Abdominal Distention

Introduction

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:

  • Excess condition: [LI4 - RN6 - SP9].
  • Deficiency condition: [RN4 - SP3].

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.