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Stomach Problems

The Stomach energetic system is paired with the Spleen in Chinese medicine and the two work together to digest and absorb foods and nutrients. The Stomach is responsible for partially digesting foods so that the Small Intestine is able to further absorb necessary sustenance. If the Stomach fails to “ripen” the food initially, the entire digestive cascade is disrupted and issues can develop throughout the digestive process. If one develops disease, it is understood that the other will also be out of balance because their inter-relation and dependency is so closely related.

Stomach's Functions in Chinese Medicine

The Stomach is Responsible for Receiving Food

Food and drink are received by the Stomach; the Stomach "receives" food and drink and keeps them down as the Stomach Qi is descending in nature. The Stomach's function of receiving food also has a relationship with the appetite. A healthy appetite indicates strong Stomach Qi, a poor appetite indicates weak Stomach Qi. The Stomach receives food depends on the harmonization of Spleen-Stomach relationship, as a poor appetite is also related to Spleen Deficiency.

The Stomach Plays a Role in Transforming Food

The Stomach transforms ingested food and drink by a process of fermentation: the ancient texts describe this as "rotting and ripening" food; this would be liken this to the acid break down that occurs in the stomach allowing the small intestine to absorb nutrients.

The Stomach Controls Descending Qi

Healthy Stomach Qi always descends, and controls the descending of Qi to the Small Intestine, and eventually the Large Intestine. Health Stomach-Qi has a downward movement providing for good digestion overall. If Stomach-Qi fails to influence the downward movement of food, food will stagnate in the stomach resulting in a feelings of fullness and distension, sour regurgitation, belching, hiccups, nausea, and possibly vomiting.

Stomach Yin-Yang Differentiation

Stomach Yang has the functions of warming and nourishing. Stomach Yin refers to the fluid of the stomach responsible for moistening and nourishing Stomach tissue. Both collectively maintain the normal functions of digestion and reception of foods. Deficiency of Stomach Yang causes Coldness, while deficiency of Stomach Yin causes Deficient Heat symptoms.

Related Article: Yin-Yang Theory

Patterns of Stomach Imbalances

Stomach disorders are generally caused by chronic poor eating habits, excess intake of fried foods, prolonged juicing and raw foods intake, pharmaceutical medication and/or chewing tobacco. Additionally, excessive consumption of alcohol, salt, hot spices, and/or coffee. These are some of the more common patterns seen:

Spleen-Stomach Imbalances

As mentioned earlier, the Spleen and Stomach are paired organs of the Earth Element according to Chinese medicine. They directly impact each other, and it is highly unlikely that you would have an imbalance of one without an imbalance of the other. The Stomach tends to be excessive and develop Heat as an imbalance, and the Spleen tends to be Deficient in nature. With Stomach Deficiency, the Spleen is often re-enforced.

Spleen-Stomach Comparison

According to the Five Element theory of traditional Chinese medicine, both Stomach and Spleen belong to the Earth, one is Yang (Stomach) and the other is Yin (Spleen). There functions are closely coordinated. This coordination and complementary actions between Stomach and Spleen are summarized in below.

  • The Stomach is Yang; the Spleen is Yin
  • Stomach Qi descends; Spleen Qi ascends
  • The Stomach benefits from wetness and is injured dryness; the Spleen benefits from dryness and is injured by wetness
  • Stomach diseases tend to be Excessive; the Spleen imbalances tend to be Deficient in nature 
  • The Stomach is prone to Heat; the Spleen is prone to Cold
  • The Stomach tends to develop Yin Deficiency; the Spleen tends to develop Qi-Yang Deficiency (although each of them may also suffer from the opposite)
  • If the Stomach is too dry, Stomach Qi cannot descend and food will not descend to the Small-Large Intestines; if the Spleen is too Damp, Spleen Qi cannot ascend and fluids and food cannot be transformed.

Stomach Qi Deficiency

When Stomach-Qi is deficient, Spleen-Qi will also be deficient because Stomach and Spleen are closely intertwined according to Chinese medicine. This results in several of the same symptoms as Spleen Qi Deficiency as seen here:

  • Uncomfortable feeling in area of stomach
  • Lack of appetite
  • Lack of taste
  • Loose stools
  • Tiredness, especially in the morning
  • Weak limbs
  • Pale tongue

Most Common Causes of Stomach Qi Deficiency;

  1. Poor dietary practices or under-eating can cause a Stomach-Qi Deficiency
  2. Chronic illness weakens Qi in general Stomach Qi Deficiency is very common to see Stomach-Oi Deficiency after a prolonged illness.
  3. Stomach Qi Deficiency can result in Stomach Yin Deficiency, Stomach Qi Stagnation, or Stomach Blood Stagnation if left untreated.

Liver Overacting on Stomach

When the Liver energetic organ system is not functioning properly it tends to become constricted or stagnant. As this congestion builds over time the Liver heats up. If the Liver Heat and Stagnation are not treated the Liver will strike out, or “attack”, susceptible, vulnerable, or weaker organ systems. Those who have genetic tendencies towards a weak digestion, those who do not eat well, and those who worry too much (an Earth Element imbalance) can develop a weak stomach susceptible to the wrath of the Liver. The symptoms would include indications of Stomach Qi Deficiency as above combined with Liver Chi Stagnation including the following:

The Liver influences the flow of Qi throughout the body and Stomach Qi Stagnation may likely be related to Liver Qi Stagnation.; thus, the symptoms are similar as seen below:

  • Epigastric pain and distension
  • Belching
  • Nausea and vomiting
  • Hiccups
  • Irritability

Causes of Stomach Qi Stagnation:

-Poor dietary habits such as eating in a hurry or eating while stressed

-Emotional stresses such as anger, frustration and resentment

Stomach Heat

Symptoms:

  • Yellow coat on tongue
  • Constant hunger
  • Chronic low-grade nausea

Chronic Liver-Fire overacting on the Stomach which is not treated correctly can develop into Stomach Heat. Stomach Heat is very prevalent in western society mainly due to the prevalence of Liver Qi Stagnation, poor eating habits, and pharmaceutical use. Initially, dairy products will sooth the symptoms and inflammation related to Stomach Heat, and those developing this imbalance will be drawn to them. Unfortunately, the overconsumption of dairy eventually causes Internal Dampness and will contribute in to many pain syndromes and diseases. Better dietary choices with Stomach Heat would be avocado, bland soups and broths, oatmeal, flax seed, and demulcent herbs; this is why we include marshmallow root in most of our formulas to help promote digestibility of the herbs.

Stomach Fire

When Stomach Heat is left untreated over a period of time it will likely develop into a more serious imbalance of Stomach Fire. One additional cause of Stomach Fire not included above would be a bacterial infection such as helicobacter pylori; however, in the way of Chinese medical thinking, a person would not be susceptible to an infection unless they were already compromised. Therefore, those developing an ulcer often have been experiencing lower grade symptoms of Stomach Heat prior to developing an actual disease. While one can address the underlying Heat and Yin Deficiency, this can be a serious condition and requires local health care and not just self-treatment.

Symptoms:

  • Red tongue with thick yellow coat
  • Strong hunger with no desire to eat
  • Burning sensation in stomach
  • Stomach ulcers
  • Duodenum ulcers
  • Mouth ulcers or canker sores
  • Vomiting possibly with blood

Comparing Stomach-Heat with Stomach-Fire:

  • Stomach-Fire is a severe form of Stomach-Heat
  • Stomach-Fire is more intense and presents with intense thirst
  • Stomach-dries up fluids to a greater degree and therefore presents with dry stools and dark urine
  • It may cause bleeding, such as bleeding gums
  • It disturbs the Mind-Shen and creates more severe mental imbalances
  • The tongue will be more red and drier with dark yellow coating

Stomach-Fire typically arises from other imbalances such as Stomach-Oi Stagnation or retention of food in the stomach. Stomach-Fire dries the Body Fluids and may lead to Stomach-Yin deficiency. In some cases, Stomach-Fire may also condense Blood and lead to Blood Stasis in the Stomach.

Stomach Yin Deficiency

Prolonged Stomach-Heat can result in Stomach Yin Deficiency if it is not properly treated. Many of the symptoms are similar to Stomach Heat, but this condition is one of Deficiency rather than excess.

  • No appetite or slight hunger with no desire to eat
  • Constipation with dry stools
  • Dull or slightly burning epigastric pain
  • Slight feeling of fullness after eating
  • Vomiting sometimes
  • Hiccups, especially after spicy food
  • Dry red tongue without coating

Dry mouth and throat especially at night and in the afternoon with a desire to drink small amounts of fluids (rather than a strong thirst with a desire to drink large amounts of cold water as seen with Stomach-Fire)

Causes of Stomach Yin Deficiency:

  1. Diet-An irregular diet and eating habits deplete Stomach-Qi and will begin to weaken Stomach-Yin in time. Eating late at night and and too many spicy foods are especially harmful for Stomach-Yin.
  2. Fevers-High fevers during the course of an acute infectious disease may cause Stomach-Yin deficiency; however, this type of Stomach Yin damage may reverts to normal in a few days or weeks.
  3. Medications-Prolonged antibiotics use or chemotherapy injures Stomach-Qi and Stomach-Yin

Yin and Yang are difficult concepts to grasp; most of us think of Yin and Yang as cold and hot or night and day relatively. This is correct, but when applying the concept to the body it is necessary to understand that Yin represents substance such as Blood and tissue. When Heat is present for a prolonged period of time it begins to consume Yin and the stomach lining and actual organ as a whole becomes less efficient and less able to assimilate nutrients.

Yin and Yang qualities are never stagnant; they are always in a state of transforming into one another. Therefore, if the Stomach is deficient of a long period of time and foods tend to stagnate in the Stomach, eventually a Cold deficient pattern will turn to Heat; think about how a pond that lacks running water eventually develops bacteria and begins to heat up.

Likewise, if the Stomach develops Heat for a prolonged period, eventually the Heat will die out once the substance is consumed through Yin consumption. It is easier to grasp this concept if you liken Yin substance to the logs on a fire. Once the Yin is fully consumed, you end up with Stomach deficiency and/or Cold in the Stomach.

Deficient Stomach or Deficient Digestive Fire

This pattern would be indicated by a white tongue coating, a tongue coat that appears as if it is not attached to the tongue body, slow digestion, undigested food in the stool, and/or abdominal distention.

Cold in the Stomach

Those developing Stomach-Heat as described above will often crave ice water and very cold substances. Unfortunately, this strategy creates further complications. The Stomach actually has to be very warm to digest food. When we drink ice water, the temperature of the stomach is lowered to the point where it cannot digest food. When the food does not break down in the stomach it tends to sit there for a long time and cause bloating, abdominal distention, and indigestion. Again, the whole digestive process is thwarted and symptoms from nausea to constipation or undigested food in the stool will develop. The main indication would be stabbing or sharp pain in the stomach area, but there are many indications that can develop with Stomach Cold as seen here:

  • Dull pain in the stomach area that improves after eating and improved with pressure or warm compresses
  • No appetite
  • Preference for warm drinks and food
  • Vomiting of clear fluid
  • Cold and weak limbs
  • Tiredness and weakness of muscles
  • Pale complexion
  • Aversion to conversing or speaking
  • Sudden severe pain in the epigastrium, a feeling of cold
  • Cold limbs
  • Preference for warmth
  • Vomiting of clear fluids which may alleviate the pain
  • Nausea, feeling worse after drinking cold liquids, which are quickly vomited, preference for warm liquids.
  • Tongue with a thick white coating or pale wet tongue

Causes of Cold Invading the Stomach:

  1. Invasion of the Stomach by exterior Cold due to exposure to cold and excessive consumption of cold foods and ice drink can cause Stomach-Cold. This is a pattern of Interior Excess-Cold. It is an acute pattern caused by the invasion of the Stomach by exterior Cold. The Stomach is one of the organs that can be attacked by exterior Cold directly, by-passing the exterior protective layers (Wei Qi) into the body, or by the ingestion of too many cold foods or drinks.
  2. Exterior Cold blocks the Stomach and prevents Stomach-Qi from descending and Cold also impairs the Yang of the Stomach and Spleen and prevents the food essences from reaching the whole body.
  3. Irregular or incorrect meal times, skipping a proper breakfast, over or under-eating, eating late at night, eating too fast or eating while emotionally stressed can all damage the Stomach and make it more vulnerable to Cold invasion.
  4. Chronic Spleen Qi Deficiency is a typical underlying imbalance leading to Stomach-Cold

Rebellious Stomach Qi

This pattern is an expression of the impairment of the descending quality of Stomach Qi. It is frequently not a pattern develops by itself, but accompanies other patterns of Stomach imbalance such as Stomach-Fire, Stomach-Qi stagnation or Cold invading the Stomach. All the symptoms are caused by the failure of Stomach Qi to descend including:

  • Nausea
  • Difficulty in swallowing
  • Belching
  • Vomiting
  • Hiccup

Food Retention of the Stomach

Often due to overeating or eating too quickly, this pattern is common in babies and children as their Stomach and Spleen are inherently weak in the first years of life and food easily accumulates in the Stomach.

  • Fullness
  • Pain and distension of the abdomen relieved by vomiting
  • Nausea
  • Vomiting of sour fluids
  • Bad breath
  • Heartburn and belching of sour fluids
  • Insomnia
  • Loose stools or constipation
  • Poor appetite
  • Thick white or yellow tongue coat

Causes of Food Retention in the Stomach:

This is an Interior Excess pattern. It could be associated with either Cold or Heat, in which case the tongue coating would be white or yellow respectively. Most of the symptoms are caused by the obstruction of food in the Stomach preventing Stomach-Oi from descending. Bad breath is due to the fermentation of food in the Stomach for too long.

Further Developments:

Retention of food in the Stomach is likely to generate Heat and lead to Stomach-Heat. The undigested food, together with the impairment of the descending of Stomach-Oi, may also lead to the formation of Dampness or Phlegm.

Blood Stasis in the Stomach

Stomach Blood-Stasis is a serious health condition as it potentially gives rise to serious diseases; for example, one can't get carcinoma of the Stomach purely from Stomach-Qi stagnation, but can from Blood-Stasis in the Stomach. This condition is not a good candidate for self-treatment, and immediate care from a health care professional should be sought. 

Symptoms may include:

  • Severe stabbing epigastric that may be worse at night
  • Discomfort of pressure to the abdomine
  • Nausea and vomiting, possibly vomiting of blood
  • Vomiting undigested foods that look like coffee grounds
  • Purple tongue bod.

Common Stomach imbalances proceeding Blood stasis:

  1. Stomach-Qi stagnation
  2. Cold invading the Stomach
  3. Stomach deficient and cold

Causes of Blood Stasis in the Stomach:

Diet-This pattern can be due to excessive consumption of rich, hot foods such as meat, spices and alcohol, and smoking (tobacco has a hot energy). In the case of Phlegm-Fire is caused by excessive consumption of hot greasy foods, such as deep-fried foods.

Emotional strain- Anger, frustration and resentment lead to stagnation of Stomach-Qi, which in turn may lead to Stomach-Fire which may be rooted in Liver-Fire.

Classical Theories of Stomach in Traditional Chinese Medicine

The Stomach likes Moisture and the Spleen likes Dryness in Chinese medical theory.

Ye Tian Shi [Ye Tianshi; ca 1690-1760 A.D. “Wenbing Tiaobian”] said: "After food has entered the Stomach, the Spleen transforms and moves it; if Spleen-Qi rises, it is healthy. If Stomach-Qi descends, it is harmony...... Yang Qi of the Spleen moves...... Yin Qi of the Stomach is quiet. The Spleen likes dryness and Stomach likes moisture."

Thus the ascending and descending of Spleen-Qi and Stomach-Qi are crucial for the production of Qi and Blood and for the harmonious crossing of Qi in the Middle Burner. “ The Spleen loathes Dampness ”

Another saying: “the Spleen is the source of Phlegm” which means that Dampness will occur causing Phlegm if Spleen-Qi is damaged and vigor-less it will fail to transport fluids properly.

The Stomach is often said to be the most important of all the Yang organs; together with the Spleen, it is known as the “Root of post-Heaven Qi”; this is because it is the origin of all Qi and Blood produced after birth.

The Stomach is the seen as the origin of fluids and the Stomach needs an abundance of fluids. The Stomach is an important source of fluids in the body, and for this reason it is said that the Stomach “likes wetness and dislikes dryness”. The Stomach's function as origin of fluids is closely related to the Kidneys. The Kidneys are sometimes called the “Gate of the Stomach” because they transform fluids in the Lower Burner. If the fluids of the body are normal, wellness is possible; if there are not enough fluids, Yin Deficiency can develop. Once Yin Deficiency develops, drinking fluids is no longer sufficient for reversing the conditions and requires herbal Yin tonic therapy.

References