Abdominal Pain

A commonly experienced ailment, abdominal pain refers to a wide range of medical conditions, all of which cause pain in the region between the ribs and pelvis. The causes of abdominal pain can be wide-ranging, due to the complex anatomical nature of the region. Your abdomen is home to multiple muscle groups, tissues, fascia, and the internal organs. In modern society, we are all well-versed in the various symptoms of abdominal pain, including anything from muscle strain or traumatic injury to pancreatitis, appendicitis, gastrointestinal spasms, or ulcers, to name but a few.

Because the causes of abdominal pain can potentially be quite serious, it is important that acupuncture and Traditional Chinese Medicine (TCM) treatment should not be undertaken in the absence of a Western biomedical diagnosis. If your condition has not been assessed by a medical doctor, it is incumbent upon your acupuncturist to encourage you to seek such a diagnosis. It is vital to rule out serious conditions requiring more than just acupuncture treatment.

TCM has much to offer in the treatment of abdominal pain, owing to its sophisticated understanding of the internal organs and how they function in bodily processes. There are several established patterns of disharmony that are possible when abdominal pain is present. It is fundamental to Chinese medicine that treatment is performed according to a differentiated pattern of disharmony. Below are the possible patterns of disharmony at play in abdominal pain. They all involve the stagnation of qi in the abdomen, but in each pattern qi the stagnation owes to a different cause.

EXTERNAL COLD INVASION

In abdominal pain owing to external invasion, there is an exposure to the elements, namely excessive cold, that plays a causal role in the abrupt onset of this type of abdominal pain. Cold invasion constricts vessels and channels in the abdomen, and causes the harmonious movement of qi and blood to slow. As a fundamental of Chinese medicine, when qi movement is impaired the result is pain.

Abdominal pain owing to cold is characterized by pain that is reduced with the application of heat, and worsened with the presence of cold. The individual experiences lack of thirst, copious clear urine, and possibly loose stools. The tongue coating is white and thick or slimy, and the pulse is deep and/or tight.
Treatment of this pattern seeks to warm the abdomen and scatter the cold, regulate the qi of the abdomen, and resolve the pain. Moxibustion is often used to warm the abdomen.

DAMP HEAT INVASION

Abdominal pain caused by damp heat is characterized as being worse with pressure – that is to say, holding or pressing the abdomen in with this type of pain causes increased discomfort. There is a sensation of abdominal fullness and distension, and bowel movements are difficult. Constipation may be experienced as well. Overconsumption of alcohol, fats, and rich greasy foods contribute to this pattern of disharmony. Signs and symptoms of this type of abdominal pain include sweating, irritability, thirst, and dark, scant urination. The tongue coating is yellow and greasy, and the pulse has a slippery character and may be rapid. Treatment of this type of abdominal pain involves resolving the dampness, unblocking the abdomen, and clearing heat.

DEFICIENT TYPE COLD

Whereas external cold invasion involves exposure to excessive environmental cold, this type of abdominal pain owes to cold caused by an insufficient ability of the body to be warm enough to perform digestive functions. This warming is considered a function of the body’s yang energy, and it is this aspect that is in a state of deficiency in this pattern.
The function of the Spleen in TCM is to transform and transport food and drink into what is useful to the body in order to be nourished. To do this adequately, the Spleen must be warm enough. There are numerous ways this function can be damaged or impaired, including a diet too highly focused on cold-natured, or raw foods, and certain pharmaceuticals including laxatives and antibiotics, and NSAIDs. Overly restrictive dieting or inadequate intake of food can also cause damage to this function. In this regard, any food or drug that impairs the body’s digestive function can be said to cause a condition of deficient cold.
In this type of abdominal pain, the pain is dull, or intermittent, and feels better with the application of heat, or with holding or pressing the abdomen. The pain worsens with hunger or fatigue.
There may be loose stools, and the individual will either feel cold, or feel an intolerance of cold. The tongue is pale, with a white coat, and the pulse will be deep and thready.
Treatment includes warming the abdomen and strengthening the digestive function, as well as moderating the pain. Moxibustion is commonly used to warm the abdomen and strengthen the digestive function, along with appropriate acupuncture point prescriptions.

FOOD RETENTION/STASIS

This is likely the most easily understood form of abdominal pain as it is commonly experienced. Caused by overeating, this type of abdominal pain features a feeling of abdominal fullness, distension, and pain that feels worse with pressure applied to the abdomen. There is no interest in further eating, and there can be belching, constipation, or difficult bowel movements.
Put simply, the digestive system in this situation is overtaxed due to overeating, and cannot perform the necessary digestive functions adequately. Pain is improved after a bowel movement.
In this situation the tongue has a greasy coat and the pulse is slippery.
Treatment involves reducing the stasis and helping to get the excess downward and out.

QI STAGNATION

This type of abdominal pain has an emotional element and can be acutely experienced following bouts of highly stressful or emotional events.
A fundamental principle in TCM is that when qi stagnates, pain is experienced, and that when qi is moving freely, there is no pain. While qi stagnation plays a role in each of the above patterns (but is caused in different ways), in this pattern qi stagnation has an emotional cause.
In addition to the emotional element, this type of abdominal pain involves a feeling of fullness or distension in the abdomen that is often intermittent and of varying intensity. The pain improves with relaxation or with the passing of gas, and the individual may experience alternating constipation and diarrhea.
The tongue has a thin white coat, and the sides are often reddish. The pulse is wiry.
Acupuncture treatment involves moving Liver Qi, resolving the qi stagnation, and strengthening the Spleen’s digestive functions in order to stop the pain.

BLOOD STASIS

Abdominal pain indicating a blood stasis pattern features intense pain at a fixed location that is stabbing, or piercing in nature. It is worsened with the application of pressure, and may involve the presence of a palpable mass or area of hardness.
Pain owing to trauma and post-surgical pain are of the blood stasis type.
In this pattern the tongue is typically purple, or features purple spots, while the tongue coat is thin and white. The pulse is characteristically wiry or choppy.
Acupuncture treatment of abdominal pain in this pattern involves invigorating the blood to resolve the stasis and stop the pain. This is accomplished with certain acupuncture point prescriptions.

Western medical conditions falling under the TCM illness of abdominal pain and treatable by acupuncture and herbs include, but are not limited to:
intestinal spasm or obstruction, appendicitis**, ulcerative colitis, gastroenteritis, chronic or acute colitis, peptic ulcer, IBS, postpartum pain, dysmenorrhea, endometriosis, diverticulitis, Crohn’s disease, pelvic inflammatory disease, inguinal hernia, uterine fibroids, ovarian cysts, post partum placental retention, intestinal obstruction or adhesion, and trauma to the abdomen
**requires immediate Western medical treatment