Epigastric Distension

Epigastric distension is a condition referenced in traditional Chinese medicine that pertains primarily to dysfunction within the spleen and stomach. It manifests as a persistent feeling of fullness and discomfort in the epigastrium. From a Western medical perspective, this condition is often linked to chronic gastritis, such as atrophic or superficial gastritis, and may also be associated with gastric ptosis or functional dyspepsia. Timely medical intervention and treatment are crucial for managing this condition effectively.

Symptoms of Epigastric Distension

1. Food Retention Syndrome

Symptoms encompass a persistent sensation of fullness and bloating in the epigastrium, which intensifies after eating. Additional symptoms may include belching with an unpleasant taste, nausea, vomiting, anorexia, irregular bowel movements, frequent passage of foul-smelling gas, a thick and greasy tongue coating, and a taut, slippery pulse. The primary treatment approach aims to digest food, eliminate stagnation, promote qi flow, and alleviate distension. The modified Baohe Pill, comprising ingredients like hawthorn, Shenqu (fermented mass of medicinal substances), radish seed, pinellia, tangerine peel, poria cocos, and forsythia, is commonly used for this syndrome.

2. Dampness-Phlegm Obstruction Syndrome

Symptoms include a sensation of fullness and discomfort in the epigastrium, accompanied by a feeling of constriction in the chest, heaviness in the head, body, and limbs, nausea, vomiting, loss of appetite, a bland taste in the mouth without thirst, difficulty urinating, a swollen and indented tongue with a white and greasy coating, and a deep, slippery pulse. Treatment focuses on drying dampness, resolving phlegm, regulating qi, and soothing the middle. The modified Erchen Decoction combined with Pingwei Powder, containing ingredients like atractylodes, pinellia, magnolia bark, tangerine peel, poria cocos, licorice, peucedanum, balloonflower, and citrus aurantium, is the primary formula used for this syndrome.

3. Damp-Heat Blocking the Stomach Syndrome

Symptoms encompass a sensation of fullness and discomfort in the epigastrium, accompanied by a burning sensation and noise in the stomach, a feeling of heat and irritation in the chest, dryness and thirstiness of the throat, a preference for cold drinks, sweating with a feverish sensation, dry or sticky bowel movements, short and dark-colored urine, a red tongue with a yellow and greasy coating, and a slippery, rapid pulse. The treatment principle involves clearing heat, resolving dampness, harmonizing the stomach, and resolving distension. The modified Dahuang Huanglian Xiexin Decoction combined with Lianpo Decoction, containing ingredients like rhubarb, coptis root, magnolia bark, calamus, pinellia, reed rhizome, gardenia, and fermented soybeans, is the primary formula used. Additional treatments may include whole trichosanthes and gardenia for constipation and irritation, pollen and forsythia for thirst, and bamboo shavings, white cardamom seed, and ginger for nausea and vomiting.