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 vomiting, irritability and nausea in the pattern “Stomach Qi 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 Qi Stagnation

Pulse type(s): Wiry (Xian)

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

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 constipation, poor appetite and dry mouth.

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, epigastric distension 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, bitter taste in the mouth 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

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, weak limbs and preference for warm drinks and foods.

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

Five herbal formulas that might help with epigastric pain

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 vomiting, irritability and nausea.

Read more about Zuo Jin Wan here

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 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 constipation, poor appetite and dry mouth.

Read more about Mai Men Dong Tang here

Si Mo Tang

Source date: 1253 AD

Number of ingredients: 4 herbs

Key actions: Promotes the movement of Qi. Directs rebellious Qi downward. Expands the chest and dissipates clumping.

Why might Si Mo 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, epigastric distension and sour regurgitation.

Read more about Si Mo 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, bitter taste in the mouth and feeling of heaviness.

Read more about Lian Po Yin 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 is a symptom.

Other symptoms characteristic of Stomach Deficient And Cold include poor appetite, weak limbs and preference for warm drinks and foods.

Read more about Xiao Jian Zhong Tang 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 Ginseng (Ren Shen) help with epigastric pain?

Because Ginseng is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Mai Men Dong Tang or Si Mo 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

Why might Fresh Ginger (Sheng Jiang) help with epigastric pain?

Because Fresh Ginger is an ingredient in several formulas indicated to treat epigastric pain as a symptom, like Ding Xiang Shi Di Tang or Xuan Fu Dai Zhe Tang for instance.

Fresh Ginger is a Warm herb that tastes Pungent. It targets the Spleen, the Stomach and the Lung.

Its main actions are: Relieves the Exterior and disperses Cold. Warms and circulates Qi in the Middle Burner. Calms a restless fetus and treats morning sickness. Treats seafood poisoning.

Read more about Fresh Ginger 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 Ju Pi Zhu Ru Tang or Mai Men Dong Tang 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