Upper Abdominal Discomfort: Insights from Traditional Chinese Medicine

Discomfort in the upper abdomen?

For the past few weeks, I have been feeling something unusual in the area just below the center of my ribs.
It’s not a painful sensation, more like a feeling of pressure or swelling when I touch it.
Last week, I visited a traditional Chinese medicine practitioner and received allergy medication.
I mentioned that something felt off, but I couldn't clearly describe it at the time, so the doctor only prescribed a digestive aid.
However, the next day, I started to experience additional sensations, particularly on the left side below my ribs, similar to the feeling of bending over and pressing down.
I also noticed that I have been eating less than usual, and towards the end of meals, I often feel a sensation of nausea in my throat, along with the urge to burp.
Currently, my appetite has returned to nearly normal, but my symptoms fluctuate between good and bad.
The area below my ribs still feels strange, as if there is a hard object present.
These symptoms come and go unpredictably.
This week, I have been taking a modified version of Xiao Yao San for a day, but my symptoms remain the same.

Gao, 10~19 year old female. Ask Date: 2013/04/18

Dr. Qiu Shuize reply Traditional Chinese Medicine

Hello, thank you for your consultation.
Based on what you mentioned, the initial assessment suggests that it may be due to weakened gastrointestinal digestion.
The presence of loose or unformed stools can further support this.
You also mentioned taking allergy medications; I would like to know about your allergy medication history and duration.
The appropriateness and properties of the medications taken during this period can also be considered.
Have you experienced similar situations in the past? Do you have a history of peptic ulcers or gastroesophageal reflux disease? Have you recently taken any prescription medications, cold medications, or antibiotics? Please take these into account as well.
Generally, stress, spicy foods, cold foods, and chilled items may also exacerbate this condition.

Reply Date: 2013/04/18

More Info

Upper abdominal discomfort can be a complex issue, often requiring a multifaceted approach to diagnosis and treatment. In Traditional Chinese Medicine (TCM), the understanding of such discomfort is rooted in the concepts of Qi (energy), Blood, and the balance of Yin and Yang within the body. The symptoms you describe, including a sensation of pressure or a hard feeling beneath the ribs, reduced appetite, nausea, and intermittent discomfort, can be interpreted through the lens of TCM.

From a TCM perspective, the area around the ribs is closely associated with the Spleen and Stomach organs, which are responsible for digestion and the transformation of food into Qi and Blood. When these organs are not functioning optimally, it can lead to symptoms such as bloating, discomfort, and changes in appetite. The sensation of something hard or a feeling of pressure may indicate a stagnation of Qi or an accumulation of phlegm or dampness, which can occur due to improper diet, emotional stress, or other lifestyle factors.

Your experience of feeling like you want to vomit after eating and the sensation of needing to burp could suggest that there is an imbalance in the Stomach's ability to process food. In TCM, this could be due to a condition known as "Stomach Qi Deficiency" or "Stomach Heat," where the Stomach is either too weak to digest food properly or is overactive, leading to discomfort. The use of "加味逍遙散" (Jia Wei Xiao Yao San), a formula traditionally used to soothe the liver and harmonize the spleen, suggests that your practitioner is addressing potential emotional stress or liver Qi stagnation that may be contributing to your symptoms.

It is also important to consider the role of diet in managing your symptoms. In TCM, certain foods are believed to either exacerbate or alleviate symptoms. For instance, greasy, spicy, or overly rich foods may contribute to dampness and heat in the body, while lighter, easily digestible foods can help restore balance. Keeping a food diary to track what you eat and how it affects your symptoms may provide valuable insights.

In addition to herbal remedies, TCM often employs acupuncture and dietary therapy as part of a comprehensive treatment plan. Acupuncture can help to stimulate the flow of Qi, alleviate pain, and promote relaxation, which may be beneficial given your symptoms. Specific acupuncture points related to the Spleen and Stomach, such as Spleen 6 (SP6) and Stomach 36 (ST36), may be particularly effective in addressing digestive issues.

If your symptoms persist or worsen, it is crucial to continue working with your healthcare provider to rule out any underlying conditions that may require further investigation. While TCM can offer valuable support, it is essential to integrate it with conventional medical advice, especially if there are concerns about more serious gastrointestinal issues.

In summary, upper abdominal discomfort can be approached through TCM by focusing on the balance of Qi and the health of the Spleen and Stomach. Your current treatment with "加味逍遙散" is a step in the right direction, but ongoing communication with your practitioner and attention to your diet and lifestyle will be key to achieving lasting relief. If symptoms persist, consider seeking further evaluation from a gastroenterologist to ensure that all potential causes are thoroughly investigated.

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