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, irritability and constipation in the pattern “Stomach Heat or Fire”. 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 Heat or Fire

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

Tongue coating: Yellow coating

Tongue color: Red centre

Stomach Fire indicates a true Excess of Heat in the Stomach, creating symptoms such as mouth ulcers, bad breath, intense thirst and gum bleeding. Stomach Fire can be the result of excessive intake of hot, spicy, greasy and deep fried foods or other factors such as alcohol, tobacco and sugar.

In addition to epigastric pain, other symptoms associated with Stomach Heat or Fire include nausea, irritability and constipation.

Stomach Heat or Fire is often treated with Tiao Wei Cheng Qi Tang, a herbal formula made of 3 herbs (including Rhubarb - Da Huang - as a key herb). Tiao Wei Cheng Qi Tang belongs to the category of "formulas that purge heat accumulation", which might be why it is often recommended for this pattern. Its main action as a formula is: "Removes Heat and Dryness in the Lower Burner".

Read more about Stomach Heat or Fire 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)

Tongue color: Normal (light red)

When Liver Qi does not flow smoothly or regularly, it becomes Stagnant and in Excess. This leads to Heat accumulating in the Liver. The feeling of ‘Distension’ (zhang 胀) is the main symptom of Liver Qi Stagnation.

In addition to epigastric pain, other symptoms associated with Liver Qi Stagnation include nausea, poor appetite and vomiting.

From a Western Medicine standpoint Liver Qi Stagnation is associated with health issues such as Low Breast Milk Supply, Mastitis or Breast Engorgement.

Liver Qi Stagnation is often treated with Xiao Yao San, a herbal formula made of 6 herbs (including Bupleurum Roots - Chai Hu - as a key herb). Xiao Yao San belongs to the category of "formulas that harmonize liver-spleen", which might be why it is often recommended for this pattern. Its main action as a formula is: "Harmonizes the function of Liver and Spleen".

Read more about Liver Qi Stagnation here

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

Stomach Deficient and Cold

Pulse type(s): Deep (Chen), Slow (Chi), Weak (Ruo)

In addition to epigastric pain, other symptoms associated with Stomach Deficient and Cold include poor appetite, cold limbs and weak limbs.

Stomach Deficient and Cold is often treated with Xiao Jian Zhong Tang, a herbal formula made of 6 herbs (including Maltose - Yi Tang - as a key herb). Xiao Jian Zhong Tang belongs to the category of "formulas that warm the middle and dispel cold", which might be why it is often recommended for this pattern. Its main action as a formula is: "Warms and tonifies the Middle Burner (Spleen and Stomach)".

Read more about Stomach Deficient and Cold 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

Cold invading the Stomach

Pulse type(s): Deep (Chen), Slow (Chi), Tight (Jin)

The Stomach is one of three Organs which can be directly invaded by Exterior Cold (along with the Large Intestine and Uterus). It is an acute condition caused by exposure to cold from improper dressing and excessive consumption of cold foods and iced drinks.

In addition to epigastric pain, other symptoms associated with Cold invading the Stomach include nausea, cold limbs and preference for warm drinks and foods.

Cold invading the Stomach is often treated with Liang Fu Wan, a herbal formula made of 2 herbs (including Lesser Galangal Rhizomes - Gao Liang jiang - as a key herb). Liang Fu Wan 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: "Warms the Middle Burner".

Read more about Cold invading the Stomach here

Five herbal formulas that might help with epigastric pain

Tiao Wei Cheng Qi Tang

Source date: 220 AD

Number of ingredients: 3 herbs

Key actions: Removes Heat and Dryness in the Lower Burner. Removes constipation.

Why might Tiao Wei Cheng Qi Tang help with epigastric pain?

Because it is a formula often recommended to treat the pattern 'Stomach Heat or Fire' of which burning epigastric pain is a symptom.

Read more about Tiao Wei Cheng Qi Tang here

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 epigastric pain?

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

Read more about Xiao Yao San here

Xiao Jian Zhong Tang

Source date: 220 AD

Number of ingredients: 6 herbs

Key actions: Warms and tonifies the Middle Burner (Spleen and Stomach). Tonifies Qi. Relieves spasmodic pain.

Why might Xiao Jian Zhong Tang help with epigastric pain?

Because it is a formula often recommended to treat the pattern 'Stomach Deficient and Cold' of which epigastric pain relieved with pressure or eating is a symptom.

Read more about Xiao Jian Zhong Tang here

Ban Xia Hou Pu Tang

Source date: 220 AD

Number of ingredients: 5 herbs

Key actions: Regulates the flow of Qi, treats esophageal spasm. Clears Phlegm.

Why might Ban Xia Hou Pu Tang 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.

Read more about Ban Xia Hou Pu Tang here

Liang Fu Wan

Source date: 1842 AD

Number of ingredients: 2 herbs

Key actions: Warms the Middle Burner. Dispels Cold. Promotes the movement of Qi. Alleviates Pain.

Why might Liang Fu Wan help with epigastric pain?

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

Read more about Liang Fu Wan here

Acupuncture points used for epigastric pain

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

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 Mai Men Dong Tang for instance.

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

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 Poria-Cocos Mushroom (Fu Ling) help with epigastric pain?

Because Poria-Cocos Mushroom is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Wu Pi Yin or Wu Ling San for instance.

Poria-Cocos Mushrooms is a Neutral herb that tastes Sweet. It targets the Heart, the Kidney, the Lung and the Spleen.

Its main actions are: Encourages urination and drains Dampness. Tonic to the Spleen/Stomach. Assists the Heart and calms the Spirit.

Read more about Poria-Cocos Mushrooms here

Why might White Peony Root (Bai Shao) help with epigastric pain?

Because White Peony Root is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Xiao Yao San or Jia Wei Xiao Yao San for instance.

White Peony Roots is a Neutral herb that tastes Bitter and Sour. It targets the Liver and the Spleen.

Its main actions are: Tonifies the Blood and preserves the Yin. Nourishes the Liver and assists in the smooth flow of Qi. Regulates the meridians and eases the pain.

Read more about White Peony Roots here

Why might Atractylodes Rhizome (Bai Zhu) help with epigastric pain?

Because Atractylodes Rhizome is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Yue Ju Wan or Shen Ling Bai Zhu San for instance.

Atractylodes Rhizomes is a Warm herb that tastes Bitter and Sweet. It targets the Spleen and the Stomach.

Its main actions are: Tonifies the Spleen Qi. Fortifies the Spleen Yang and dispels Damp through urination. Tonifies Qi and stops sweating. Calms restless fetus when due to Deficiency of Spleen Qi.

Read more about Atractylodes Rhizomes here

Why might Flying Squirrel Faeces (Wu Ling Zhi) help with epigastric pain?

Because Flying Squirrel Faeces is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Shi Xiao San or Ge Xia Zhu Yu Tang for instance.

Flying Squirrel Faeces is a Warm herb that tastes Bitter and Sweet. It targets the Spleen and the Liver.

Its main actions are: Disperses congealed Blood in the lower abdomen and uterus and relieves pain. Promotes childhood nutrition with Cold Stagnation and focal abdominal swelling.

Read more about Flying Squirrel Faeces here