Digestivekǒuqiāng kuìyáng

Mouth Ulcers & Canker Sores

Also called:Mouth ulcersCanker soresOral ulcers

From the TCM perspective: TCM 'kou chuang' / 'kou mi'; located in heart and spleen-stomach, involving liver and kidney.

Overview

Mouth ulcers are recurrent round/oval painful sores on the oral mucosa. TCM calls them 'kou chuang' / 'kou mi'. Excess patterns are mainly heart-stomach fire exuberance or damp-heat steaming upward; deficiency patterns include yin deficiency with effulgent fire and weak spleen-stomach with chronic recurrence.

☯Common patterns (syndrome differentiation)

Exuberant heart-stomach fire

Key distinguishing signs: Multiple ulcers with red swollen halos and burning pain, bad breath, dry mouth preferring cold drinks, vexation, constipation, dark urine, red tongue with yellow coat, rapid pulse.
Treatment principle: Clear heart/stomach fire and cool blood

Yin deficiency with effulgent fire

Key distinguishing signs: Recurrent mildly painful ulcers, dry mouth/throat, heat in palms/soles, insomnia, sore weak knees, red tongue with little coat, fine rapid pulse.
Treatment principle: Nourish yin and downbear fire

Spleen-stomach weakness

Key distinguishing signs: Recurrent pale slow-healing ulcers, fatigue, poor appetite, post-meal bloating, loose stool, pale tongue with white coat, weak pulse.
Treatment principle: Strengthen spleen qi and warm the middle

Damp-heat steaming upward

Key distinguishing signs: Ulcers with yellow-white bases and red halos, sticky bitter taste, stomach oppression, sticky stool, red tongue with yellow greasy coat, slippery rapid pulse.
Treatment principle: Clear heat, drain dampness and transform turbidity

Daily self-care

Use a soft toothbrush and avoid spicy, very hot, rough or trigger foods (some react to nuts, chocolate, etc.).
Maintain oral hygiene, rinse with warm salt water after meals, sleep regularly and reduce stress.
Track triggers (trauma, stress, nutrient deficiencies, medications); any ulcer lasting over two weeks should be examined.

When to seek medical help

The following warning signs require prompt medical evaluation — do not rely on self-treatment:

An ulcer not healing beyond two weeks, with hard edges, bleeding or a neck lump: prompt oral/ENT evaluation (rule out malignancy).
High fever with widespread oral blisters/erosion, eye or genital ulcers or rash: urgent care.
Oral ulcers in immunocompromised patients, chemotherapy or chronic steroid use: seek early care.

Medical disclaimer: Educational content about traditional Chinese medicine for information only; it is not a diagnosis or treatment and does not replace a qualified clinician. If symptoms worsen or warning signs appear, seek medical care.

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