deficiency' of which epigastric pain is a symptom.

Other symptoms characteristic of Stomach Yin Deficiency include poor appetite, constipation and dry stools.

Read more about Shen Ling Bai Zhu San here

Ju Pi Zhu Ru Tang

Source date: Essentials from the Golden Cabinet

Number of ingredients: 6 herbs

Key actions: Directs rebellious Qi downward. Stops hiccup. Augments Qi. Clears heat.

Why might Ju Pi Zhu Ru Tang help with epigastric pain?

Because it is a formula often recommended to treat the pattern 'Rebellious Liver Qi invading the Stomach' of which epigastric pain is a symptom.

Other symptoms characteristic of Rebellious Liver Qi Invading The Stomach include irritability, belching and sour regurgitation.

Read more about Ju Pi Zhu Ru Tang here

Lian Po Yin

Source date: 1862 AD

Number of ingredients: 7 herbs

Key actions: Clears Heat. Transforms Dampness. Regulates Qi. Harmonizes the Middle Burner.

Why might Lian Po Yin help with epigastric pain?

Because it is a formula often recommended to treat the pattern 'Damp-Heat invading the Spleen' of which epigastric pain is a symptom.

Other symptoms characteristic of Damp-Heat Invading The Spleen include poor appetite, feeling of heat and feeling of heaviness.

Read more about Lian Po Yin here

The five Chinese Medicinal herbs most likely to help treat epigastric pain

Why might Evodia Fruit (Wu Zhu Yu) help with epigastric pain?

Because it is both specifically indicated to treat epigastric pain and also because it is an ingredient in herbal formulas known to treat epigastric pain as a symptom (such as Zuo Jin Wan for instance).

Evodia Fruits is a Hot herb that tastes Bitter and Pungent. It targets the Spleen, the Stomach, the Kidney and the Liver.

Its main actions are: Warms the Spleen, expels Cold, relieves pain and helps the Liver. Directs Rebellious Qi downward

Read more about Evodia Fruits here

Why might Corydalis Tuber (Yan Hu Suo) help with epigastric pain?

Because it is both specifically indicated to treat epigastric pain and also because it is an ingredient in herbal formulas known to treat epigastric pain as a symptom (such as Ge Xia Zhu Yu Tang for instance).

Corydalis Tubers is a Warm herb that tastes Bitter and Pungent. It targets the Spleen, the Heart, the Liver and the Lung.

Its main actions are: Moves the Blood, breaks Blood Stagnation and reduces associated pain. Regulates Stagnant Qi and reduces associated pain.

Read more about Corydalis Tubers here

Why might Liquorice (Gan Cao) help with epigastric pain?

Because Liquorice is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Shen Ling Bai Zhu San or Jia Wei Xiao Yao San for instance.

Liquorice is a Neutral herb that tastes Sweet. It targets the Spleen, the Stomach, the Heart and the Lung.

Its main actions are: Tonifies the Basal Qi and nourishes the Spleen Qi. Clears Heat and dispels toxicity. Moistens the Lungsexpel phlegm and stop coughing. Relieves spasms and alleviates pain. Harmonizes and moderates the effects of other herbs.

Read more about Liquorice here

Why might Ginseng (Ren Shen) help with epigastric pain?

Because Ginseng is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Shen Ling Bai Zhu San or Mai Men Dong Tang for instance.

Ginseng is a Warm herb that tastes Bitter and Sweet. It targets the Spleen, the Heart and the Lung.

Its main actions are: Very strongly tonifies the Qi. Tonifies the Lungs and Spleen. Assists the body in the secretion of Fluids and stops thirst. Strengthens the Heart and calms the Shen (mind/spirit).

Read more about Ginseng here

Why might Crow-Dipper Rhizome (Ban Xia) help with epigastric pain?

Because Crow-Dipper Rhizome is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Ban Xia Hou Pu Tang or Xuan Fu Dai Zhe Tang for instance.

Crow-Dipper Rhizomes is a Warm herb that tastes Pungent. It targets the Spleen, the Stomach and the Lung.

Its main actions are: Drains Dampness and reduces Phlegm. Reverses the flow of Rebellious Qi. Reduces hardenings and relieves distention.

Read more about Crow-Dipper Rhizomes here