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 : Zhongwan ( Ren 12 ) , Tianshu ( S 25 ) , Zusanii ( S 36 ) , Shangjuxu
( S 37 ) . Supplementary points : Excess condition : Hegu ( Li 4 ) , Qihai ( Ren 6 ) ,
Yinlingquan ( Sp 9 ) .
Deficiency condition : Guanyuan ( Ren 4 ) , Taibai ( Sp 3 ) .
Explanation : Application of Zhongwan ( Ren 12 ) , the Front - ( Mu ) point of the
stomach , Zusanli ( S 36 ) , the Lower He - ( Sea ) point of the stomach , Tianshu ( S
25 ) , the Front - ( Mu ) point of the large intestine and Shangjuxu ( S 37 ) , 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 . Hegu ( Li4 ) and Qihai ( Ren 6 ) are combined to adjust the
circulation of qi , while Yinlingquan ( Sp 9 ) can eliminate damp heat . Taibai
( Sp 3 ) and Guanyuan ( Ren 4 ) 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 .
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