Epigastric Pain
In Chinese medicine, epigastric pain suggests pain around the stomach, upper abdomen, or below the chest.
It is often accompanied by belching, acid regurgitation, or nausea. Epigastric pain is usually caused by pathology of the stomach including such biomedically defined conditions as peptic ulcer, gastritis or gastrointestinal neurosis.
Excess type epigastric pain: acute onset, short period, severe pain aggravated by eating; resistant to pressure; thick tongue coat, forceful pulse.
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Differentiation |
Symptoms |
Formula |
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E x c e s s |
Excess heat accumulation in the middle Jiao |
severe epigastric burning pain which is resistant to touch and worse after a meal; sensation of fullness or bloating in the epigastrium and abdomen; constipation with dry stools, red tongue with yellow greasy coating, wiry and rapid pulse |
Da Cheng Qi Tang, |
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Excess cold accumulation in the middle Jiao |
excruciating epigastric and abdominal pain that is intolerant to touch; a strong sensation of cold, vomiting and inability to eat; cold limbs, white slippery tongue coating; tight and wiry or slow and wiry pulse |
Da Jian Zhong Tang |
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Cold-damp in the Stomach with wind-cold attack |
epigastric pain that is alleviated by warmth; fullness and distention in the chest and epigastrium; nausea, vomiting, cold extremities, diarrhea; may have chills and fever; pale moist tongue coat, floating and slippery pulse |
Huo Xiang Zhen Qi San |
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Food stagnation |
epigastric and abdominal pain, distention which is worse after eating and relieved after a bowel movement or vomiting; rotten-smelling belching; acid regurgitation, nausea, vomiting, aversion to food, yellow greasy tongue coating, slippery pulse |
Bo He Wan |
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Blood stagnation |
sharp, fixed epigastric pain worse after eating, possible vomiting of blood, bloody stools, or mass in the epigastric area; purple tongue with dark spots on the tongue edge, choppy pulse |
Xue Fu Zhu Yu Tang modified |
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Qi stagnation |
epigastric distention and pain which comes and goes, possibly during menstruation period; no fixed location, dull pain that sometimes radiates to the hypochondriac region and lower abdomen; can be induced by emotional stress; retching, belching, wiry pulse |
Si Ni San, Xiao Yao San |
Epigastric Pain, cont.
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Differentiation |
Symptoms |
Formula |
|
E x c e s s |
damp-phlegm in the middle Jiao |
dull epigastric pain, distention, fullness, and tightness; symptoms aggravated by hunger or overeating, nausea, vomiting with phlegm, thick white moist tongue coating, slippery pulse |
Ping Wei San + Wu Ling Tang |
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Heat-cold accumulation in the middle Jiao |
epigastric focal distention, fullness and tightness with very slight or no pain; dry heaves or frank vomiting, borborygmus with diarrhea; reduced appetite, thin yellow greasy tongue coating; |
Ban Xia Xie Xin Tang |
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Six stagnations |
epigastric and abdominal pain which may feel fixed and piercing; distention and fullness, nausea, vomiting, poor digestion, acid regurgitation, white or yellow greasy coating, wiry pulse |
Yue Ju Wan |
Deficiency type epigastric pain: chronic pain, easily recurring; dull or vague pain or ache; relieved by eating, relieved by pressure or warmth; weak pulse.
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D e f |
Middle Jiao deficiency with cold |
persistent vague chronic epigastric pain which is relieved by pressure and warmth, pain induced by hunger or exertion; loose stools, abdominal distention, poor appetite, nausea or vomiting, |
Li Zhong Wan |
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Spleen and Stomach Qi deficiency |
chronic epigastric pain that is dull with empty sensation, relieved by pressure; no appetite, pale face, fatigue, lassitude, shortness of breath, soft stools but with difficult bowel movement, |
Bu Zhong Yi Qi Tang, Si Jun Zi Tang |