Gallbladder Stones

Gallbladder stone disease (gallstone disease of the gallbladder) refers to various pathological changes in the gallbladder caused by stones that originate within it.

TCM Pattern Differentiation and Medication Reference

|Common Symptoms

Clinical Description:

Burning or stabbing pain in the hypochondrium; tenderness or a palpable mass below the ribs; slightly red tongue with a thin white or slightly yellow coating; normal pulse or wiry and slightly rapid pulse.

In Plain Language:

  • The areas beneath the ribs may feel as if they are burning or being pricked with needles. Discomfort may be more noticeable when moving or turning.
  • Pressing below the ribs on either side may worsen the pain, and you may not want the area touched; a firm, lump-like mass may also be palpable.
  • The tongue may appear slightly red, with a thin white or slightly yellow coating.
  • The pulse may be generally normal, or feel taut and slightly fast under the fingers.

|Treatment Approach

Clinical Description:

Soothe the liver and relieve constraint; clear heat and promote bile flow.

In Plain Language:

  • Aims to promote the smooth flow of liver qi and relieve constraint, easing discomfort such as fullness in the chest and hypochondrium, low mood, or frequent sighing.
  • Aims to clear constrained heat in the liver and gallbladder and promote bile flow, easing symptoms such as a bitter taste, dry throat, hypochondriac distending pain, nausea, poor appetite, yellowing of the eyes or skin, or dark urine.

|Related Medications

The products listed below are for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical Description:

Distending pain in the hypochondrium, yellowing of the body and eyes; red tongue with a thick, yellow, greasy coating; slippery, rapid pulse.

In Plain Language:

  • The areas beneath the ribs may feel distended and painful, with symptoms more noticeable when moving or when pressure is applied; it may feel as though something is pressing from within.
  • The skin and the whites of the eyes may both appear distinctly yellow, which may be clearly visible in the mirror.
  • The tongue may look red, with a noticeably bright red color.
  • The tongue may have a thick, yellow, greasy coating, as if covered with a layer of oily yellow material.
  • The pulse may feel smooth and fast, with an increased rate and a flowing sensation beneath the fingers.

|Treatment Approach

Clinical Description:

Clear heat and promote bile flow; transform dampness and promote downward movement.

In Plain Language:

  • Aims to clear heat in the liver and gallbladder and promote bile flow, easing symptoms such as a bitter taste, dry throat, hypochondriac distending pain, or yellowing of the eyes and skin.
  • Aims to transform dampness in the body, easing discomfort such as a heavy feeling, fullness in the chest or abdomen, or poor appetite.
  • Aims to promote downward movement and clear accumulated stagnation, easing symptoms such as constipation, abdominal fullness, or difficulty passing stool.

|Related Medications

The products listed below are for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical Description:

Distending, burning pain in the hypochondrium and high fever; dry, red or crimson tongue, possibly with ecchymoses; thick yellow or charred-black coating, or no coating; surging, rapid pulse.

In Plain Language:

  • The areas beneath the ribs may feel distended with burning pain, accompanied by a high fever and a pronounced sensation of heat throughout the body.
  • The tongue may look dry and red, or darker and crimson, and may show dark purple spots or patches.
  • The tongue coating may be thick and yellow, dry and charred-looking or nearly black, or almost entirely absent.
  • The pulse may feel full and forceful as well as fast, with a strong, rapid beat under the fingers.

|Treatment Approach

Clinical Description:

Purge fire and resolve toxins; nourish yin and promote bile flow.

In Plain Language:

  • Aims to clear excessive internal heat, easing symptoms such as restlessness, thirst, a red and swollen throat, or facial redness and heat.
  • Aims to clear harmful substances from the body, easing discomfort such as red, swollen sores, a sore throat, or mouth ulcers.
  • Aims to nourish yin and promote bile flow, easing symptoms such as a bitter taste, yellowing of the eyes, hypochondriac distending pain, or poor appetite.

|Related Medications

The products listed below are for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical Description:

Intermittent pain in the right hypochondrium, described as distending, stuffy, and shifting; pale red tongue with a thin white, thin white and greasy, or thin yellow coating; normal or wiry pulse.

In Plain Language:

  • Pain may come and go in the right side beneath the ribs. It is often distending and stuffy, and may shift to nearby areas; movement or pressure may make it more noticeable.
  • The tongue may appear pale red rather than deeply red.
  • The tongue coating may be thin and white, thin and white with a greasy appearance, or thin and pale yellow.
  • The pulse may be generally steady, or feel taut and straight beneath the fingers, like a stretched string.

|Treatment Approach

Clinical Description:

Soothe the liver and promote bile flow; move qi and relieve pain.

In Plain Language:

  • Aims to promote the smooth flow of liver qi and bile, easing symptoms such as hypochondriac distending pain, a bitter taste, dry throat, or yellowing of the eyes and skin.
  • Aims to regulate the flow of qi and relieve pain, easing discomfort such as fullness in the chest and hypochondrium, frequent belching, or dull upper abdominal pain.

|Related Medications

The products listed below are for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.

|Common Symptoms

Clinical Description:

Persistent, lingering pain in the right hypochondrium, worsened by exertion, with dizziness and blurred vision; red tongue with little or peeled coating; wiry, fine pulse or fine, rapid pulse.

In Plain Language:

  • Pain may persist in the right side beneath the ribs, varying in intensity but lingering without fully going away.
  • Pain may worsen noticeably with fatigue or increased activity, with greater distending discomfort.
  • Dizziness or blurred vision may occur, with vision feeling unsteady or wavering; this may be more noticeable when standing or walking.
  • The tongue may appear red with very little coating, or have a shiny, peeled appearance.
  • The pulse may feel taut and fine beneath the fingers, or fine and rapid with reduced strength.

|Treatment Approach

Clinical Description:

Nourish yin and soften the liver; soothe the liver and promote bile flow.

In Plain Language:

  • Aims to nourish yin and ease liver tension, helping with symptoms such as restlessness, irritability, dry mouth and throat, or muscle and tendon tightness.
  • Aims to promote the smooth flow of liver qi and bile, easing discomfort such as hypochondriac distending pain, a bitter taste, yellowing of the eyes, or poor appetite.

|Related Medications

The products listed below are for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and leaflet, and use under the guidance of a doctor or pharmacist.

References

  1. Zhu Peiting, Zhu Shimin. Practical TCM Biliary Disease[M]. Beijing: People’s Medical Publishing House, 1999.
  2. Zhang Jingzhe, Yuan Zuobiao, et al. Experimental study on the effects of liver-nourishing and liver-softening methods in reversing the lithogenicity of bile in guinea pigs[J]. Journal of Chinese Integrative Medicine, 2003, 1(1): 289–293.
  3. Wu Jiefping, Qiu Fazu. Huang Jiasi’s Surgery[M]. Beijing: People’s Medical Publishing House, 2002, 12(6): 1257–1277.
  4. Expert Committee on the Chinese Consensus on the Internal Medicine Diagnosis and Treatment of Chronic Cholecystitis and Cholelithiasis. Chinese consensus on the internal medicine diagnosis and treatment of chronic cholecystitis and cholelithiasis (2014, Shanghai)[J]. Chinese Journal of Digestive Diseases, 2014, (12): 795–799.
  5. Gu Honggang, Zhang Jingzhe, Zhu Peiting. A brief analysis of the pathogenesis of biliary stone disease during acute episodes[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2004, 10(7): 72–73.
  6. Zhang Xuelin, Zhu Peiting, Zhang Jingzhe. A brief analysis of the principle of “treating biliary disorders by addressing the liver”[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2000, 6(1): 43–45.