Vague or gnawing discomfort in the stomach area
What is a vague or gnawing sensation in the stomach region?
Some stomach problems are difficult to describe exactly. You do not have a clear stomach pain and no common hunger, but your stomach doesn't feel comfortable anyway. It can be an gnawing, empty, nagging, restless or difficult to describe feeling in the upper abdomen. Sometimes you have the idea that you need something to eat to get rid of the feeling, while at the same time you have little appetite or are again full after a few bites.
This type of complaint is described as unintended epigastric discomfort within Chinese medicine. The symptoms are usually prolonged or recurrent and may be associated with a bloated feeling, belching, nausea, reflux or changes in bowel movements.
Because similar symptoms may have different causes, it is important to investigate possible medical causes if persistent or recurrent stomach problems occur.
Possible Western disorders
A vague or gnawing feeling in the stomach area is not a separate Western diagnosis. Similar complaints may occur with:
- functional dyspepsia;
- chronic gastritis;
- atrophic gastritis;
- gastrointestinal ulcers;
- gastrooesophageal reflux;
- disturbances in gastric motility;
- disorders of the gall bladder.
Certain medicines may also cause or worsen stomach problems, including NSAIDs such as ibuprofen and aspirin.
In case of unexplained weight loss, blood vomiting, black tar-like stool, swallowing problems, persistent vomiting or clearly increasing symptoms medical assessment is important.
Possible causes
Food can play an important role. A lot of or heavy food, highly seasoned food, alcohol and other products that irritate the stomach may cause problems. Also irregular eating, skipping meals, late-night eating or long-term eating can contribute more than digestion can.
In addition, stress plays a clear role in some people. Tension, frustration, anger, worry and prolonged mental stress can affect stomach function. It is then striking that the stomach sensation becomes stronger during stress periods.
Long-term stomach problems can also gradually change. An initial mainly functional disturbance may over time be associated with irritation and heat, weakening of digestion or dryness and a shortage of body fluids.
What can acupuncture do?
Acupuncture looks at the exact way in which the stomach feels. Does it get worse because of stress? Does the stomach feel empty while you do not want to eat much? Does food give temporary relief or does the discomfort get worse? Do you also suffer from belching, reflux, nausea, bloating, dryness or changes in stool?
These differences help determine which underlying TCM pattern is most likely. The treatment may include:
- support the normal downward movement of Stomach-Qi, for example in belching or nausea
- improve Qi flow when stress and stress disturb the stomach
- Reduce heat in the Stomach in case of burning, acid reflux or an irritated sensation
- Reduce phlegm and accumulation when a heavy, full or nausea sensation is present
- strengthen the Spleen and Stomach when digestion is weakened
- Stomach-Yin feeding when dryness and insufficient body fluids play a role
- improve Qi and Blood circulation in long-term, more stuck complaints
The treatment is therefore not only tailored to the stomach feeling itself, but to the overall picture of complaints.
What can Chinese herbal medicine do?
Chinese herbs are also chosen based on the underlying pattern. This may be relevant especially in case of prolonged stomach upset, as several processes can be present at the same time.
For example, someone can have a weaker digestion while stress disturbs the Stomach extra. In another case, heat and reflux are at the forefront, while in long-term complaints, Stomach may gradually become drier and more sensitive.
Depending on the pattern, herbal treatment may focus on:
- To harmonise Stomach and support the normal movement of Stomach-Qi
- Controlling stuck Qi in case of stress-related stomach problems
- Reduce heat or Phlegm-Heat
- strengthen the Spleen and Stomach in Qi deficiency
- Stomach-Yin and body fluids feed in dryness
- Support blood circulation when Blood stasis is present
Acupuncture and herbs can be used separately, but can also complement each other in the event of prolonged complaints. Herbs can provide daily between treatments by support.
How does Chinese medicine view vague or gnawing discomfort in the stomach area?
Within Chinese medicine, the main focus of this complaint is Stomach and Spleen. The Stomach receives nutrition and initiates the digestion process, while according to TCM, the Spleen is important for further processing and spreading nutrients.
An important function of the Stomach is the downward movement of Stomach-Qi. When this movement is disturbed, a full or restless stomach feeling, belching, nausea and reflux can occur.
The Liver organ system can also be important. Within TCM, the Liver supports the free movement of Qi. In case of stress, frustration or prolonged emotional tension, this motion may stagnate. This so-called Liver-Qi stagging can then disrupt the Stomach. This is a common explanation within TCM for stomach problems that clearly respond to stress.
If this exists for a long time, stagnation can develop Heat. Heat can then affect the Yin of Stomach: the nourishing and moistening aspects that are important for the stomach wall and body fluids. In other people, a shortage of Qi is central and the digestive function is insufficient.
In addition, in case of very long-term complaints the circulation of Blood can be disturbed and Blood stasis may develop.
A recognizable combination of such complaints and physical characteristics is called a TCM pattern. Below are the most common patterns. Other patterns are possible and multiple patterns can be present at the same time. This allows you to recognize yourself in multiple descriptions. Not everyone with the same pattern has all the mentioned symptoms. The pattern is determined based on the overall grievance image.
What is a TCM organ system?
Within TCM, an organ name refers not only to the anatomical organ, but to a broader set of functions and relationships within the body. Read more about this at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of symptoms and symptoms that indicates which functions according to Chinese medicine are out of balance. It forms the basis for the choice of treatment. Read more about this at TCM basics .
Most common TCM patterns
Liver-Qi disturbs the Stomach
Brief explanation
In this pattern, stuck Liver-Qi interferes with the normal movement of the Stomach. This occurs especially when stomach complaints clearly respond to stress, frustration or emotional tension. The stomach sensation can sometimes temporarily improve by eating something but then returning.
Common symptoms: a vague, tense or gnawing sensation in the stomach region, symptoms that increase with stress, a bloated upper abdomen, belching, sighs, nausea, varying stool, tension under the ribs, irritability and tense neck or shoulder muscles.
Examples of Western disorders: functional dyspepsia, chronic gastritis, reflux symptoms and functional stomach complaints that respond strongly to stress.
Stomach- and Liver-Heat
Brief explanation
When Qi stagnates for a long time, according to TCM Heat can occur. A lot of strongly seasoned or heating food can also contribute to this. The stomach sensation often gets a burning, acidic or irritated character.
Common symptoms: regular stomach discomfort, acid regurgitation, acid belching, dry mouth, thirst preferred for cold drinks, a bitter or unpleasant taste, irritability and tendency to constipation. Stress and strongly seasoned eating may exacerbate the symptoms.
Examples of Western disorders: gastritis, reflux symptoms and gastric or 12-fingered intestinal ulcers.
Phlegm-Heat in the Stomach
Brief explanation
Heat goes together with Phlegm. Phlegm not only means visible mucus within TCM, but can also refer to accumulation that occurs when body fluids are not properly processed. This can hinder the normal function and movement of the Stomach.
Common symptoms: vague stomach feeling with nausea, feeling heavy or short or breathy in the chest or upper abdomen, feeling mucus, bitter or unpleasant taste, mild thirst, restlessness, poor sleep, nervousness and sometimes dizziness.
Examples of Western conditions: chronic gastritis and prolonged stomach discomfort after a fever disease.
Stomach-Yin-deficiency
Brief explanation
Yin within TCM covers, among other things, the nourishing and moistening aspects of the body. At Stomach-Yin deficiency, Stomach and body fluids are not sufficiently nourished and moistened. This can develop after prolonged heat or chronic stomach problems.
Common symptoms: mild but persistent stomach discomfort, often stronger later in the day or evening, dry mouth and throat, dry lips or skin, thirst, acidic regurgitation, mild nausea and dry stools or constipation. Sometimes a person wakes up at night because of the stomach sensation.
When Liver-Qi stagnation is also present, stress sensitivity and a tense feeling may be associated with these dryness symptoms.
Examples of Western disorders: chronic atrophic gastritis and gastric or 12-fingered intestinal ulcers.
Spleen- and Stomach-Qi-deficiency
Brief explanation
With this pattern, the digestion according to TCM is not sufficiently powerful. An empty Stomach can cause a gnawing or empty feeling that you think you need something to eat. However, once you start eating, you can be full after a small amount of unpleasantness.
Common symptoms: empty or unintended stomach feeling, quickly full, bloated abdomen, low appetite, decreased taste, tiredness, weak or heavy limbs and soft stools or diarrhoea. Cold or raw food may exacerbate the symptoms.
In some people this pattern coincides with Cold, while in others Dampness or food stagnation is present.
Examples of Western disorders: functional dyspepsia, chronic gastritis and other functional digestive symptoms.
Blood stasis in the Stomach
Brief explanation
Blood stasis is usually a later stage of prolonged stomach discomfort. According to TCM the circulation of Blood in the stomach region is disturbed. The initial vague stomach feeling is often more clearly located and can become more painful.
Common symptoms: prolonged and persistent stomach discomfort, a steady or stabbing pain, a clearly sensitive spot at pressure, symptoms that may be worse at night, low appetite and nausea. A dark or purple-like tongue can support the pattern.
Examples of Western disorders: chronic atrophic gastritis and gastric or 12-fingered intestinal ulcers.
Regular medical assessment is necessary in case of permanent or increasing pain, unexplained weight loss, blood vomiting or black stools.
Outlook
The course of treatment depends on the cause, duration of the symptoms and the underlying pattern. Relatively recent functional complaints, such as stress and Qi-stagnation, can generally change faster than long-term complaints where the function or moistening of the Stomach is clearly weakened.
In the initial phase, once a week treatment is a usual guideline. In case of persistent complaints a higher frequency may temporarily be appropriate. If improvement occurs, the frequency can be gradually reduced. In case of long-term Qi or Yin deficiency a treatment course of several months may be required. Chinese herbs can be used daily during this period and adjusted where necessary.
These are guidelines; the final course of treatment will be tailored to your symptoms and response to the treatment.
Contact
Do you regularly have a vague, empty or gnawing sensation in the stomach region and want to know if acupuncture and/or Chinese herbal medicine fit your symptoms? During a first appointment we will discuss your stomach problems, digestion, nutrition and other relevant symptoms. On this basis we will look at which TCM pattern suits your situation best and what treatment fits it.