Abdominal pain
Abdominal pain is a common complaint that can be felt in different areas of the abdomen. The pain may be spasmsing, nagging, sharp or stabbing and may be present continuously or occur in seizures. Sometimes abdominal pain coincides with bloating, flatulence, belching, nausea or changes in stool.
The cause can vary greatly. Sometimes the digestion plays a clear role, for example when the symptoms occur after eating or along with diarrhoea or constipation. Also stress and tension may provoke or exacerbate abdominal discomfort.
Within Chinese medicine, therefore, not only where the stomach hurts, but also the character of the pain, possible triggers and other complaints. Acupuncture and Chinese herbs are then tuned to this overall picture.
Do you especially have abdominal pain around menstrual periods or at other times in the cycle? Please check with Menstruation and cycle symptoms, including menstrual pain, ovulation pain and endometriosis.
Western disorders that may cause abdominal pain
Abdominal pain is a symptom and not a condition in itself. Possible causes include:
- irritable bowel syndrome (PDS)
- constipation or diarrhoea
- gastrointestinal infections
- food intolerances
- reflux or other stomach discomfort
- inflammatory bowel diseases such as Crohn's disease and ulcerative colitis
- diverticulitis
- appendicitis
- gallbladder or urinary problems
- gynaecological disorders, such as endometriosis
The place and type of pain sometimes give clues about the cause, but are not in itself sufficient to make a diagnosis.
Important: sudden or very severe abdominal pain, a hard or severe abdominal pain, persistent vomiting, high fever, blood in the stool or other severe or rapidly increasing symptoms must be medically assessed. New or persistent abdominal pain without obvious cause also deserves further investigation.
Possible causes
Abdominal pain can be caused by upset stomach or intestines, for example by infection, constipation, food that is not well tolerated or disturbed bowel function. Eating too much or too heavy can cause temporary pain, cramps and bloating.
In chronic or recurrent abdominal pain, multiple factors are often involved. Stress can affect the movement and sensitivity of the intestines, for example. In others, weaker digestion is at the forefront.
In women, abdominal pain may also be related to the menstrual cycle. These symptoms are discussed more extensively in Menstruation and cycle complaints.
How can acupuncture help with abdominal pain?
Acupuncture first looks at the pattern behind the abdominal pain. For example, pain that arises after eating requires a different approach than spasming pain which occurs especially in case of stress or abdominal pain that clearly improves by heat.
Depending on the picture of complaints, treatment may be directed at:
- regulate the movement of stomach and intestines
- Reduce tension and cramps in the abdomen
- reduce stagnation when the abdomen feels tense or set up
- support digestion when weakened
- Removing cold when heat gives clear lighting
- Heat of Dampness-Heat reduce when abdominal pain coincides with obvious heat or inflammatory symptoms
- promote Qi and Blood circulation in fixed, local pain
Therefore, the acupuncture points chosen vary per person and can be adjusted during the treatment process when the complaint image changes.
How can Chinese herbal medicine help with abdominal pain?
Chinese herbs are also chosen based on the underlying pattern. In addition, it is important not only that there is abdominal pain, but also, for example, whether the pain is spasming or stinging, better or worse because of food and pressure, reacts to heat and goes together with diarrhoea, constipation, nausea or bloating.
Depending on the pattern, herbs can be used to:
- support digestion and intestinal movement
- to reduce accumulated food and a sense of fullness
- regulate the movement of Qi in case of tension and a bloated abdomen
- support the Spleen and Stomach in a weak digestion
- Repel cold and heat the abdomen
- Reduce heat and Dampness Heat
- to promote blood circulation in Blood stasis
Acupuncture and herbs work in their own way and can complement each other. Herbs can be used daily between acupuncture treatments.
How does Chinese medicine view abdominal pain?
In Chinese medicine, pain is often seen as a sign that the normal movement of Qi and Blood is obstructed somewhere. Qi can easily be seen as functional activity and movement in the body. If this movement in the abdomen is not smooth, pain, cramps, tension and bloating may occur.
In abdominal pain, the TCM organ systems Stomach and Spleen and the Intestines are particularly important. The Stomach and Spleen are closely involved in processing nutrition and digestion within TCM. The Liver can also play a role. This system is involved in free flow of Qi. Therefore, stress and emotions in some people can clearly affect abdominal complaints.
Not all abdominal pain, however, is caused by the same mechanism. Cold can slow down normal movement and cause cramps, while Heat can give a different kind of abdominal pain. Food can also become temporarily stuck and create pressure and fullness. In sharp, highly localized pain, Blood stasis can play a role.
A recognizable combination of such complaints and characteristics is called a TCM pattern. The Western diagnosis can be the same for two people, while the TCM pattern differs and therefore the treatment also becomes different.
Below are only some common patterns discussed. Other patterns are possible and different patterns may be present at the same time. Moreover, you don't have to have all of these symptoms to fit within a certain pattern. The pattern is determined based on the overall picture of complaints.
Common TCM patterns in abdominal pain
Cold in the abdomen
Cold inhibits normal movement in the abdomen. This can cause a spasming or nagging abdominal pain. An important feature is that heat often feels comfortable.
Cold can occur relatively suddenly, but with long-term complaints an underlying weakness of the digestive system can also play a role. The pain is often less severe and may be associated with fatigue and a general feeling of cold.
Common symptoms:
- spasming or nasty abdominal pain
- heat improvement
- pain that is often more pleasant with gentle pressure
- cold hands or feet
- loose stools
- with a weaker pattern also fatigue and low energy
Examples of Western disorders: PDS, chronic bowel symptoms and some types of chronic stomach or abdominal pain.
Heat or Dampness-Heat in the Intestines
With Heat, the abdominal pain is usually clearer and pressure on the abdomen is often unpleasant. When Heat is combined with Dampness . . within TCM an accumulation that may be associated with a heavy or sticky character of complaints . . . . diarrhoea and other bowel problems can also occur.
This pattern can occur especially in acute gastrointestinal problems, but certain forms of Dampness-Heat may also remain present for longer.
Common symptoms:
- clear or severe abdominal pain
- pain that gets worse with pressure
- diarrhoea and/or constipation
- thirst or dry mouth
- strong smelling feces
- dark or concentrated urine
- for acute symptoms, possibly fever
Examples of Western disorders: gastroenteritis, dysentery, diverticulitis and inflammatory bowel diseases.
In severe abdominal pain with fever, strong abdominal pressure or acute illness medical assessment is important.
Liver-Qi-stagnation
This is an important pattern when abdominal symptoms clearly respond to stress, tension or emotions. Within TCM, tension can interfere with the free movement of Qi. This may manifest itself in the abdomen as cramps, pressure or bloating.
The pain is often variable: the place and intensity can change and relaxation can improve.
Common symptoms:
- variable or spasming abdominal pain
- feeling bloated or tense
- symptoms that become worse due to stress
- Enlightenment by belching or winds
- variable stools, sometimes alternating diarrhoea and constipation
- irritability, tension or difficulty with relaxation
Examples of Western disorders: PDS, functional abdominal pain and stress-related bowel problems.
Blood stasis
In Blood stasis, the circulation according to TCM is locally impaired. Unlike the more variable pain with Qi-stagnation, the pain is usually clearly localized and more often remains in the same place.
Common symptoms:
- fixed, local abdominal pain
- sharp or stabbing pain
- pain that can get worse due to pressure
- prolonged or recurrent pain
Blood stasis may occur after prolonged stagnation, surgery or trauma. The pattern may also occur in gynaecological complaints.
Examples of Western disorders: adhesions after surgery, some chronic abdominal discomfort and certain gynaecological conditions.
When the pain is mostly related to the menstrual cycle, this is discussed more extensively in Menstruation and Cycle Complaints , Menstruation Pain and Endometriosis.
Food stagnation
Food stagnation temporarily does not process enough food and according to TCM it remains stagnant in Stomach and Intestines. This can occur after too much, too heavy or difficult to digest.
The symptoms are usually clearly related to meals and may decrease after the intestines have emptied or when someone has been farming.
Common symptoms:
- abdominal or stomach pain after eating
- Feeling full and bloated
- worse after eating and under pressure
- belching and flatulence
- nausea
- decreased appetite
- Sour rebuffing
- constipation, slow stools or diarrhoea
- relief after stools or belching
Examples of Western disorders: indigestion, functional dyspepsia, reflux and temporary digestive symptoms after excessive eating.
According to TCM, when food stagnation comes back regularly, a weaker digestion may also be present in the background.
Outlook
How quickly abdominal pain improves depends heavily on the cause, duration and severity of the symptoms and possible underlying conditions. Acute functional complaints can sometimes change relatively quickly, while chronic abdominal pain, long-term bowel problems or complaints involving various factors at the same time usually require more time.
In the initial phase acupuncture is often applied approximately once a week. In case of acute or severe complaints, a higher frequency can be temporarily appropriate. If the symptoms improve steadily, the frequency can be reduced. Chinese herbs may be used for a longer period between treatments.
In the case of recurrent or unexplained abdominal pain, it is important that any medical causes have been adequately investigated.
Contact
Do you have regular abdominal pain and want to know if acupuncture or Chinese herbal medicine can fit your symptoms? During the first appointment we will discuss your complaints, digestion and general health. On this basis we will examine which TCM pattern is most likely and which treatment fits in with it.