–Abdominal Pain (Fu Tong)

TCM Definition:

1. Any subjective, unpleasant and painful sensation in the abdominal region
2. Abdominal region: area from beneath the epigastrium to the suprapubic margin
3. Abdomen is the merging area for the 3 hand and 3 foot yin channels, some hand and foot yang channels, and also the Chong, Ren and Dai meridians.
4. Abdominal pain signifies various disorders from the internal organs, as well as the channels and vessels.

Etiology and Pathogenesis:

1. Invasion of Seasonal exterior pathogens
   • Cold invasion slow down the movement of the qi and blood, leading to pain;
   • Cold transforming into heat or damp-heat invasion can inhibit the intestinal peristalsis and obstruct the qi flow in the intestines.
   • Impairment of the SP and ST’s function to T&T vital substances caused by cold, summerheat and dampness invasion in the MJ causes qi fails to flow smoothly result in abdominal pain.
2. Improper Diet
   • Consumption of food exceeding the SP and ST’s capacity precipitates food stagnation.
   • Indulgence of a greasy, sweet and rich diet contributes to the generation of D-H in the digestive system.
   • Raw and cold food can injure the SP yang and may inhibit normal functions of the SP.
   • Obstruction by food retention and D-H accumulation, and SP deficiency lead to abdominal pain.
3. Emotional stress:
   • Constrained LV qi secondary to emotional stress can progress into qi stagnation & blood stasis.
   • Constrained LV qi can also overact on the SP & ST.
   • Disharmony of the LV, SP and ST with stagnant qi and blood will then cause abdominal pain.
4. Constitutional yang deficiency
   • Internal cold d/t Yang qi def congeals and fails to warm the internal organs results in chronic lingering deficient type of abdominal pain.
5. Miscellaneous
   • Qi stagnation, blood stasis and obstruction in the channels and vessels resulting from surgeries and/or traumatic injuries.

Diagnosis

Identification of cold, heat, excess and deficiency:

Excess	Pain aggravated by pressure or after meals
Deficiency	Preference to pressure or pain aggravated by hunger
Cold	Pain alleviated by warmth
Heat	Pain alleviated by cold
Qi stagnation	Distending and migrating pain
Blood stasis	Stabbing and fixed pain
Involve LV & GB	Pain localized at the lower flank radiating to the hypochondria
Involve SP, KD & UB	Pain located at the suprapubic area and the periumbilical region