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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".
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".
The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine
Phlegm in Kidneys or Gallbladder
Pulse type(s): Slippery (Hua), Wiry (Xian)
Tongue coating: Sticky coating, Thick coating
Tongue shape: Swollen
According to Chinese medicine, gallstones or kidney stones are a form of Phlegm.
In addition to epigastric pain, other symptoms associated with Phlegm in Kidneys or Gallbladder include gallstones, kidney stones and back pain.
Phlegm in Kidneys or Gallbladder is often treated with Si Ni San, a herbal formula made of 4 herbs (including Bupleurum Roots - Chai Hu - as a key herb). Si Ni 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: "Regulates Liver and Spleen".
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".
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".
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.
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.
Pai Shi Tang
Number of ingredients: 10 herbs
Key actions: Discharge Gallstones. Clear Damp-Heat. Facilitate urination.
Why might Pai Shi Tang help with epigastric pain?
Because it is a formula often recommended to treat the pattern 'Phlegm in Kidneys or Gallbladder' of which epigastric pain is a symptom.
Other symptoms characteristic of Phlegm In Kidneys Or Gallbladder include gallstones, kidney stones and back pain.
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.
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.
Acupuncture points used for epigastric pain
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
Why might Sichuan Chinaberry (Chuan Lian Zi) 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 Pai Shi Tang for instance).
Sichuan Chinaberries is a Cold herb that tastes Bitter. It targets the Spleen, the Liver and the Small intestine.
Its main actions are: Clears Damp Heat. Circulates Qi. Relieves chest, epigastric and abdominal pains. Expels parasites.
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.
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 Si Ni San or Shen Ling Bai Zhu 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.
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).
Other symptoms often associated with epigastric pain
Nausea Poor appetite Chest pain Vomiting Irritability Constipation Dry stools Feeling of heat Dry mouth Bleeding gums