Upper Abdominal Distensionaccording to TCM

What is Upper Abdominal Distension?

Upper abdominal distension is a common symptom characterized by an uncomfortable feeling of tightness or swelling in the upper part of the abdomen. It is often associated with a range of conditions, manifesting as a bloated feeling in the epigastric region.

This discomfort can vary in intensity and may be accompanied by other symptoms such as nausea, belching, or a feeling of fullness even after a light meal. It's important to distinguish this symptom from other forms of abdominal swelling or distention for accurate diagnosis and treatment.

How Does TCM View Upper Abdominal Distension?

In Traditional Chinese Medicine (TCM), upper abdominal distension is viewed through the lens of energetic imbalances and blockages within the body's organ systems. TCM practitioners believe that this symptom arises from disruptions in the flow of Qi (vital energy) and Blood, often due to factors such as emotional stress, dietary habits, or environmental conditions.

TCM emphasizes the interconnectedness of the body's systems, hence the importance of identifying the underlying patterns of disharmony to effectively address the root causes of the symptom.

Root Causes of Upper Abdominal Distension in TCM

TCM identifies several patterns that can lead to upper abdominal distension, focusing on the flow and balance of Qi and Blood within the body. Liver Qi Stagnation is a primary cause, characterized by the interruption of Qi flow, leading to symptoms like hypochondriac distention and mood swings. Another significant pattern is the obstruction of the Spleen by Dampness coupled with Liver Qi Stagnation, manifesting as nausea, lack of appetite, and a sensation of heaviness.

Additionally, Rebellious Liver Qi invading the Stomach is highlighted as a critical pattern, where the Qi of the Liver disrupts the normal function of the Stomach, causing symptoms such as epigastric distension, irritability, and nausea.

Explore below more details about what might cause Upper abdominal distension according to TCM.

  • By Syndrome
  • By Organ
  • Liver
  • Stomach
  • Spleen
Detailed description of the cause

Qi Stagnation

Qi Stagnation in TCM is like having a traffic jam in your body's energy system. Qi, the vital life force that flows through your body, is supposed to move smoothly to maintain health and balance. But with Qi Stagnation, this flow gets blocked or slowed down, like cars stuck on a highway. This can lead to symptoms like feeling stressed, emotional mood swings, and physical discomfort, often described as a feeling of fullness or tightness, especially in the chest or abdomen. It's as though the body's internal energy circulation is disrupted, causing various issues. TCM sees this as an energy flow problem, different from modern medicine's focus on specific physiological processes.... see more

Qi Stagnation Patterns That Can Lead to Upper Abdominal Distension

Common Symptoms: Irritability Hypochondriac Distention Depression Nausea Lack Of Appetite Belching Abdominal Distention Melancholia

Pattern Name Relevant Symptoms Relevant Formulas
Liver Qi Stagnation Epigastric distension, Epigastrium distension, Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia, Depression, Mood swings, Irregular periods, Globus sensation, Pre menstrual breast distension, Pre menstrual tension, Anxiety, Anger... see more Xia Ru Yong Quan San | Xiao Yao San | Yue Ju Wan | Chai Hu Shu Gan San | Jia Wei Xiao Yao San | Yi Guan Jian
Obstruction Of the Spleen By Dampness with Liver Qi Stagnation Epigastric distension, Upper abdominal oppression, Nausea, Lack of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink, Dull shallow face, Irritability, Upper abdominal distension, Hypochondriac distention, Hypochondriac pain... see more Ping Wei San | Dang Gui Shao Yao San
Stagnant Liver Qi turning into Fire Epigastric distension, Hypochondriac distention, Upper abdominal distension, Feeling of oppression of the chest, Irritability, Melancholia, Depression, Mood swings, Globus sensation, Feeling hot, Flushed face, Thirst, Anger, Pre menstrual tension, Irregular periods, Pre menstrual breast distension, Excessive menstruation... see more Dan Zhi Xiao Yao San
Stomach Qi Stagnation Epigastric distension, Upper abdominal pain, Upper abdominal distension, Belching, Nausea, Vomit, Hiccups, Irritability... see more Ban Xia Hou Pu Tang | Zuo Jin Wan
Liver Qi Stagnation invading the Stomach Epigastric distension, Belching, Abdominal distention, Upper abdominal distension, Depression, Irritability, Dry mouth, Lack of appetite, Craving for sour foods, Dry throat, Acid reflux... see more Ban Xia Hou Pu Tang | Zuo Jin Wan
Detailed description of the cause

Qi Rebellion

Rebellious Qi in TCM is a bit like having a rebel inside your body. Qi, which is the vital energy flowing through your body, is supposed to move in certain directions to keep everything in balance and working well. But with Rebellious Qi, this energy decides to go the opposite way. Think of it like a river flowing upstream instead of downstream. This can cause various issues like heartburn, coughing, or even headaches. It's as if the body's natural flow is disrupted, creating a kind of internal chaos. TCM focuses on correcting this flow, restoring order and balance.... see more

Qi Rebellion Patterns That Can Lead to Upper Abdominal Distension

Common Symptoms: Hypochondriac Distention Hiccups Sighing Nausea Or Vomiting Belching Irritability Stomach Churning Breast Engorgement

Pattern Name Relevant Symptoms Relevant Formulas
Rebellious Liver Qi Epigastric distension, Hypochondriac distention, Upper abdominal distension, Hiccups, Sighing, Nausea or vomiting, Belching, Stomach churning, Irritability, Breast engorgement, Headaches, Dizziness... see more Chai Hu Shu Gan San | Si Ni San
Rebellious Liver Qi invading the Stomach Epigastric distension, Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression, Acid reflux, Hiccups, Belching, Nausea or vomiting, Sighing, Weak limbs... see more Ban Xia Hou Pu Tang | Xuan Fu Dai Zhe Tang | Si Mo Tang | Ju Pi Zhu Ru Tang | Ding Xiang Shi Di Tang
Detailed description of the cause

Heat

In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more

Heat Patterns That Can Lead to Upper Abdominal Distension

Common Symptoms: Irritability Hypochondriac Distention Upper Abdominal Oppression Nausea Lack Of Appetite Diarrhea Feeling Of Heaviness Dry Mouth Without Desire To Drink

Pattern Name Relevant Symptoms Relevant Formulas
Obstruction Of the Spleen By Dampness with Liver Qi Stagnation Epigastric distension, Upper abdominal oppression, Nausea, Lack of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink, Dull shallow face, Irritability, Upper abdominal distension, Hypochondriac distention, Hypochondriac pain... see more Ping Wei San | Dang Gui Shao Yao San
Stagnant Liver Qi turning into Fire Epigastric distension, Hypochondriac distention, Upper abdominal distension, Feeling of oppression of the chest, Irritability, Melancholia, Depression, Mood swings, Globus sensation, Feeling hot, Flushed face, Thirst, Anger, Pre menstrual tension, Irregular periods, Pre menstrual breast distension, Excessive menstruation... see more Dan Zhi Xiao Yao San
Detailed description of the cause

Dampness

"Dampness" in TCM is a concept that describes a pattern of disharmony where the body accumulates excess moisture. Imagine the heavy, sticky feeling you get on a very humid day; that's similar to what dampness feels like internally. It can manifest as a sense of heaviness, bloating, sluggishness, or even a foggy mind. This condition is often thought to arise from environmental factors like living in a damp place, dietary habits that promote moisture in the body, or internal imbalances that hinder the body's ability to process fluids properly. In TCM, dampness can obstruct the normal flow of energy and fluids in the body, leading to various symptoms.... see more

Dampness Patterns That Can Lead to Upper Abdominal Distension

Pattern Name Relevant Symptoms Relevant Formulas
Obstruction Of the Spleen By Dampness with Liver Qi Stagnation Epigastric distension, Upper abdominal oppression, Nausea, Lack of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink, Dull shallow face, Irritability, Upper abdominal distension, Hypochondriac distention, Hypochondriac pain... see more Ping Wei San | Dang Gui Shao Yao San
Detailed description of the cause

Liver

In TCM the Liver is viewed as the organ responsible for the smooth flow of Qi, Blood, and emotions throughout the body. It plays a key role in regulating mood, storing blood, supporting digestion, and ensuring the health of tendons and eyes. When the Liver malfunctions or is imbalanced in TCM, it can lead to a range of issues such as irritability, mood swings, menstrual irregularities, eye problems, and muscular stiffness or pain. A malfunctioning Liver in TCM reflects not only physical disturbances but also emotional and mental disharmony, emphasizing the holistic approach of TCM in addressing health and wellness.... see more

Liver Patterns That Can Lead to Upper Abdominal Distension

Common Symptoms: Irritability Hypochondriac Distention Belching Sighing Depression Hiccups Hypochondriac Pain Lack Of Appetite

Pattern Name Relevant Symptoms Relevant Formulas
Liver Qi Stagnation Epigastric distension, Epigastrium distension, Hypochondriac distention, Chest distension, Upper abdominal distension, Abdominal distention, Sighing, Melancholia, Depression, Mood swings, Irregular periods, Globus sensation, Pre menstrual breast distension, Pre menstrual tension, Anxiety, Anger... see more Xia Ru Yong Quan San | Xiao Yao San | Yue Ju Wan | Chai Hu Shu Gan San | Jia Wei Xiao Yao San | Yi Guan Jian
Obstruction Of the Spleen By Dampness with Liver Qi Stagnation Epigastric distension, Upper abdominal oppression, Nausea, Lack of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink, Dull shallow face, Irritability, Upper abdominal distension, Hypochondriac distention, Hypochondriac pain... see more Ping Wei San | Dang Gui Shao Yao San
Rebellious Liver Qi Epigastric distension, Hypochondriac distention, Upper abdominal distension, Hiccups, Sighing, Nausea or vomiting, Belching, Stomach churning, Irritability, Breast engorgement, Headaches, Dizziness... see more Chai Hu Shu Gan San | Si Ni San
Rebellious Liver Qi invading the Stomach Epigastric distension, Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression, Acid reflux, Hiccups, Belching, Nausea or vomiting, Sighing, Weak limbs... see more Ban Xia Hou Pu Tang | Xuan Fu Dai Zhe Tang | Si Mo Tang | Ju Pi Zhu Ru Tang | Ding Xiang Shi Di Tang
Stagnant Liver Qi turning into Fire Epigastric distension, Hypochondriac distention, Upper abdominal distension, Feeling of oppression of the chest, Irritability, Melancholia, Depression, Mood swings, Globus sensation, Feeling hot, Flushed face, Thirst, Anger, Pre menstrual tension, Irregular periods, Pre menstrual breast distension, Excessive menstruation... see more Dan Zhi Xiao Yao San
Liver Qi Stagnation invading the Stomach Epigastric distension, Belching, Abdominal distention, Upper abdominal distension, Depression, Irritability, Dry mouth, Lack of appetite, Craving for sour foods, Dry throat, Acid reflux... see more Ban Xia Hou Pu Tang | Zuo Jin Wan
Detailed description of the cause

Stomach

In TCM the Stomach is regarded as the "sea of nourishment," pivotal for digesting food and transforming it into Qi and blood. It works closely with the Spleen to distribute these essential nutrients throughout the body. When the Stomach is out of balance or malfunctions in TCM, it often leads to digestive problems such as bloating, nausea, vomiting, poor appetite, or a feeling of fullness. There may also be issues like acid reflux or a sour taste in the mouth. Emotionally, an imbalanced Stomach can contribute to excessive worry and overthinking, reflecting the TCM belief that physical and emotional well-being are deeply interconnected.... see more

Stomach Patterns That Can Lead to Upper Abdominal Distension

Common Symptoms: Belching Irritability Acid Reflux Upper Abdominal Pain Hiccups Abdominal Distention Depression Dry Mouth

Pattern Name Relevant Symptoms Relevant Formulas
Rebellious Liver Qi invading the Stomach Epigastric distension, Irritability, Upper abdominal pain, Upper abdominal distension, Hypochondriac pain, Hypochondriac distention, Upper abdominal oppression, Acid reflux, Hiccups, Belching, Nausea or vomiting, Sighing, Weak limbs... see more Ban Xia Hou Pu Tang | Xuan Fu Dai Zhe Tang | Si Mo Tang | Ju Pi Zhu Ru Tang | Ding Xiang Shi Di Tang
Stomach Qi Stagnation Epigastric distension, Upper abdominal pain, Upper abdominal distension, Belching, Nausea, Vomit, Hiccups, Irritability... see more Ban Xia Hou Pu Tang | Zuo Jin Wan
Liver Qi Stagnation invading the Stomach Epigastric distension, Belching, Abdominal distention, Upper abdominal distension, Depression, Irritability, Dry mouth, Lack of appetite, Craving for sour foods, Dry throat, Acid reflux... see more Ban Xia Hou Pu Tang | Zuo Jin Wan
Detailed description of the cause

Spleen

In TCM the Spleen plays a vital role in digestion and transformation, converting food into energy and nutrients, and overseeing the distribution of Qi and Blood. It's also crucial in maintaining the health of muscles and limbs and ensuring the blood remains within the vessels. When the Spleen malfunctions in TCM, it can lead to a variety of issues such as digestive disorders, fatigue, weak muscles, bloating, and a feeling of heaviness. It can also cause a pale complexion, poor appetite, and a tendency to bruise easily. Emotionally, a Spleen imbalance is often associated with excessive worry or overthinking, reflecting its role in the interplay between physical and mental health.... see more

Spleen Patterns That Can Lead to Upper Abdominal Distension

Pattern Name Relevant Symptoms Relevant Formulas
Obstruction Of the Spleen By Dampness with Liver Qi Stagnation Epigastric distension, Upper abdominal oppression, Nausea, Lack of appetite, Diarrhea, Feeling of heaviness, Dry mouth without desire to drink, Dull shallow face, Irritability, Upper abdominal distension, Hypochondriac distention, Hypochondriac pain... see more Ping Wei San | Dang Gui Shao Yao San

TCM Herbal Formulas for Upper Abdominal Distension

To address the complexities of upper abdominal distension, TCM prescribes specific formulas based on the identified patterns. For the disruption caused by Liver Qi Stagnation, Xia Ru Yong Quan San, containing Dong Quai, is recommended to soothe and invigorate Blood. When Dampness affects the Spleen along with Liver Qi Stagnation, Ping Wei San, with Cang Zhu, works to eliminate dampness and harmonize the stomach.

For cases of Rebellious Liver Qi invading the Stomach, treatment focuses on restoring harmony between the Liver and Stomach. Formulas such as Ban Xia Hou Pu Tang, which features Crow-Dipper Rhizomes, are used to promote Qi movement and alleviate the Rebellious Qi, effectively addressing the root of distension and associated discomfort.

Explore below some TCM herbal formulas used to address upper abdominal distension, organized by cause and by formula type.

  • By Cause
  • By Formula Type
  • Formulas that promote qi movement
  • Formulas that harmonize liver-Spleen
  • Formulas for a rebellious qi
  • Formulas that invigorate blood and dispel blood stagnation
  • Formulas that clear heat
  • Formulas that transform dampness and harmonize stomach
  • Formulas that clear liver-Heat
  • Formulas that nourish yin and tonify

All Formulas Recommended for Upper Abdominal Distension Caused by Qi Stagnation

Formula Patterns Suitable For
Ban Xia Hou Pu Tang Liver Qi Stagnation invading the Stomach, Stomach Qi Stagnation
Zuo Jin Wan Liver Qi Stagnation invading the Stomach, Stomach Qi Stagnation
Chai Hu Shu Gan San Liver Qi Stagnation
Xia Ru Yong Quan San Liver Qi Stagnation
Xiao Yao San Liver Qi Stagnation
Yue Ju Wan Liver Qi Stagnation
Jia Wei Xiao Yao San Liver Qi Stagnation
Yi Guan Jian Liver Qi Stagnation
Ping Wei San Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
Dang Gui Shao Yao San Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
Dan Zhi Xiao Yao San Stagnant Liver Qi turning into Fire

All Formulas Recommended for Upper Abdominal Distension Caused by Qi Rebellion

Formula Patterns Suitable For
Ban Xia Hou Pu Tang Rebellious Liver Qi invading the Stomach
Chai Hu Shu Gan San Rebellious Liver Qi
Si Ni San Rebellious Liver Qi
Xuan Fu Dai Zhe Tang Rebellious Liver Qi invading the Stomach
Si Mo Tang Rebellious Liver Qi invading the Stomach
Ju Pi Zhu Ru Tang Rebellious Liver Qi invading the Stomach
Ding Xiang Shi Di Tang Rebellious Liver Qi invading the Stomach

All Formulas Recommended for Upper Abdominal Distension Caused by Heat

Formula Patterns Suitable For
Ping Wei San Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
Dang Gui Shao Yao San Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
Dan Zhi Xiao Yao San Stagnant Liver Qi turning into Fire

All Formulas Recommended for Upper Abdominal Distension Caused by Dampness

Formula Patterns Suitable For
Ping Wei San Obstruction Of the Spleen By Dampness with Liver Qi Stagnation
Dang Gui Shao Yao San Obstruction Of the Spleen By Dampness with Liver Qi Stagnation

All "formulas that promote qi movement" recommended for upper abdominal distension

Formula Patterns Suitable For (if applicable)
Ban Xia Hou Pu Tang Liver Qi Stagnation invading the Stomach, Rebellious Liver Qi invading the Stomach, Stomach Qi Stagnation... see more
Chai Hu Shu Gan San Rebellious Liver Qi, Liver Qi Stagnation
Yue Ju Wan Liver Qi Stagnation
Si Mo Tang Rebellious Liver Qi invading the Stomach

All "formulas that harmonize liver-Spleen" recommended for upper abdominal distension

Formula Patterns Suitable For (if applicable)
Xiao Yao San Liver Qi Stagnation
Si Ni San Rebellious Liver Qi
Jia Wei Xiao Yao San Liver Qi Stagnation

All "formulas that invigorate blood and dispel blood stagnation" recommended for upper abdominal distension

Formula Patterns Suitable For (if applicable)
Xia Ru Yong Quan San Liver Qi Stagnation
Dang Gui Shao Yao San Obstruction Of the Spleen By Dampness with Liver Qi Stagnation

All "formulas for a rebellious qi" recommended for upper abdominal distension

Formula Patterns Suitable For (if applicable)
Xuan Fu Dai Zhe Tang Rebellious Liver Qi invading the Stomach
Ju Pi Zhu Ru Tang Rebellious Liver Qi invading the Stomach
Ding Xiang Shi Di Tang Rebellious Liver Qi invading the Stomach

Acupoints for Upper Abdominal Distension

TCM also employs acupuncture as a complementary treatment for upper abdominal distension, targeting specific acupoints to restore balance. Points like Chengman ST-20 and Guanmen ST-22 are stimulated to harmonize the Middle Burner and invigorate Stomach Qi.

Liangmen ST-21 is used for its effect on Stomach Qi and clearing Stomach Heat. In addressing the underlying patterns, points on the Liver and Spleen channels, such as Qimen LIV-14 and Gongsun SP-4, are also utilized to invigorate Liver Qi and harmonize the Spleen, providing relief from distension.

Explore below some acupoints used to address upper abdominal distension, organized by meridian.

  • By Meridian
  • Stomach Channel
  • Directing Vessel
  • Liver Channel
  • Spleen Channel
  • Pericardium Channel
  • Bladder Channel
  • Gall Bladder Channel
Chengman ST-20

Chengman ST-20

5 cun above the umbilicus and 2 cun lateral to the anterior midline, or 1 cun below Burong ST-19.

Liangmen ST-21

Liangmen ST-21

4 cun above the umbilicus and 2 cun lateral to the anterior midline.

Guanmen ST-22

Guanmen ST-22

3 cun above the umbilicus and 2 cun lateral to the anterior midline.

Zhongwan REN-12

Zhongwan REN-12

On the midline of the abdomen, 4 cun above the umbilicus and 4 cun below the sternocostal angle.

Shangwan REN-13

Shangwan REN-13

On the midline of the abdomen, 5 cun above the umbilicus and 3 cun below the sternocostal angle.

Juque REN-14

Juque REN-14

On the midline of the abdomen, 6 cun above the umbilicus and 2 cun below the sternocostal angle.

Taichong LIV-3

Taichong LIV-3

On the dorsum of the foot, between the 1st and 2nd metatarsal bones, in the depression proximal to the metatarsophalangeal joints and the proximal angle between the two bones.

Zhangmen LIV-13

Zhangmen LIV-13

On the lateral side of the abdomen, below the free end of the 11th rib.

Qimen LIV-14

Qimen LIV-14

On the mammillary line, two ribs below the nipple, in the 6th intercostal space, 4 cun lateral to the midline. Please note that there is an alternative location for LIV-14 at the lower edge of the ribcage in line with the nipple or, in women, 4 cun from the midline. In fact, one could look upon these as two separate points. The one in the intercostal space is used more for Channel problems. While the one at the lower edge of the ribcage is used more for Organ problems.

Taibai SP-3

Taibai SP-3

Proximal and inferior to the head of the 1st metatarsal bone, at the border of the red and white skin.

Gongsun SP-4

Gongsun SP-4

In the depression distal and inferior to the base of the 1st metatarsal bone, at the border of the red and white skin.

Neiguan P-6

Neiguan P-6

2 cun above Daling P-7 on the transverse crease of the wrist, between the tendons of palmaris longus and flexor carpi radialis muscle.

Weishu BL-21

Weishu BL-21

1.5 cun lateral to the lower border of the spinous process of the 12th thoracic vertebra (T12).

Yanglingquan GB-34

Yanglingquan GB-34

In the depression anterior and inferior to the head of the fibula.