Abdominal Pain
腹痛
Pain or discomfort in the abdominal region from various internal imbalances.
Quick Facts
Abdominal Pain in Traditional Chinese Medicine
In Traditional Chinese Medicine, abdominal pain is organised by pattern rather than by location alone. The same pain may be associated with Yang deficiency, Blood stasis, Stomach Heat or Blood deficiency. Differentiation asks whether the pain is relieved by warmth and pressure or worsened by them, whether there is constipation or loose stools, fixed or moving pain, and whether heat signs such as thirst and a yellow tongue coating are present. Classical formulas are matched to these pattern distinctions, not to the word “abdominal pain” in isolation.
TCM Patterns Associated With Abdominal Pain
The same presentation may be understood through more than one pattern. Pattern differentiation weighs the accompanying signs, not the symptom on its own.
| Pattern | Common Features | Related Formulas |
|---|---|---|
| Summer Heat暑熱證Exterior Patterns | Fever or a strong sense of heat after exposure to hot weather, heavy sweating, thirst, and fatigue or heaviness of the body. There may be irritability, scanty dark urine, and a preference for cool drinks. Symptoms often start in high summer. Tongue red with a dry yellow coating; pulse rapid and possibly soft or large. | |
| Shaoyang Syndrome少陽證Exterior Patterns | Alternating chills and fever, fullness and discomfort in the chest and rib-side, a bitter taste in the mouth, dry throat, dizziness, poor appetite and nausea, and an irritable or restless mood. Tongue with a thin white coating; pulse wiry. | |
| Phlegm-Heat痰熱證Phlegm Patterns | Yellow or sticky phlegm that is hard to expectorate, chest tightness, and a sense of heat or restlessness. There may be a bitter taste, thirst, and constipation or dark urine when heat is marked. Cough can be forceful with a rattling sound. Tongue red with a yellow greasy coating; pulse slippery and rapid. | |
| Stomach Heat胃熱證Heat Patterns | Burning or discomfort in the epigastrium, thirst with preference for cold drinks, bad breath, and a tendency toward constipation or dry stools. The gums may feel swollen or sore, and appetite can be strong yet unsettled. Tongue red with a yellow coating, possibly dry in the centre; pulse slippery and rapid. | |
| Damp-Heat濕熱證Damp Patterns | A heavy body with a sense of heat, sticky or bitter taste in the mouth, scanty dark urine, and discomfort that worsens in hot humid weather. There may be greasy skin, sticky stools, or yellowish discharge. Thirst is present but drinking may not feel satisfying. Tongue red with a yellow greasy coating; pulse slippery and rapid. | |
| Food Stagnation食積證Stagnation Patterns | Epigastric or abdominal fullness and distension after eating, foul belching or sour regurgitation, and reduced appetite for the next meal. Stools may be foul-smelling or sticky, and the person often feels better after vomiting or passing stool. Symptoms clearly relate to overeating or irregular meals. Tongue with a thick greasy coating; pulse slippery. | |
| Qi Stagnation氣滯證Stagnation Patterns | Distension, tightness or a constrained feeling in the chest, flanks or abdomen that comes and goes with emotion or stress. Frequent sighing, a sense that emotions are hard to move, and in women premenstrual breast or lower abdominal discomfort are common. Symptoms often ease after movement, expression or belching. Tongue may be normal or slightly dusky; pulse wiry. | |
| Blood Stasis血瘀證Stagnation Patterns | Fixed, stabbing or piercing pain that does not move freely, often worse at night or with pressure. The complexion may look darker or purplish, and in women the menstrual flow can be dark with clots. Lips or nails may appear dusky. Tongue dark or with purple spots or congested veins under the tongue; pulse choppy or wiry and hesitant. | |
| Cold Accumulation寒積證Cold Patterns | Fixed cold pain in the abdomen that prefers warmth and worsens with cold food or exposure. There may be constipation or difficult stools, cold limbs, and a preference for warm drinks. The abdomen can feel hard or full on pressure. Tongue pale with a white coating; pulse deep and tight or wiry. | |
| Blood Deficiency血虛證Deficiency Patterns | A pale or sallow complexion, dry hair or skin, light-headedness on standing, blurred vision, and easy fatigue. In women the menstrual flow is often scanty and pale. Sleep may be light, and the hands and feet can feel numb when tired. Tongue pale and thin; pulse thin and weak. | |
| Yang Deficiency陽虛證Deficiency Patterns | Aversion to cold, cold limbs, preference for warm drinks and clothing, and low energy that worsens in cold weather. There may be loose stools, clear copious urine, a pale puffy face, and reduced libido or lumbar weakness. The person feels better with warmth and worse with cold exposure. Tongue pale and possibly swollen with a white coating; pulse deep and weak. |
Classical Formulas Traditionally Associated
Associated with 40 classical formulas
Listed for study. Which formula fits, if any, depends on the pattern rather than the symptom.
Xiao Jian Zhong Tang
小建中湯 · Xiǎo Jiàn Zhōng Tāng
Yang DeficiencyYang-Tonifying FormulasLi Zhong Tang
理中湯 · Lǐ Zhōng Tāng
Yang DeficiencyYang-Tonifying FormulasDa Jian Zhong Tang
大建中湯 · Dà Jiàn Zhōng Tāng
Yang DeficiencyYang-Tonifying FormulasHuang Qi Jian Zhong Tang
黃芪建中湯 · Huáng Qí Jiàn Zhōng Tāng
Yang DeficiencyYang-Tonifying FormulasFu Zi Li Zhong Tang
附子理中湯 · Fù Zǐ Lǐ Zhōng Tāng
Yang DeficiencyYang-Tonifying FormulasSi Ni Tang
四逆湯 · Sì Nì Tāng
Yang DeficiencyYang-Tonifying FormulasWen Jing Tang
溫經湯 · Wēn Jīng Tāng
Blood DeficiencyBlood-Tonifying FormulasDa Cheng Qi Tang
大承氣湯 · Dà Chéng Qì Tāng
Stomach HeatPurgative FormulasTao Hong Si Wu Tang
桃紅四物湯 · Táo Hóng Sì Wù Tāng
Blood StasisBlood-Invigorating FormulasZhen Wu Tang
真武湯 · Zhēn Wǔ Tāng
Yang DeficiencyYang-Tonifying FormulasGe Xia Zhu Yu Tang
膈下逐瘀湯 · Gé Xià Zhú Yū Tāng
Blood StasisBlood-Invigorating FormulasShao Fu Zhu Yu Tang
少腹逐瘀湯 · Shǎo Fù Zhú Yū Tāng
Blood StasisBlood-Invigorating FormulasSheng Hua Tang
生化湯 · Shēng Huà Tāng
Blood StasisBlood-Invigorating FormulasSi Shen Wan
四神丸 · Sì Shén Wán
Yang DeficiencyAstringent FormulasXiao Cheng Qi Tang
小承氣湯 · Xiǎo Chéng Qì Tāng
Stomach HeatPurgative FormulasTiao Wei Cheng Qi Tang
調胃承氣湯 · Tiáo Wèi Chéng Qì Tāng
Stomach HeatPurgative FormulasMu Xiang Bing Lang Wan
木香檳榔丸 · Mù Xiāng Bīn Láng Wán
Food StagnationDigestive FormulasWu Zhu Yu Tang
吳茱萸湯 · Wú Zhū Yú Tāng
Yang DeficiencyYang-Tonifying FormulasGe Gen Qin Lian Tang
葛根黃芩黃連湯 · Gé Gēn Huáng Qín Huáng Lián Tāng
Damp-HeatHeat-Clearing FormulasHuai Hua San
槐花散 · Huái Huā Sàn
Blood StasisBlood-Invigorating FormulasDa Huang Mu Dan Tang
大黃牡丹湯 · Dà Huáng Mǔ Dān Tāng
Damp-HeatPurgative FormulasXiong Gui Jiao Ai Tang
芎歸膠艾湯 · Xiōng Guī Jiāo Ài Tāng
Blood DeficiencyBlood-Tonifying FormulasZhi Shi Dao Zhi Wan
枳實導滯丸 · Zhǐ Shí Dǎo Zhì Wán
Food StagnationDigestive FormulasXiang Ru Yin
香薷飲 · Xiāng Rú Yǐn
Summer HeatExterior-Releasing FormulasBai Tou Weng Tang
白頭翁湯 · Bái Tóu Wēng Tāng
Damp-HeatHeat-Clearing FormulasTong Xie Yao Fang
痛瀉要方 · Tòng Xiè Yào Fāng
Qi StagnationHarmonising FormulasXiao Ji Yin Zi
小薊飲子 · Xiǎo Jì Yǐn Zǐ
Blood StasisHeat-Clearing FormulasShao Yao Gan Cao Tang
芍藥甘草湯 · Sháo Yào Gān Cǎo Tāng
Blood DeficiencyHarmonising FormulasBa Zheng San
八正散 · Bā Zhèng Sàn
Damp-HeatHeat-Clearing FormulasChai Hu Gui Zhi Gan Jiang Tang
柴胡桂枝乾薑湯 · Chái Hú Guì Zhī Gān Jiāng Tāng
Qi StagnationHarmonising FormulasDang Gui Shao Yao San
當歸芍藥散 · Dāng Guī Sháo Yào Sàn
Blood DeficiencyBlood-Tonifying FormulasJin Ling Zi San
金鈴子散 · Jīn Líng Zǐ Sàn
Qi StagnationQi-Regulating FormulasGui Zhi Fu Ling Tang
桂枝茯苓湯 · Guì Zhī Fú Líng Tāng
Blood StasisBlood-Invigorating FormulasShi Xiao San
失笑散 · Shī Xiào Sàn
Blood StasisBlood-Invigorating FormulasXiao Xian Xiong Tang
小陷胸湯 · Xiǎo Xiàn Xiōng Tāng
Phlegm-HeatPhlegm-Resolving FormulasWu Mei Wan
烏梅丸 · Wū Méi Wán
Cold AccumulationAstringent FormulasDa Chai Hu Tang
大柴胡湯 · Dà Chái Hú Tāng
Shaoyang SyndromeHarmonising FormulasMu Xiang Shun Qi Wan
木香順氣丸 · Mù Xiāng Shùn Qì Wán
Qi StagnationQi-Regulating FormulasHou Po Wen Zhong Tang
厚朴溫中湯 · Hòu Pò Wēn Zhōng Tāng
Cold AccumulationQi-Regulating FormulasWu Lin San
五淋散 · Wǔ Lín Sǎn
Damp-HeatDampness-Draining FormulasLearn More About Abdominal Pain
Related Health Topic
Digestive Health — Formulas that strengthen the spleen and stomach, aid digestion, and ease gastrointestinal discomfort.
Health Topic
See all Digestive Health conditions
Frequently Asked Questions
How does Traditional Chinese Medicine understand abdominal pain?
In TCM, abdominal pain (腹痛) arises when Qi and Blood in the Middle Burner or intestines become obstructed or fail to nourish the abdomen. Cold accumulation, Heat, Qi stagnation, Blood stasis, food retention, parasites, or deficiency of Spleen Yang can all cause pain, each with a different quality and triggering factor.
What are the common TCM patterns of abdominal pain?
Frequent patterns include Cold accumulation (pain eased by warmth), Damp-Heat (burning pain, sticky stools), Qi stagnation (distending pain linked to emotions), Blood stasis (fixed stabbing pain), food stagnation (pain after overeating), and deficiency Cold (dull pain, preference for pressure and warmth). Accurate pattern differentiation determines the treatment approach.
How does TCM regulate abdominal pain?
The main principles are to warm the Middle, move Qi, clear Heat, resolve stasis or tonify deficiency according to the pattern. Formulas such as modifications of Liang Fu Wan, Chai Hu Shu Gan San or Xiao Jian Zhong Tang may be considered only after professional assessment. Sudden or severe abdominal pain requires conventional medical evaluation first.
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This library is educational. It describes how Traditional Chinese Medicine has traditionally understood these presentations. It is not a diagnosis, and it is not a treatment recommendation.
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