Finding Relief: A Holistic Approach to Managing Chronic Upper Abdominal Pain

In Traditional Chinese Medicine (TCM), chronic upper abdominal pain is characterized by various factors that disrupt the flow of Qi (energy) and affect the balance of Yin and Yang within the body. It is often associated with digestive, Liver, and spleen imbalances. Common symptoms include a dull or burning pain in the upper abdomen, bloating, belching, nausea, and changes in bowel movements. The prevalence of chronic upper abdominal pain varies, but it is frequently observed in individuals with conditions such as gastritis, peptic ulcers, gallstones, and functional gastrointestinal disorders. TCM aims to identify the underlying patterns of disharmony and restore balance through a combination of herbal remedies, acupuncture, dietary adjustments, and lifestyle modifications. 

Understanding Chronic Upper Abdominal Pain

In Chinese medicine, identifying the diagnosis is primary. The body presents signs that create patterns. A diagnostic design refers to a comprehensive assessment of an individual’s signs, symptoms, and overall constitution to identify the underlying imbalance or disharmony within the body. It involves observing various aspects such as physical appearance, tongue condition, pulse quality, and detailed questioning about the patient’s health history, lifestyle, and emotional well-being. These patterns are based on the principles of Yin and Yang, Qi (energy) flow, and the interactions of organ systems.

A diagnostic pattern is a framework that helps the practitioner understand the unique presentation of a patient’s condition and guides them in formulating an appropriate treatment plan. It involves categorizing the observed symptoms and signs into specific patterns, such as excess or deficiency, heat or cold, stagnation or depletion, and identifying the particular affected organs or meridians.

By identifying the diagnostic pattern, the practitioner can determine the root cause of the imbalance and develop a personalized treatment strategy using various modalities like herbal medicine, acupuncture, dietary adjustments, and lifestyle recommendations. The goal is to restore harmony and balance within the body, addressing the underlying disharmony rather than merely alleviating symptoms.

These four types of patterns identify pain in the upper abdomen

Wind-cold –

abdominal pain characterized as “wind-cold” refers to a specific diagnostic design related to the imbalance of Qi (energy) and the invasion of external pathogenic factors. Wind and cold are considered external influences that can affect the body and cause abdominal discomfort. 

The symptoms associated with the wind-cold pattern of abdominal pain may include:

1. Abdominal pain that is sharp, cramping, or colicky.
2. The pain tends to worsen with exposure to cold or cold environments.
3. The feeling of coldness in the abdomen.
4. Reduced appetite.
5. Bloating and distension in the stomach.
6. The pain may migrate or change location.
7. Other accompanying symptoms may include aversion to cold, chills, and a pale tongue with a white coating.

Wind-cold invasions can obstruct the flow of Qi and blood in the abdominal region, leading to pain and discomfort. The treatment approach for this pattern typically involves expelling the external pathogenic factors, dispersing the cold, and regulating the flow of Qi and blood in the abdomen. This may include using warming herbs, acupuncture points, and techniques to promote circulation and restore balance within the body.

Superficial dampness heat-

In Chinese medicine, external dampness heat is a diagnostic pattern that reflects an imbalance in the body’s internal environment. It occurs when there is an excessive accumulation of dampness, often coupled with heat, on the surface of the body. 

The characteristic symptoms associated with superficial dampness heat may include:

1. The feeling of heaviness and stickiness in the body.
2. Swelling or edema in the affected areas.
3. Skin rashes or eruptions that are red and itchy.
4. The sensation of heat or burning in the affected areas.
5. Increased sweating, especially in the affected regions.
6. Thirst with a preference for cold drinks.
7. Urinary symptoms such as dark-colored urine with a strong odor.
8. Digestive issues such as poor appetite, bloating, and loose stools.
9. The tongue may appear red and swollen with a greasy or sticky coating.

This pattern often arises from poor diet, exposure to damp or humid environments, and weak spleen or kidney function. Treatment aims to eliminate dampness, clear heat, and restore balance within the body. This may involve herbal medicine formulations that have diuretic, cooling, and drying properties, along with dietary modifications that reduce the intake of greasy and dampening foods. Additionally, acupuncture and other techniques may regulate the body’s energy and promote the resolution of dampness and heat.

Liver fire upsurging-

Liver fire upsurging is a diagnostic pattern that reflects an imbalance and excessive activity of the Liver system, particularly the Liver fire. It is characterized by the body’s upward movement of extreme heat and energy.

The characteristic symptoms associated with Liver fire upsurging may include:

1. Irritability, anger, or emotional agitation.
2. Headaches or migraines are often located on the sides of the head.
3. Red and painful eyes, blurred vision, or sensitivity to light.
4. Dizziness or vertigo.
5. Bitter taste in the mouth and a dry throat.
6. Insomnia or restless sleep.
7. Restlessness, including difficulty sitting still or a tendency to fidget.
8. A tendency towards impulsive behavior.
9. Possible menstrual irregularities or premenstrual syndrome (PMS) symptoms in women.
10. The tongue may appear red with a yellow coating, and the pulse may be rapid and wiry.

Liver fire upsurging is often associated with prolonged emotional stress, repressed anger, and a sedentary lifestyle. Treatment aims to clear heat and soothe the Liver, restoring a harmonious flow of energy. This may involve herbal formulas that have a cooling and calming effect; acupuncture points that regulate Liver energy, and lifestyle modifications that promote relaxation and stress reduction. Meditation or tai chi may also be recommended to support emotional balance and enhance overall well-being.

Energy congestion or stagnation of energy-

energy congestion or stagnation of power refers to a diagnostic pattern in which the flow of Qi (energy) in the body becomes obstructed or stagnant—a disruption or blockage in the smooth movement of Qi through the meridians and organs.

The characteristic symptoms associated with energy congestion or stagnation may include the following:

1. Pain or discomfort that is fixed, localized, and often sharp.
2. Distending or bloating sensations in the affected areas.
3. Tenderness or sensitivity upon palpation.
4. A tendency for symptoms to worsen with stress or emotional upheaval.
5. Emotional symptoms such as irritability, frustration, or mood swings.
6. Digestive issues such as belching, acid reflux, or abdominal distension.
7. Menstrual irregularities or premenstrual syndrome (PMS) symptoms in women.
8. Muscle tension, stiffness, or cramping.
9. Fatigue or feeling drained.
10. The tongue may appear pale or purple, and the pulse may be wiry or choppy.

Energy congestion or stagnation can occur due to emotional stress, poor diet, lack of exercise, or physical injuries. The treatment approach aims to promote the smooth flow of Qi, disperse stagnation, and restore balance within the body. This may involve acupuncture to stimulate specific points and meridians, herbal formulas promoting Qi movement, and lifestyle modifications encouraging relaxation, training, and emotional well-being. Dietary adjustments may also be recommended to support healthy digestion and minimize stagnation-inducing foods.

Lifestyle Modifications for Pain Relief

Chinese medicine offers some unique lifestyle modifications for pain relief that may not be typical in Western medicine. Here are a few recommendations:

1. Cupping Therapy: Cupping involves placing heated glass or silicone cups on the skin to create suction. This technique helps to improve blood circulation, relax muscles, and relieve pain. It is commonly used for conditions such as muscle tension, back pain, and sports injuries.

2. Guasha: Guasha is a therapy that involves scraping the skin with a specialized tool to stimulate blood flow and promote healing. It can be used to alleviate pain, reduce inflammation, and improve mobility. Guasha is often utilized for conditions such as neck and shoulder tension, migraines, and muscle pain.

3. Moxibustion: Moxibustion involves the burning of dried mugwort herb (moxa) near specific acupuncture points. The heat generated helps to stimulate circulation, warm the body, and alleviate pain. Moxibustion is commonly used for conditions associated with cold and dampness, such as arthritis, menstrual pain, and digestive disorders.

4. Qi Gong: Qi Gong is a practice that combines gentle movements, breath control, and meditation to cultivate and balance the body’s Qi (energy). Regular practice of Qi Gong can enhance overall well-being, promote relaxation, and reduce pain. It is often recommended for chronic pain conditions and as a preventive measure.

5. Dietary Therapy: Chinese medicine emphasizes the therapeutic properties of food and its impact on health. A Chinese medicine practitioner may recommend specific dietary modifications based on your individual condition. This can involve incorporating warming or cooling foods, balancing the five flavors, and avoiding foods that may exacerbate pain or inflammation.

Lifestyle modifications can play a crucial role in pain relief and promoting overall well-being. Here are some lifestyle modifications commonly recommended:

Regular Exercise 

Engage in gentle exercises such as Tai Chi, Qi Gong, or yoga to promote the flow of Qi and maintain flexibility. Avoid excessive or strenuous activities that can aggravate pain.

Mind-Body Practices 

Practice meditation, deep breathing exercises, or mindfulness techniques to reduce stress, calm the mind, and improve overall energy flow.

Adequate Rest

Get sufficient rest and sleep to allow the body to heal and recharge. Avoid excessive physical or mental exertion that can exacerbate pain.

Stress Management 

Adopt stress management techniques such as meditation, relaxation exercises, or engaging in activities that bring joy and promote emotional well-being. Chronic stress can contribute to pain and hinder the body’s natural healing processes.

Healthy Diet 

Maintain a balanced and nourishing diet that includes fresh fruits, vegetables, whole grains, and lean proteins. Avoid excessive consumption of greasy, spicy, or processed foods that can contribute to inflammation and dampness in the body.

Maintain a Healthy Weight

Maintain a healthy weight through proper nutrition and regular exercise. Excess weight can put additional strain on joints and exacerbate pain.

Good Sleep Routine 

Establish a regular sleep schedule, create a comfortable environment, and practice good sleep hygiene habits to promote restful and rejuvenating sleep.

It is essential to consult with a qualified Chinese medicine practitioner to receive personalized recommendations based on your specific condition and constitution.

In instances of wind cold, the Xiao Chi Hu Tang herbal formula may offer some relief. Peppermint (including oil), spearmint, sweet basil, cayenne pepper, fennel, fresh ginger, mustard seed, star anise, and prickly ash leaf are recommended foods. For conditions akin to superficial dampness and heat, therapeutic properties can be found in carp, celery, hyacinth bean, jellyfish, job tears, and oregano. Sweet basil, adzuki beans, bamboo shoots, sprouts, black mushrooms, sea salt, spinach, strawberries, cucumber, beet leaves, mung beans, and peppermint can all raise the body’s pH level, balance the gut microbiome, and promote the growth of gut flora. In cases that warrant it, a prescription of Yin Chen Hao Tang or Long Dan Xie Gan Tang formula may extend from weeks to months.

Seek Professional Guidance

Seeking a professional Chinese medicine practitioner experienced in all five branches of medicine is crucial for comprehensive and effective healthcare. Chinese medicine encompasses five components: herbal medicine, acupuncture, dietetics, therapeutic exercises (such as Tai Chi and Qi Gong), and Tui Na (a therapeutic massage). An experienced practitioner in all these branches can provide a holistic approach to addressing your health concerns. By integrating various modalities, they can tailor a treatment plan that considers your specific condition, symptoms, and overall well-being.

Collaboration between your Chinese medicine practitioner and primary care doctor is essential for optimal care. A practitioner who understands how to work alongside your primary care doctor can ensure a coordinated approach that considers all aspects of your health. They can communicate effectively, exchange information, and create a cohesive treatment strategy that complements Western and Chinese medical perspectives. This collaboration is essential when herbal formulas are unsuitable or contraindicated. An experienced practitioner can incorporate food therapy and dietary adjustments into the treatment plan. This integration ensures a comprehensive and individualized approach to promote overall health and well-being.