Stomachache Flashcards
Etiology/Pathology
- Invasion of cold = Qi stag. Or blood stasis
- Emotional frustration = LiverQi stag. Creating fire
- Irregular diet = spleen yang Deficency or stomach yin Deficency creating cold
- Elderly/Long term illness = spleen Deficency
definition of stomachache
pain in the epigastric region
Digestive Signs and Symptoms
Heartburn Acid Reflux Nausea/Vomiting Belching Poor Appetite
3 Ways to remove evil Qi
Vomiting
Sweating
Diarrhea
Differentiate between Excess or Deficency Patterns
- Better or worse after eating
- Acute vs. Chronic onset
- Cold vs. Heat
- Nature of Pain
- Palpate better or worse on palpation
- Qi Stag vs Blood Stasis
What are the 3 types of pain to differentiate from stomachache pain?
- Cardiac Pain
- Hypochondriac Pain ( referring from Liver/GB, usually on the right)
- Abdominal Pain ( Referring from Spleen)
How to differentiate between Qi stagnation or blood stasis
Qi Stagnation = relieved after gas and pain moves
Blood Stasis= fixed pain
Tongue and Pulse for Cold in ST
Thin and white coating
Wiry and tight
Acupuncture points for Cold in Stomach
ST34
SP 4
Cold in Stomach Symptoms
Sudden epigastric Pain which is releived by warmth and aggrevated by cold, chills, no thirst and prefer warm drink
POT for Cold in ST
Warm middle Jiao to dispel cold
Food Retention Symptoms
Fullness and distending pain in epigastric region, which is relieved by vomiting, belching, acid regurgitation, vomit with undigested food, hesitant food retention
Tongue and Pulse for Food Retention
Thick greasy coating
Slippery
Acupuncture Pt for Food Retention
RN11
InnerNeiting (St-44)
POT of Food Retention
Promote digestion and harmonize the stomach
HEAT IN STOMACH
Heat in Liver & Stomach Symptoms
Acute epigastric pain, irritability, anger, bitter taste in the mouth, dry mouth, belching, acid regurgitation
Tongue and Pulse for HEAT IN STOMACH
Heat in Liver & Stomach
Red tongue with yellow coat
Wiry and Rapid
Acupuncture Pt for
HEAT IN STOMACH
Heat in Liver & Stomach
ST 44
Liv 2
POT of
HEAT IN STOMACH
Heat in Liver & Stomach
Soothe Liver and clear heat
HEAT IN STOMACH:
Damp Heat in MJ
symptoms?
Epigastric burning pain, thirst with no desire to drink, belching, dry mouth, bitter taste, yellow scanty urine, hesitant bowel movement
Tongue and Pulse for
HEAT IN STOMACH
Damp Heat in MJ
Yellow and greasy coating
Slippery and Rapid
POT for
HEAT IN STOMACH
Damp Heat in MJ
Clear damp heat, regulate Qi to harmonize middle jiao
Acupuncture PT for
HEAT IN STOMACH
Damp Heat in MJ
RN 9
SP 9
Stomache Ache excess patterns
Qi Stag Blood Stasis Cold in St Food Retention Heat in St
Stomache ache Deficency Patterns
St yin Deficency
Deficency cold
Qi Stagnation Symptoms
Distending/ wandering pain in epigastric region which refers to hypochondrium, frequent belching, related to emotional changes, hesitant bowel movement
Tongue and Pulse for
Qi Stagnation
Thin white coating
Wiry
POT for Qi Stagnation
Soothe liver, regulate Qi and harmonize ST
Acupuncture Pt for Qi stagnation
Liv 14, liv 3, GB 34
Blood stasis Symptoms
Fixed stabbing epigastric pain, pain releieved by meal, blood in stool, hematemesis
Tongue and Pulse for Blood Stasis
Dark purple to gue
Choppy
POT for Blood Stasis
Move blood to circulate the Collaterals, regu,ate Qi and harmonize ST
Acupuncture Pt for Blood Stasis
SP 10
BL 17
RN 10
ST Yin Deficency Symptoms
Dull lingering pain in epigastrium, dry mouth and throat, thirst no desire to drink, dry stool
Tongue and Pulse for ST yin Deficency
Red tongue no coating
Wiry and thready
Acupuncture Pt for ST Yin Deficency
Sp 6
BL 21
Deficency Cold Symptoms (yang def)
Dull lingering pain in the epigastrium which is releieved by warmth/pressure/meal, loose stool, vomiting clear water, poor appetite, listlessness, fatigue, cold limbs
Tongue and Pulse for Cold (yang def)
Pale Tongue
Soft and weak
POT For Deficency Cold (yang def)
warm middle jiao and strengthen spleen
Acupuncture Pt for Deficency Cold (yang def)
BL 20, 21
RN 6
POT for St Yin Deficency
Nourish Stomach Yin
Client Education/Prevention
- Diet- don’t over eat
- Avoid smoking/alcohol
- Regulate Emotions
- Avoid eating excess meat
- Watch vomit and stool for blood
Name for stomachache in Western Medicine
Gastritis- acute or chronic
Causes for Acute Gastritis
Very common
- Alcohol
- Drugs/steroids
- Diet (food poisoning)
Acute Gastritis Symptoms
Sudden onset poor appetite nausea/vomiting food poisoning watery diarrhea fever dehydration
Chronic Gastritis Symptoms
No real symptoms - recurrent mild symptoms Dull epigastric pain worse after eating belching nausea acid reflex poor appetite anemia Mouth sores gallstones
Causes for Chronic Gastritis
Unknown….Helicobacter Pylori?!
Acupuncture Pt for Gastritis
Use a distal point first: St 36
then move to local points.
~ask if Qi sensation to stomach and pain will decrease within 3minutes
Acu points for Excess pattern?
front MU of ST: CV12
he-sea of ST: St-36
use reducing technique
Acu points for deficient pattern?
Back SHU of ST: UB-21
Back SHU of SP: UB20
use tonifying technqiue
Alternative methods?
Moxa: (CV-4/6/12, ST-36/25, PC-5) with ginger for yang def
auricular: (ST, SP, Shenmen, sympathetic, endocrine)
scalp acu: (DU-9)
herbal remedy
lifestyle: dont overeat, quit smoking, limit alcohol, re. emotions, rest,
watch for blood in stool/vomit
Chief pathology of stomachache?
St Qi stagnation
Duodenum vs Stomach Ulcer
1) Pain Location
- Duodenum epigastric pain on the right
- Stomach epigastric pain on the left
2) Pain Pattern
- Duodenum when stomach is empty (2-3 hours after eating, before eating, middle of night)
- Stomache pain occurs half an hour to one hour after eating
- If ulcer on posterior wall of stomach patient may have back pain around T4-T7.. Rule out musculoskeletal vs ulcer by signs and symptoms
- Duodenum usually has more acid reflux
POT for Peptic Ulcer
- Move Qi and Blood
- Harmonize Stomach
*stop pain and heal ulcer
Modalities for Peptic Ulcer
- Moxa (Warming needle, moxa box, Back shu/.
Alarm pts use Moxa coins)
*esp. good for duodenum ulcer - Flash Cupping (around st and lung meridian and
navel region) - Auricular on sp, st, liver, duodenum, brain pts
How can you educate patient for ulcers?
- Regulate Diet
* 2.Regulate Stress
Basic stomachache points: (4)
1) CV-12
2) PC-6
3) ST-36
4) ST-21
What is the basic POT for stomachache?
- reg. QI
- stop pain
- harmonize ST
General TX for Excess Stomachache patterns?
- points: CV-12 (MU-ST), ST-36 (Heavenly star)
- use reducing technique
- if cold combine with moxa
What is the basic TX for deficient stomachache patterns?
- Points: UB-21 (SHU ST), UB-20 (SHU SP)
- use tonifying technique
- if cold pattern combine with moxa