Clinical Information For the Treatment Of Abdominal Pain
What Is Abdominal Pain?
Abdominal Pain - Basics
Abdominal pain indicates pain in the abdominal area which extends from your rib line down to your groin. Pain within this area can arise by stomach issues as well as problems within any of the other organs in the abdominal cavity. People may experience mild or severe pain and this can indicate any number of health issues.
What Patterns Are Related To Abdominal Pain?
Abdominal Pain - Diagnostic Patterns
The Chinese Medicine treatment of abdominal pain generally involves arriving at the appropriate TCM diagnosis or pattern. This pattern within the individual is what treatment is based on not the general condition (see treating the cause and not the symptoms).
The following patterns may represent the underlying contributing factors for the development of abdominal pain:Blood StagnationStomach ColdStomach FireStomach Food StagnationStomach Qi DeficiencyStomach Rebellious Qi
Which Acupuncture Point Protocols May Be Applied For Abdominal Pain?
Abdominal Pain - Acupuncture Protocols
The treatment of conditions with acupuncture can be a complicated endeavor that should only be undertaken by individuals with a deep understanding of the underlying Chinese Medicine theory (and/or whatever system being used for treatment). There are many approaches, but generally speaking few viable approaches are involved on a point to condition basis. Rather using proper diagnostic procedures the patients diagnostic pattern is ascertained and that is what is treated. The protocols listed here exemplify some of these clinical approaches.
The following acupuncture treatment protocols may be used with abdominal pain:
Which Tam Healing and Tongren Therapy Protocols Apply To Abdominal Pain?
Abdominal Pain - Tam Healing and Tongren Therapy Protocols
Tong Ren Therapy is the energy healing/medical qi gong aspect of the Tam Healing System. The areas of focus for abdominal pain that we would use in Tong Ren techniques form the basis for our acupuncture treatments as well. Generally you would mix these primary points with points specific to the patients underlying TCM pattern and then our tuina (medical massage) would be largely focused on these points as well.
The following Tam healing and tong ren therapy protocols may be used with abdominal pain:
40 Points Are Empirically Important For Abdominal Pain
30 TCM Herbs Are Potentially Used With Abdominal Pain
The Following (23)Formulas TCM Herbal Formulas May Be Useful For Abdominal Pain
Ban Xia Bai Zhu Tian Ma Wan (Pinellia, Atractylodis and Gastrodia Combination)
- Nausea with possible vomitting from combination of damp with liver qi stagnation causing rebellious qi.
- Dizziness, migraines, and vertigo from damp and liver wind rising.
- Heavy or oppressed sensation of the chest.
This formula should not be used to treat dizziness or vertigo due to liver yang rising patterns.
Ban Xia Xie Xin Wan (Pinellia Drain Epigastrium Pills)
- Distension and fullness of the epigastrium usually without pain.
- Borborygmus (gurgling sounds), and diarrhea if spleen qi is affected.
- Vomiting with possible dry heaves due to rebellious stomach qi.
Do not use for epigastric distention due to food stagnation. Use with caution if patient has yin deficiency.
Bao He Wan (Preserve Harmony Pills)
- Epigastric and or abdominal fullness or painful distention after meals.
- Acid reflux, belching, vomiting with possible aversion to food due to food stagnation.
- This formula can also be used for acute food poisoning.
Use with caution with weak or qi deficient patients.
Chen Xiang Hua Qi Wan (Aquilaria Qi Transforming Pills)
For spleen qi deficiency with damp heat accumulation in the lower. The spleen system is effectively the western version of the digestive system. The spleen is responsible for extracting the energy from the food and properly breaking the food down. When the spleen is weak the overall energy tends to drop, the appetite may be poor, and the mood may also be on the down side. Furthermore, the weakness of the spleen results in the accumulation of byproducts (damp) which tend to accumulate in the lower.
Symptoms may include diarrhea, constipation, excessive gas, and abdominal distension. This formula is used to treat belching, acid reflux, poor appetite, abdominal distension, flatulence, constipation, and abdominal cramping and discomfort.
Tongue: puffy, sticky or greasy coat
Pulse: slippery, weak
Contraindicated during pregnancy
Da Huang Mu Dan Pi Wan (Rhubarb and Moutan Combination)
- Breaks up heat, moves blood stagnation and reduces swelling, release through the bowels - appendicitis, lower abdominal distension with pain, intestinal abscesses, hemorrhoids.
- Post surgical infections, particularly in the colon and/or lower warmer.
- Pelvic inflammatory disease.
- Groin pain relieved by flexing hip and without urinary difficulty (but with symptoms similar to a UTI).
- Avoid during pregnancy.
- As this formula will cause looser stools use with caution in deficient and/or elderly patients.
- Used for general appendicitis - avoid in infant appendicitis, or appendicitis with necrosis, peritonitis and/or parasites.
Fu Zi Li Zhong Wan (Aconite Regulate Middle Pills)
- Spleen yang deficiency resulting in coldness of the limbs and/or interior, borborygmus, and possible loose stools or diarrhea.
- Feeling full even with small amounts of food, bloating, epigastric/abdominal pain, possible decrease in appetite.
- Vomitting and nausea especially if it occurs shortly after eating.
Gan Bing Zhi Ben Wan (Liver Disease Recovery Pills)
- Irritibility or easily prone to outburts or anger.
- Liver disease such as hepatitis, cirrhosis, fatty liver.
- Jaundice - yellowing of the skin, brittle nails, pale complexion.
- Ovoid foods and drugs that tax the liver such as coffee, alcohol, fried foods, etc.
- Use with caution during pregnancy.
Ge Xia Zhu Yu Wan (Drive Out Blood Stasis Below The Diaphragm Decoction)
- For blood stasis below the diaphgram - abdominal masses, liver and spleen masses/swelling, colitis.
- A range of liver disorders are possibly applicable - cirrhosis, hepatic hemangioma, hepatitis, jaundice.
- Spleen disorders - splenomegaly.
- Pleural adhesions.
- A range of menstrual disorders - fibroids, endometriosis, dysmenorrhea (although Shao Fu Zhu Yu Wan may be more appropriate as that targets more the lower jiao).
- Pelvic inflammatory disease.
- May be used to help expel ectopic pregnancy.
- Avoid during pregnancy.
- Use only under direction during menstruation.
- Use only under direction if you are taking blood thinners.
- Generally not for long term use.
Gui Zhi Fu Ling Wan (Cinnamon and Poria Teapills)
- For abdominal masses such as uterine cysts, ovarian cysts, benign tumors.
- May be used when blood stagnation symptoms appear during pregnancy.
- Uterine bleeding especially if the color is dark.
- Use with caution during pregnancy.
- Use with caution if patient presents with more severe blood stagnation and qi deficiency.
Huo Xiang Zheng Qi Wan (Agastache Powder to Correct the Qi)
- Acute flu or cold symptoms including fever, aversion to cold, headaches, sinus pressure, runny nose.
- Vomitting and diarrhea from interior damp with possible abdominal cramps or pains.
- Not suitable for patients that present with yin and/or blood deficiency.
Jian Pi Wan (Strengthen Spleen Pills)
- For stomach and spleen qi deficiency with dampness that has potentially generated mild interior-heat - diarrhea, abdominal pain, poor appetite, epigastric pain.
- May be used in early pregnancy for more deficient patients particularly with a tendency towards miscarriage.
- May be used with pediatric patients for poor appetite and looser stools.
Ping Wei Wan (Calm the Stomach Powder)
- Damp cold stagnation in the middle jiao - poor appetite, indigestion, gastritis, loose stools, heavy sensation of the limbs, fatigue.
- Can be used to induce labor with appropriate underlying diagnoses.
- Avoid in pregnancy and in yin deficient and/or blood deficient cases due to the warming and drying nature.
Shao Fu Zhu Yu Wan (Abdominal Stasis Relief Pills)
- Qi and blood stagnation in the lower jiao - lower abdominal masses, fibroids, ovarian cysts, endometriosis.
- Fertility issues in both men and women with the right underlying signs - amenorrhea, dysmenorrhea, irregular cycles, uterine bleeding.
- Can be used to dispel ectopic pregnancy.
- Ulcerative colitis, urinary stones.
- Avoid during pregnancy.
- Not generally applicable to heavy menstrual bleeding coming from deficiency.
Shao Yao Gan Cao Wan (Peony and Licorice Decoction)
- Cramping and/or muscle spasms that are due to fluid deficiency.
- Frozen shoulder, trigger finger.
- General tightness or cramps especially along the tendons or ligaments.
- Restless leg syndrome for patients who present with yin and blood deficiency as the primary cause.
Shu Gan Wan (Liver Comfort Pills)
- Abdominal and/or Hypochondriac pain, cramps or spasms resulting from liver qi stagnation.
- Alternating chills and fever.
- Nausea, bloating, acid reflux, alternating stools, or IBS like symptoms caused by the liver invading the spleen.
- Use with caution with pregnancy.
Wu Mei Wan (Mume Fruit Pill)
- Generally used with roundworms - abdominal pain, irritability, stifled chest w/heat, vomiting after eating, cold hands and/or feet.
- Chronic diarrhea, IBS, or other digestive disorders characterized by both heat and cold.
Xiang Sha Liu Jun Zi Wan (Aucklandia, Amomi & Six Gentlemen Pills)
- A modified version of the base, zhi zhu wan, which is used to treat qi stagnation and food retention from qi deficiency. This modification includes herbs which add more movement and damp drying.
- Distention and fullness in the epigastric area - bloating, indigestion, gastritis, gastric prolapse.
- Poor appetite (from Spleen Qi Deficiency), anorexia.
- Avoid raw and cold food when taking this formula (and generally for Spleen Qi Deficiency).
Xiao Chai Hu Tang Wan (Minor Bupleurum Decoction)
- Shao Yang Syndrome (or "lesser yang stage") - alternating fever and chills, hypochondriac pain, irritability, bitter taste in mouth, poor appetite, nausea. Often used for illnesses (chronic or short-term) such as the flu, etc. that have "cleared" but not completely. People will describe not feeling quite right or having a range of low level symptoms for months or longer after a particular illness. Instead of fever and chills alternating they may manifest with cold extremities and warm interior or other variations.
- A range of liver related conditions including malaria, jaundice, hepatitis, liver cancer, meniere's disease, general protection from medicines that may harm the liver, etc. among issues with other digestive organs - pancreatitis, stomatitis, gastritis.
- Liver/speen disharmonies resulting in broader issues such as depression, chronic fatigue syndrome, menstrual irregularities (PMS, cramping, etc.).
- Other general immune issues such as the common cold, flu, tonsillitis, general seasonal allergies with the right underlying factors.
- Use with caution with yin and/or blood deficiencies.
- Avoid cold, raw, and spicy foods while taking xiao chai hu tang.
Yi Guan Jian Wan (Linking Decoction)
- GI issues from yin deficiency (liver and kidney) with liver qi stagnation leading to stomach yin issues - gastritis, ulcers, reflux, bloating.
- The underlying factors lead to dryness of the blood, that coupled with liver qi stagnation and yin deficiency may lead to PMS, inosmnia, etc.
- With the right underlying factors useful for a range of liver conditions - hepatitis, fatty liver.
- Essential hypertension, preeclampsia.
Yue Ju Wan (Escape Restraint Pill)
- An important formula for plum pit qi and related issues arising from qi stagnation (from many factors) - an oppressive sensation in the chest and/or diaphgram, gerd, reflux, indigestion, nausea, belching with a fetid odor.
- Gastritis, peptic ulcer disease, intercostal neuralgia, cholecystitis, cholelithiasis.
- Infectious hepatitis.
- Migraines when the underlying factor is that of stagnation.
- Besides a range of digestive issues, the formula may be used for a wide range of psychiatric conditions including depression, schizophrenia, panic disorder, etc. when the underlying factor is chiefly stagnation.
- Generally should be avoided in cases where the issues are arising from predominately deficiency syndromes (weakness, loose stools, no appetite).
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