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STOMACH PAIN
NESA Int Med STOMACH PAIN
Question | Answer |
---|---|
Define stomach pain. | Painful sensation between the lower margin of the sternum and the infracostal margins. |
What are the most common etiologies and pathologies of stomach pain? | Cold evil qi attacking the Stomach and obstructing the circulation of qi and blood; improper diet impairing the Stomach; Liver qi overacting on Stomach; overexertion; constitutional weakness; improper medical treatment damaging the Stomach (TCM or pharma) |
What is the site of disease in cases of stomach pain? | Stomach, but intimately related to Spleen and Liver |
What are the crucial points in diagnosing stomach pain? | Distinguish cold from heat, xu from shi and qi stagnation from blood stasis and determine the sit of disease (organ involvement) |
What are the common treatment strategies for stomach pain? | Regulate the qi (Liver or Stomach); Harmonize the Stomach, improve digestion; Descend rebellious Stomach qi; Expel evil qi; Tonify deficiency |
What are the eight patterns associated with stomach pain? | Cold invading the Stomach; retention of food; Liver qi attacking the Stomach; accumulation of heat in the Liver and Stomach; blood stasis in the Stomach; heat-dampness obstructing the middle burner; Stomach yin xu; and Spleen and Stomach yang xu |
What are the s/s, treatment principle and formula for cold invading the Stomach? | Sudden onset of severe epigastric pain, better w/warmth, worse w/cold and pressure, cold extremities, T:thin w/twc, P:wiry,tight; Warm the Stomach, dispel cold, promote the movement of qi and alleviate pain w/ Liang Fu Wan |
What are the s/s, treatment principle and formula for retention of food? | Dull pain, fullness, distension, belching, acid reflux, foul breath, nausea, vomiting undigested food, alt loose stools and constipation, T:thick greasy tc, P:slippery; Reduce food stagnation, regulate qi, harmonize the Stomach and stop pain w/ Bao He Wan |
What are the s/s, treatment principle and formula for Liver qi attacking the Stomach? | Distending pain radiating toward hypochondria worse w/emotional strain, freq hiccups, jaw tension, h/a, irreg BMs, T:twc, P:deep,wiry; Soothe the Liver, regulate qi, harmonize the Stomach and relieve pain w/ Chai Hu Shu Gan San |
What are the s/s, treatment principle and formula for accumulation of heat in the Liver and Stomach? | Acute, sudden burning pain w/acid reflux, irritability, dry mouth, bitter taste, strong hunger, T:red w/dry ytc, P:wiry,slippery,rapid; Soothe the LV, clear heat, harmonize the ST and relieve pain w/ Jia Wei Xiao Yao San or Hua Gan Jian plus Zuo Jin Wan |
What are the s/s, treatment principle and formula for blood stasis in the Stomach? | Fixed, stabbing pain, worse at night, worse w/pressure and after meals, poss. hematemesis or melena, T:dark purple w/petechiae, P:choppy; Invigorate the blood, dispel blood stasis, harmonize the Stomach and relieve pain w/ Shi Xiao San plus Dan Shen Yin |
What are the s/s, treatment principle and formula for heat-dampness obstructing the middle burner? | Burning sensation, gnawing hunger, thirst, bitter taste, dark urine, sluggish body, low appetite, foggy headed, irreg BM, T:red w/thick greasy ytc, P:slippery, rapid; Clear heat, transform dampness, regulate qi and harmonize the Stomach w/ Qing Zhong Tang |
What are the s/s, treatment principle and formula for Stomach yin xu? | Vague burning epigastric pain, hunger sans desire to eat, dry mouth and throat, dry stools, T:dry, red, P:thin, rapid; Nourish yin, strengthen the Stomach, harmonize the middle burner and alleviate pain w/ Yi Guan Jian plus Shao Yao Gan Cao Tang |
What are the s/s, treatment principle and formula for Spleen and Stomach yang xu? | Vague, dull epigastric pain, better w/warmth, pressure and after meals, worse w/hunger, vomiting water, low appetite, fatigue, cold limbs, loose stools, T:pale w/wtc, P:weak,slow; Warm and supplement SP and ST and relieve pain w/ Huang Qi Jian Zhong Tang |