Abdominal Distention
Abdominal distention is common in clinic. Distention and fullness
are likely to occur in both the upper and lower abdomen. The stomach
- is located in the upper abdomen, while the small and large
intestines are in the lower; they jointly complete the storage,
digestion, and assimilation of food and excretion of the wastes.
Once the stomach and intestines lose their functions, abdominal
distention and pain, belching, vomiting, etc. will occur. This
section deals with the syndromes mainly manifested by abdominal
distention due to disorders of the stomach and intestines.
Etiology and Pathogenesis
Irregular or excessive food intake impairs the stomach and
intestines, causing dysfunction of transportation and
transformation, thus the retained food is stagnated and blocks the
flow of qi, or the stagnated food turns into heat, which enters the
stomach and intestines, causing abdominal distention.
Because of the weakened function of the spleen and stomach or
general debility due to long illness, the spleen and stomach fail in
their transporting functions, so the circulation of qi in the
stomach and intestines is impaired, resulting in abdominal
distention.
In addition, abdominal distention may also follow an abdominal
operation.
Differentiation
Excess condition
Main manifestations: Persistence of distention and fullness in the
abdomen, which is aggravated by pressure, abdominal pain, belching,
foul breath, dark yellow urine, constipation, sometimes associated
with fever, vomiting, yellow thick tongue coating, rolling, rapid
and forceful pulse.
Analysis: Indigested food retained in the stomach gives rise to
distention and fullness in the epigastrium, foul breath, belching,
and even vomiting, and when it is retained in the intestines, there
will be fullness and pain in the abdomen and constipation. Retention
of food is an excess condition. This is why the pain is aggravated
by pressure. Fever, dark yellow urine, yellow thick tongue coating,
rolling, rapid and forceful pulse are the signs of excessive heat in
the stomach.
Deficiency condition
Main manifestations: Abdominal distention relieved by pressure,
borborygmi, loose stools, loss of appetite, lassitude, listlessness,
clear urine, pale tongue with white coating and forceless pulse.
Analysis: Qi deficiency of the spleen and stomach results in
dysfunction of transportation and transformation. Consequently there
are loss of appetite, borborygmus and loose stools. Pain relieved by
pressure is due to deficiency. Failure in creating qi and blood due
to impaired transportation and transformation is the cause of
lassitude and listlessness. Pale tongue with white coating, and
forceless pulse are signs of qi deficiency in the spleen and
stomach.
Treatment
Method: The points of Yangming Meridian of Foot are selected as the
principal points. The excess condition is treated by the reducing
method to regulate the qi flow in the fu organs while the deficiency
condition is treated by the reinforcing method or combined with
moxibustion to invigorate the function of the stomach and spleen and
to adjust the circulation of qi to relieve the distention.
Prescription: [RN12 - ST25 - ST36 - ST37].
Supplementary points:
Explanation: Application of RN12, the Front-Mu point of the stomach,
ST36, the Lower He-Sea point of the stomach, ST25, the Front-Mu
point of the large intestine and ST37, the Lower He-Sea point of the
large intestine, are used as a combination of Front-Mu and Lower
He-Sea points to regulate the function of the stomach and intestines
in order to maintain normal flow of qi and relieve the distention.
LI4 and RN6 are combined to adjust the circulation of qi, while SP9
can eliminate damp heat. SP3 and RN4 are beneficial to strengthen
the spleen and stomach and to help transportation and
transformation.
Remarks
This condition is involved in gastroptosis, acute gastrectasia,
enteroparalysis, intestinal obstruction, gastrointestinal neurosis,
etc.
