Abdominal fullness

A subjective feeling of fullness in the abdomen without pronounced visible or palpable expansion. Abdominal fullness may be observed in vacuity and repletion patterns. Continued fullness without relief, associated with hard stool or continued fullness relieved by passing of flatus, belching, or defecation indicates repletion. Periodically abating fullness that likes pressure, associated with sloppy stool or with fullness following defecation is a vacuity pattern. Essential Prescriptions of the Golden Cabinet (金匮要略 jīn guì yào lüè) describes the former as abdominal fullness with little or no relief, and the latter as abdominal fullness recurring after periods of relief. Abdominal fullness commonly occurs in the cold-damp, spleen-stomach vacuity, damp-heat, food stagnation, and heat bind patterns.

Patterns

Cold-damp (寒湿 hán shī) abdominal fullness is attributable to cold evil directly striking the interior, living in damp places or eating unclean cold foods. The fullness is unrelieved by pressure (repletion) and is accompanied by poor appetite, nausea, vomiting, diarrhea, pain in the stomach duct or abdomen, thirst without desire for fluids, and a slimy tongue fur and stringlike pulse.

Medicinal therapy: Warm and transform cold-damp using Stomach-Calming Poria Five Decoction (胃苓汤 wèi líng tāng) or Officinal Magnolia Bark Center-Warming Decoction (厚朴温中汤 hòu pò wēn zhōng tāng).

Acumoxatherapy: Base treatment for abdominal fullness mainly on ST and CV, selecting ST-25 (Celestial Pivot, 天枢 tiān shū), CV-6 (Sea of Qì, 气海 qì hǎi), PC-6 (Inner Pass, 内关 nèi guān), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ) as the main points. For cold-damp, add SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán) and LI-4 (Union Valley, 合谷 hé gǔ); needle with drainage and large amounts of moxa.

Spleen-stomach vacuity cold (脾胃虚寒 pí wèi xū hán) abdominal fullness arises from usual presence of spleen-stomach yáng vacuity, excessive consumption of cold and fatty foods, or excess use of cold or cool medicinals in treatment, imbalance following major illness, and lack of nourishment due to enduring illness. The fullness is intermittent, likes warmth and pressure (and sometimes warm drinks or food)and is accompanied by lassitude of spirit and lack of strength, a pale tongue possibly with dental impressions, a thin white tongue fur, and a slow pulse.

Medicinal therapy: Use Center-Rectifying Decoction (理中汤 lǐ zhōng tāng) or Officinal Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction (厚朴生姜半夏甘草人参汤 hòu pò shēng jiāng bàn xià gān cǎo rén shēn tāng).

Acumoxatherapy: To the main points given above add BL-20 (Spleen Transport, 脾俞 pí shù), BL-21 (Stomach Transport, 胃俞 wèi shù), CV-4 (Pass Head, 关元 guān yuán), and LR-13 (Camphorwood Gate, 章门 zhāng mén); needle with supplementation and add moxa. Cross moxa and the Five Pillar Points (五柱穴 wǔ zhù xué) can also be used to warm the center and dispel cold.

Damp-heat (湿热 shī rè) abdominal fullness is associated with distension stomach duct glomus, nausea and vomiting, vexation and oppression in the heart, thirst without desire to drink much, periodic sweating, sloppy diarrhea, short voidings of reddish urine, slimy yellow tongue fur, and a soggy rapid pulse.

Medicinal therapy: Transform dampness and clear heat using Wáng’s Coptis and Officinal Magnolia Bark Beverage (王氏连朴饮 wáng shì lián pò yǐn).

Acumoxatherapy: To the main points given above, add LI-11 (Pool at the Bend, 曲池 qū chí), LI-4 (Union Valley, 合谷 hé gǔ), SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán), and ST-44 (Inner Court, 内庭 nèi tíng); needle with drainage.

Food stagnation (食滞 shí zhì) abdominal fullness is relieved by the passing of flatus or belching and is associated with sour belching, acid swallowing, diarrhea smelling like rotten eggs, thick slimy tongue fur, and a slippery sunken pulse.

Medicinal therapy: Disperse food and abduct stagnation using Harmony-Preserving Pill (保和丸 bǎo hé wán).

Acumoxatherapy: To the main points given above, add Lǐ Inner Court (里内庭 lǐ nèi tíng), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), and CV-10 (Lower Stomach Duct, 下脘 xià wǎn); needle with drainage.

Heat bind (热结 rè jié) abdominal fullness, which occurs in febrile disease, is fullness without relief sometimes associated with hardness and pain, pain around the umbilicus, constipation, streaming sweat on the hands and feet, tidal heat, delirious speech, a sunken replete pulse or forceful slow pulse, and a dry yellow tongue fur.

Medicinal therapy: Drain and precipitate the heat bind with Major Qì-Coordinating Decoction (大承气汤 dà chéng qì tāng).

Acumoxatherapy: To the main points given above, add LI-4 (Union Valley, 合谷 hé gǔ), LI-11 (Pool at the Bend, 曲池 qū chí), ST-37 (Upper Great Hollow, 上巨虚 shàng jù xū), and SP-14 (Abdominal Bind, 腹结 fù jié); needle with drainage. Compare abdominal distension; glomus.