Acute Gastroenteritis
Overview
Acute gastroenteritis falls under the TCM categories of 'vomiting', 'diarrhea', and 'cholera-like disorder'. It is commonly caused by exogenous pathogenic factors, improper diet, or pre-existing spleen-stomach deficiency. The disease is located in the spleen, stomach, and large and small intestines, with the pathogenesis involving disordered ascending and descending of spleen-stomach qi and interference between clear and turbid. Clinically it presents with sudden onset of nausea, vomiting, abdominal pain, and diarrhea, often accompanied by fever, thirst, and fatigue. Pattern differentiation should distinguish cold-damp, damp-heat, food stagnation, and spleen-stomach deficiency-cold. Treatment focuses on activating the spleen, harmonizing the stomach, transforming dampness, and stopping diarrhea, while addressing the exterior, clearing heat, promoting digestion, or warming the middle as appropriate.
Pattern differentiation (clinical patterns)
Cold-Damp Encumbering the Spleen
Vomiting of clear water or thin saliva, watery diarrhea, abdominal pain with borborygmus, epigastric oppression and poor appetite, heaviness of the head and body, aversion to cold with fever, white greasy tongue coating, and a soggy slow pulse.
Transform dampness with aromatic herbs; warm the middle and disperse cold.
Damp-Heat Accumulation
Vomiting of sour or foul material, urgent and foul-smelling diarrhea, abdominal pain aggravated by pressure, burning sensation at the anus, fever and thirst, scanty dark urine, red tongue with yellow greasy coating, and a slippery rapid pulse.
Clear heat and transform dampness; harmonize the stomach and stop diarrhea.
Food Stagnation in the Stomach and Intestines
Vomiting of sour and rotten food, foul diarrhea resembling rotten eggs, epigastric and abdominal distension, belching and anorexia, abdominal pain with borborygmus, thick greasy tongue coating, and a slippery pulse.
Promote digestion and guide out stagnation; harmonize the stomach and descend rebellious qi.
Connections
Daily care & prevention
During the acute phase, consume a light liquid or semi-liquid diet such as rice water or thin congee; avoid raw, cold, greasy, and unclean foods. Keep the abdomen warm and drink mild salt water in moderation to prevent dehydration. Gently massage the abdomen clockwise and press Zusanli (ST36) and Neiguan (PC6) to harmonize the stomach and stop vomiting. Rest and monitor urine output and mental state; gradually resume normal diet as symptoms improve.
When to seek medical care
Seek immediate medical attention if there is severe vomiting preventing fluid intake, frequent diarrhea with obvious dehydration, persistent high fever, blood or black stools, severe abdominal pain with rigidity, confusion, cold limbs, or significantly reduced urine output. Infants, the elderly, and pregnant women should seek prompt care if symptoms worsen.