Constipation, Diarrhea, and other bowel concerns Flashcards
A patient presents with dry stools, thirst, dark scanty urine, epigastric pain, and a red tongue. What is the most likely TCM pattern?
A) Damp-Heat
B) Liver Qi Stagnation
C) Heat in the Stomach and Large Intestine
D) Spleen Yang Deficiency
Correct Answer: C
✅ C is correct because dry stools, thirst, dark urine, and epigastric pain point to Heat in the Stomach and Large Intestine. This can lead to constipation and a burning sensation in the anus.
❌ A is incorrect because Damp-Heat would present with diarrhea, foul-smelling stools, and burning, rather than constipation.
❌ B is incorrect because Liver Qi stagnation typically causes alternating constipation and diarrhea, bloating, and emotional distress.
❌ D is incorrect because Spleen Yang Deficiency would cause loose stools, cold intolerance, and fatigue, not dry stools and heat signs.
Which of the following describes an optimal bowel movement in Traditional Chinese Medicine (TCM)?
A) Small, hard pellets, requiring straining
B) Loose stools that do not hold form when flushed
C) Formed, easy to pass, minimal wiping, and occurs ≤ 3 times/day
D) Urgent, explosive diarrhea that leaves a burning sensation
Correct Answer: C
✅ C is correct because in TCM, an optimal bowel movement is well-formed, easy to pass, requires minimal wiping, and occurs at a frequency that matches food intake (ideally once per day but up to three times per day).
❌ A is incorrect because small, hard pellets suggest Liver Qi stagnation or Blood/Yin deficiency.
❌ B is incorrect because unformed, loose stools suggest Spleen Qi deficiency or Dampness.
❌ D is incorrect because urgent, explosive diarrhea with burning indicates Damp-Heat in the intestines.
Which external pathogen is most likely responsible for watery diarrhea, abdominal pain, aversion to cold, and a thick white tongue coating?
A) Heat/Fire
B) Damp-Heat
C) Damp-Cold
D) Summer-Heat
Correct Answer: C
✅ C is correct because Damp-Cold causes watery diarrhea, aversion to cold, a thick white sticky tongue coating, and a slow, slippery pulse.
❌ A is incorrect because Heat/Fire leads to constipation with dry stools, not watery diarrhea.
❌ B is incorrect because Damp-Heat would present with foul-smelling stools, burning in the anus, and a yellow sticky tongue coating.
❌ D is incorrect because Summer-Heat typically causes acute diarrhea in warm weather due to exposure to an external pathogen, and often includes fever or sweating.
A patient reports alternating diarrhea and constipation, bloating, belching, and irritability. Which pattern is most likely?
A) Qi Deficiency
B) Damp-Cold in the Large Intestine
C) Liver Qi Stagnation
D) Blood Deficiency
Correct Answer: C
✅ C is correct because Liver Qi Stagnation is characterized by alternating bowel habits, bloating, irritability, and emotional symptoms.
❌ A is incorrect because Qi Deficiency causes fatigue, difficulty passing stools, and loose stools, rather than alternating diarrhea/constipation.
❌ B is incorrect because Damp-Cold leads to watery diarrhea, heaviness, and cold intolerance, not alternating stool patterns.
❌ D is incorrect because Blood Deficiency would cause dry stools, pale complexion, and numbness, not alternating bowel habits.
A patient with IBS has frequent loose stools, abdominal bloating, and fatigue. They often feel cold and have a pale tongue with teeth marks. What is the best diagnosis?
A) Liver Qi Stagnation overacting on Spleen
B) Spleen Qi Deficiency
C) Damp-Heat in the Large Intestine
D) Blood Deficiency
Correct Answer: B
✅ B is correct because Spleen Qi Deficiency presents with loose stools, bloating, fatigue, pale tongue with teeth marks, and a weak pulse.
❌ A is incorrect because while Liver Qi stagnation can cause IBS, it usually involves alternating diarrhea and constipation, with more emotional symptoms.
❌ C is incorrect because Damp-Heat would cause urgent diarrhea with a foul odor and burning sensation.
❌ D is incorrect because Blood Deficiency leads to dry stools, difficulty defecating, and dizziness, not loose stools.
A patient presents with early morning diarrhea, cold intolerance, frequent urination, sore back and knees, and a deep, weak pulse. What is the most likely pattern?
A) Spleen Qi Deficiency
B) Kidney Yang Deficiency
C) Liver Qi Stagnation
D) Retention of Food
Correct Answer: B
✅ B is correct because Kidney Yang Deficiency presents with early morning diarrhea, cold signs, frequent urination, sore lower back, and a deep, weak pulse.
❌ A is incorrect because Spleen Qi Deficiency causes loose stools but not the early morning pattern or frequent urination.
❌ C is incorrect because Liver Qi Stagnation involves alternating bowel habits, not a clear cold pattern.
❌ D is incorrect because Retention of Food causes foul-smelling stools, bloating, and bad breath, not loose stools.
Which treatment principle is most appropriate for a patient with constipation due to Blood Deficiency?
A) Clear heat and drain fire
B) Resolve dampness and dissipate cold
C) Tonify Blood and moisten intestines
D) Harmonize the Liver and Spleen
Correct Answer: C
✅ C is correct because Blood Deficiency causes dry stools and difficulty defecating. Treatment focuses on tonifying Blood and moistening the intestines.
❌ A is incorrect because clearing heat is for Heat-type constipation, which presents with thirst and dark urine.
❌ B is incorrect because resolving dampness and dissipating cold applies to Damp-Cold diarrhea, not constipation.
❌ D is incorrect because harmonizing the Liver and Spleen applies to Liver Qi Stagnation, which causes alternating bowel habits.
Scanty urine occurs in heat conditions affecting the Stomach (ST) and Large Intestine (LI) because excess heat dries up body fluids, leading to reduced urine production. Here’s how it happens:
- Heat Consumes Body Fluids
When there is excess heat in the Stomach or Large Intestine, it evaporates and depletes fluids in the body.
This results in symptoms like dry stools, thirst, and dark, scanty urine because there isn’t enough moisture to properly hydrate the stool or support normal urination. - Heat Disrupts Fluid Distribution
The Stomach and Large Intestine are Yangming organs, which generate a lot of metabolic activity and heat.
When excessive heat builds up, it interferes with fluid transportation and diverts moisture away from the urinary system, leading to scanty urine. - Heat Damages the Kidneys and Bladder Function
When the body is overheated, it tries to preserve fluids to compensate for dehydration, leading to a decrease in urination.
The Bladder relies on sufficient fluid intake and balance—but when the Stomach and Large Intestine are too hot, they consume moisture, reducing the amount available for urination. - Dark Color of Urine
The urine is dark because it is more concentrated due to fluid loss.
Less fluid means higher waste concentration, making the urine appear darker and more pungent.
Which of the following acupuncture points is most commonly used to clear Heat and drain Fire from the Large Intestine?
A) ST 36
B) LI 11
C) SP 6
D) CV 12
Answer: B) LI 11
LI 11 (Quchi) is a key point for clearing heat and fire, particularly in cases of high fever, inflammation, and excess heat syndromes like constipation due to heat in the Large Intestine.
ST 36 (A) is primarily a Qi-tonifying point and does not clear heat.
SP 6 (C) is more related to regulating the Spleen, Liver, and Kidney but is not specifically a heat-clearing point.
CV 12 (D) is useful for digestive issues but does not clear heat specifically.
Which acupoint is indicated for Damp-Cold diarrhea with heaviness, abdominal pain, and a thick white tongue coating?
A) CV 12
B) ST 40
C) SP 9
D) ST 25
Answer: C) SP 9
SP 9 (Yinlingquan) is the primary point for resolving dampness in TCM and is used to treat Damp-Cold diarrhea and water retention issues.
CV 12 (A) supports digestion and Spleen Qi but does not resolve dampness as effectively as SP 9.
ST 40 (B) is for resolving phlegm and dampness, but it is more associated with dampness in the Lungs rather than Damp-Cold diarrhea.
ST 25 (D) is a powerful Large Intestine regulation point, but it does not focus on dampness directly.
Which acupuncture point is commonly used to resolve Damp-Heat in the Large Intestine, presenting as foul-smelling diarrhea, burning in the anus, and thirst?
A) LI 11
B) UB 25
C) ST 37
D) All of the above
Answer: D) All of the above
LI 11 (Quchi) clears heat and resolves Damp-Heat conditions.
UB 25 (Large Intestine Shu) directly influences Large Intestine function and can treat damp-heat diarrhea.
ST 37 (Lower He-Sea of the Large Intestine) is effective for intestinal disorders including diarrhea, colitis, and dysentery.
Since all of these points address Damp-Heat in the Large Intestine, the correct answer is D) All of the above.
Which of the following acupoints is most appropriate for treating Liver Qi stagnation causing alternating diarrhea and constipation?
A) ST 36
B) LR 3
C) LI 4
D) CV 12
Answer: B) LR 3
LR 3 (Taichong) is the primary point to move Liver Qi and resolve stagnation, making it the best choice for alternating bowel habits due to Liver Qi stagnation.
ST 36 (A) tonifies Qi and is useful for general digestion but does not address the Liver.
LI 4 (C) is good for moving Qi but is not as specific to Liver Qi stagnation as LR 3.
CV 12 (D) helps with Stomach and Spleen function, not Liver Qi stagnation.
A patient presents with exhaustion, sweating after bowel movements, early-morning diarrhea, and cold limbs. Which set of acupoints is most appropriate?
A) ST 36, UB 20, CV 4, GV 4, SP 15
B) LI 11, ST 44, LR 2, LI 4
C) CV 12, ST 40, SP 9, SP 6
D) LR 3, GB 34, CV 10, SP 15
Further clarification
Answer: A) ST 36, UB 20, CV 4, GV 4, SP 15
These points address Yang Deficiency, which is the underlying pattern of early-morning diarrhea and post-defecation fatigue.
B) LI 11, ST 44, LR 2, LI 4 clears Heat, which is unrelated to these symptoms.
C) CV 12, ST 40, SP 9, SP 6 treats Damp-Cold, which has different symptoms.
D) LR 3, GB 34, CV 10, SP 15 is for Liver Qi Stagnation, not Yang Deficiency.
Symptoms: Exhaustion, sweating after bowel movements, early-morning diarrhea, and cold limbs point toward Yang Deficiency.
Correct answer: A) ST 36, UB 20, CV 4, GV 4, SP 15
ST 36 & UB 20: Tonify Spleen Qi and Yang.
CV 4 & GV 4: Strengthen Kidney Yang, which plays a role in warming the body and preventing early-morning diarrhea.
SP 15: Regulates the Large Intestine and aids in bowel movements.
Why not the other choices?
B) LI 11, ST 44, LR 2, LI 4: These points clear Heat, which does not match a Yang Deficiency pattern.
C) CV 12, ST 40, SP 9, SP 6: These points treat Damp-Cold, which presents with heaviness, sluggish digestion, and thick tongue coating.
D) LR 3, GB 34, CV 10, SP 15: These points treat Liver Qi Stagnation, which presents with alternating diarrhea and constipation rather than persistent early-morning diarrhea.
Which acupoint combination is best suited for treating Blood Deficiency constipation with dry stools, pale complexion, and numbness in the limbs?
A) CV 4, SP 6, KD 6, UB 23, UB 25
B) LI 11, ST 44, LR 2, LI 4
C) ST 25, CV 12, ST 21, ST 44
D) CV 12, ST 40, SP 9, SP 6
Further Information
Answer: A) CV 4, SP 6, KD 6, UB 23, UB 25
These points nourish Blood and Yin, improving bowel function in Blood Deficiency constipation.
B) LI 11, ST 44, LR 2, LI 4 treats Heat, which is not the case here.
C) ST 25, CV 12, ST 21, ST 44 addresses food retention, not Blood Deficiency.
D) CV 12, ST 40, SP 9, SP 6 is for Damp-Cold patterns.
Symptoms: Constipation with dry stools, pale complexion, and numbness in the limbs indicate Blood Deficiency.
Correct answer: A) CV 4, SP 6, KD 6, UB 23, UB 25
CV 4 & SP 6: Nourish Blood and Yin.
KD 6: Moistens dryness caused by Blood/Yin Deficiency.
UB 23: Strengthens Kidney function in supporting Blood production.
UB 25: Regulates the Large Intestine to help relieve constipation.
Why not the other choices?
B) LI 11, ST 44, LR 2, LI 4: Clears Heat, which does not match Blood Deficiency.
C) ST 25, CV 12, ST 21, ST 44: These points address Food Retention, which presents with abdominal fullness and bad breath rather than dryness and pale complexion.
D) CV 12, ST 40, SP 9, SP 6: These treat Damp-Cold, which presents with watery diarrhea, not dry stools.
