Irritable Bowel Syndrome
Overview
Irritable bowel syndrome (chang yu) is a common functional bowel disorder characterized by abdominal pain or discomfort with altered bowel habits (diarrhea, constipation, or alternating), relieved after defecation. It relates to emotional imbalance, dietary irregularity, and constitutional weakness; located in the intestine but governed mainly by liver and spleen. The core mechanism is liver constraint with spleen deficiency and impaired large-intestine conveyance, which may involve the kidney over time.
Pattern differentiation (clinical patterns)
Liver Constraint with Spleen Deficiency (Pain-Diarrhea)
Pain followed by urgent diarrhea with relief afterward, borborygmi and gas, triggered by frustration, anger, or stress, chest and rib fullness, poor appetite and fatigue, pale red tongue with thin white coating, wiry moderate pulse.
Restrain the liver and support the spleen; harmonize the qi dynamic.
Spleen-Stomach Weakness
Intermittent loose stools with undigested food, epigastric stuffiness after meals and more bowel movements after greasy food, poor appetite, fatigue, sallow face, pale tongue with white coating, fine weak pulse.
Fortify the spleen and boost qi; transform dampness to check diarrhea.
Connections
Daily care & prevention
Eat regularly and chew thoroughly; keep a food-symptom diary and avoid triggers; a short low-FODMAP diet for diarrhea-predominant IBS is best guided by a dietitian. Hydrate, exercise regularly, and prioritize stress management and sleep. Try abdominal massage and Tianshu (ST25), Zusanli (ST36), Taichong (LR3), and Neiguan (PC6), with diaphragmatic breathing.
When to seek medical care
Seek evaluation for blood in stool or black stools, nocturnal diarrhea, unexplained weight loss, fever, anemia, symptom onset after 50, or a family history of colorectal cancer.