Epigastric Pain (Gastritis)
Overview
Epigastric pain (wei wan tong) is pain in the upper abdomen near the stomach, often with bloating, belching, acid regurgitation, nausea, and poor appetite. Common TCM causes include cold invading the stomach, dietary injury, liver qi invading the stomach, damp-heat obstruction, spleen-stomach deficiency cold, and insufficiency of stomach yin. The core mechanism is stagnation of stomach qi causing pain from obstruction, or the stomach losing nourishment causing pain from deficiency.
Pattern differentiation (clinical patterns)
Liver Qi Invading the Stomach
Distending epigastric pain radiating to the ribs, frequent belching and acid regurgitation, worsened by emotional upset, thin white coating, wiry pulse.
Soothe the liver and regulate qi; harmonize the stomach to stop pain.
Spleen-Stomach Deficiency Cold
Dull stomach pain that prefers warmth and pressure, worse on an empty stomach and relieved by food, clear vomitus, poor appetite, loose stools, fatigue, cold limbs, pale tongue with white coating, deep fine weak pulse.
Warm the middle and fortify the spleen; harmonize the stomach to stop pain.
Connections
Daily care & prevention
Eat warm, soft, regular meals in smaller, more frequent portions and chew well; avoid fasting and overeating, spicy irritants, strong tea and coffee, alcohol, and cold-raw foods. Keep the abdomen warm and manage stress. Apply a warm compress, use moxibustion at Zhongwan (CV12), Zusanli (ST36), and the navel, and massage Neiguan (PC6).
When to seek medical care
Seek prompt care for black stools, vomiting blood, sudden severe or persistent abdominal pain, dysphagia, repeated vomiting, unexplained weight loss or anemia, pain that wakes you at night, or a family history of gastrointestinal cancer.