Peptic Ulcer

Peptic ulcer (PU) mainly refers to gastric and duodenal ulcers. The principal lesions are localized tissue defects, inflammation, and necrotic changes in the mucosa that extend to the muscularis mucosae. The lesions result from the self-digestion of the mucosa by gastric acid and pepsin, hence the term “peptic ulcer.” In traditional Chinese medicine (TCM), it falls within the categories of “stomach pain” and “gastric stuffiness.”

TCM Pattern Differentiation and Medication Guide

|Common Symptoms

Clinical description:

Distending pain in the epigastrium that may extend to both flanks; chest oppression with frequent sighing; stomach pain worsened by emotional distress; frequent belching; pale-red tongue with a thin white or thin yellow coating; wiry pulse

In plain language:

  • Distending pain in the upper abdomen that may spread to the sides of the rib cage
  • A feeling of tightness in the chest, often relieved by sighing
  • Stomach pain that becomes noticeably worse when emotions are unsettled
  • Frequent belching
  • A pale-red tongue with a thin white or thin yellow coating
  • A wiry, tense pulse, traditionally associated with emotional constraint and Liver–Stomach disharmony

|Treatment Approach

Clinical description:

Soothe the Liver, regulate qi, harmonize the Stomach, and relieve pain

In plain language:

  • Use methods to soothe the Liver and regulate constrained qi, helping qi flow more smoothly and easing distension and pain in the flanks, chest discomfort, low mood or irritability, and frequent sighing.
  • Also regulate the Stomach and ease pain, directing upward-rising qi downward to help relieve upper-abdominal fullness and distension, belching, acid reflux, hiccups, and nausea, and improve poor appetite and distending pain.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Clinical description:

Dull epigastric pain that is relieved by warmth and pressure; worse when the stomach is empty and eased by eating; fatigue and lack of energy; poor appetite and loose stools; pale, swollen tongue with teeth marks along the edges and a thin white coating; deep, fine or slow pulse

In plain language:

  • A dull ache in the upper abdomen that feels better with warmth and pressure
  • Pain is worse on an empty stomach and eases after eating something
  • Easy fatigue and lack of energy
  • Poor appetite, often accompanied by loose stools
  • A pale, swollen tongue with teeth marks along the edges and a thin white coating
  • A deep, fine or relatively slow pulse, traditionally associated with Spleen–Stomach deficiency-cold and impaired digestive function

|Treatment Approach

Clinical description:

Warm the middle, strengthen the Spleen, harmonize the Stomach, and relieve pain

In plain language:

  • Use warming methods to support the middle burner and strengthen Spleen qi, helping digestive function and easing sensitivity to cold, a cold abdomen, poor appetite, post-meal bloating, fatigue, and loose stools.
  • Also regulate the Stomach and ease pain, gradually reducing upper-abdominal distending pain or a dull ache that feels better with warmth or pressure, and helping with belching, acid reflux, and nausea.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Minor Center-Fortifying Decoction

|Common Symptoms

Clinical description:

Burning epigastric pain; dry, bitter taste in the mouth; heaviness and fatigue; nausea and vomiting; thick, yellow, greasy tongue coating; slippery pulse

In plain language:

  • A burning pain in the upper abdomen
  • Dry mouth and a bitter taste
  • A feeling of heaviness and easy fatigue
  • Frequent nausea, feeling like vomiting, or vomiting
  • A thick, yellow, greasy tongue coating
  • A slippery pulse, traditionally associated with damp-heat obstruction

|Treatment Approach

Clinical description:

Clear damp-heat, harmonize the Stomach, and relieve pain

In plain language:

  • Use methods to clear and drain damp-heat, helping address internal damp-heat and ease feelings of oppressive heat and stickiness, bitter or sticky mouth, fatigue and heaviness, a thick, greasy tongue coating, and scant, dark urine.
  • Also regulate Stomach qi and ease pain, gradually reducing upper-abdominal fullness or distending pain and helping with poor appetite, nausea, belching, acid reflux, and post-meal fullness.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Clinical description:

Dull or burning epigastric pain; hungry but with little desire to eat; dry mouth; constipation; red tongue with little coating; fine pulse

In plain language:

  • A dull ache or burning sensation in the upper abdomen
  • Feeling hungry but not wanting to eat
  • Dry mouth
  • Dry, difficult-to-pass stools
  • A red tongue with very little coating
  • A fine, weak pulse, traditionally associated with Yin deficiency

|Treatment Approach

Clinical description:

Strengthen the Spleen, nourish Yin, benefit the Stomach, and relieve pain

In plain language:

  • Use methods to support the Spleen’s digestive function and nourish fluids, helping digestion and hydration, and easing poor appetite, post-meal bloating, fatigue and heaviness, dry mouth and throat, and loose or sticky stools that are difficult to pass.
  • Also nourish the Stomach and ease pain, gradually reducing upper-abdominal distending pain or a dull ache and helping with upper-abdominal fullness, belching, acid reflux, and nausea.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Clinical description:

Distending or stabbing epigastric pain in a fixed location; worse at night; dry mouth without desire to drink; dark-purple tongue or purple spots and patches; choppy pulse

In plain language:

  • Distending or stabbing pain in the upper abdomen that remains in one place
  • Pain worsens at night
  • Dry mouth, but no desire to drink
  • A dark-purple tongue or visible purple spots or patches
  • A choppy pulse, traditionally associated with blood stasis obstruction

|Treatment Approach

Clinical description:

Invigorate blood, dispel blood stasis, unblock the collaterals, and relieve pain

In plain language:

  • Promote blood circulation and help disperse stagnant blood, allowing qi and blood to flow more smoothly and easing pain.
  • Help unblock the channels and collaterals, easing areas of obstruction and gradually relieving pain.

|Related Products

The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

References

  1. Chinese Society of Gastroenterology, Chinese Medical Association. Recommendations for the diagnosis and treatment of peptic ulcer disease[J]. Chinese Journal of Digestion, 2008, 28(7): 447-450.
  2. Cheng Hong, Hu Fulian, Yuan Shenyuan, et al. An epidemiological analysis of peptic ulcer disease in the Beijing area[J]. World Chinese Journal of Digestology, 2007, 15(33): 3518-3523.
  3. Hopkins RJ, Girardi LS, Turney EA. Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review[J]. Gastroenterology, 1996, 110(4): 1244-1252.
  4. Yang Huixiang, Zhang Guiying, Zou Yiyou, et al. Recurrence of peptic ulcer after Helicobacter pylori eradication[J]. Chinese Journal of Digestion, 2002, 22(6): 378-379.
  5. Chen Haozhu. Practical Internal Medicine (12th ed.)[M]. Beijing: People’s Medical Publishing House, 2005: 1866.
  6. Digestive Diseases Committee of the Chinese Association of Integrative Medicine. Consensus recommendations on the integrated Chinese and Western medicine diagnosis and treatment of peptic ulcer disease[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2012, 32(6): 733-737.
  7. Digestive Diseases Committee of the Chinese Association of Integrative Medicine. Integrated Chinese and Western medicine diagnosis and treatment plan for peptic ulcer disease (draft)[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2005, 25(5): 478-944.
  8. Spleen and Stomach Disease Branch of the China Association of Chinese Medicine. Consensus recommendations on TCM diagnosis and treatment of peptic ulcer disease[J]. Journal of Traditional Chinese Medicine, 2010, 51(10): 941-944.