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IBS due to Liver Qi Stagnation
Qi stagnation syndrome is one cause of what people call IBS. What makes it unique is the simple fact that there is a distending pain. Distending pain is the sensation of bloating even though there may or may not actually be any enlargement of the abdomen or intestines. There may be gas also. This gas is frequently very benign in smell. It can be more like air than anything offensive.
Another unique symptom that may arise in association with the Liver Qi stagnation syndrome is what can be described as ittty-bitty stools. The bowel movement is made up of a bunch of little rocks that tend to fall apart as they exit the anus. A normal stool should stay together like a log or a Tootsie roll, or a chocolate eclair, something like that. These stools arrive into this world as large malted milk balls. These itty-bitty stools are really arising secondary to heat in the intestines. One of our assumptions in TCM is that Qi stagnation can cause heat. This is like saying the friction of the Qi unable to move is causing heat. The heat dries up the fluids in the intestines and this gives rise to the pellet stools.
Qi Stagnation is sometimes called Liver Qi stagnation. In regards to IBS, all Qi stagnation is Liver Qi stagnation. It is the Liver's job, according to traditional Chinese medicine to get the Qi circulating smoothly throughout the body. Should this activity be compromised, the flow of Qi energy in the body will be effected and that gives rise to the symptomological picture that has caused you to arrive at this page.
The Liver Qi stagnation tongue may not actually show any indications of problems. It could look totally normal. However, given time, it can develop a thick coating as the Spleen's function is compromised and gives rise to internal dampness. Or, if the Liver really starts to become a problem, it can begin to generate some heat which can manifest as the red dots on the left side of the illustration shown here. The dots don't actually have to end up on the left side, though they are more likely going to be found along one or both of the sides of the tongue. They can also end up spreading to the tip of the tongue too.
The Liver is especially sensitive to stress. So, when you're upset, the Liver stays in a constant state of upset. This prevents its Qi from flowing well, and simply stated this gives rise to abdominal pain that makes you feel large. There may or may not be any specific enlargement of your tummy, but the sensation will be there that it is bloated.
Its kind of interesting to note that when the Liver Qi becomes stagnated, it gives rise to one very unique symptom and that is pain below the ribs. This could be on either side in front, or on the flanks or even below the ribs in the back. "Below" is "hypo" in medical terms. And "ribs" is "chondria" in medical language. The term "hypochondriac" has come to mean one who makes up symptoms because of either a need for attention or a sensitivity to suggestion. In the TCM reality this is Liver Qi stagnation.
Western medicine has no real treatment for hypochondriac pain but to send these patients to therapy to see if they can fix the problem through the mind. However, Chinese medicine has a very simply way of treating these stress induced non-physical pains below the ribs. Being a hypochondriac in Chinese medicine means simply that the Qi beneath the ribs, an area ruled by the Liver isn't flowing well and with a few needles and/or herbs, the pain is gone, the Qi flows and all is well in heaven and earth. Give or take.
Liver Qi stagnation is very easy to recognize in its relationship to other illnesses or pathologies. Simply stated, if the problem is induced or aggravated by stress or emotions, we've got a Liver pathology. Another sign of a Liver involvement in any pathology including IBS is if the problem is aggravated by the menstrual cycle. In other words, if your IBS symptoms are worse the week before or during the menstrual period, you're reading the correct page. The Liver is said to store the blood in Chinese medicine and is instrumental in assisting the flow of blood out of the uterus. Any Liver Qi stagnation issue that is bubbling under the surface will be much more evident during that week prior or during the menstruation.
When the Liver Qi is stagnated, the Qi in the Stomach and intestines is also stagnated. That results in problems in moving the contents of the intestines. That creates pain, perhaps gurgling, maybe some gas, and of course constipation, sometimes followed by diarrhea. When the symptoms go beyond a bloated or distended sensation, we call this pathology Liver attacking Spleen.
When the Liver Qi is stagnating the downward motion of the stomach contents and they begin to bubble upward as a result leading to heartburn, we call this "Liver Attacking Stomach". The formula that addresses this condition very well is called Wu Ji Wan (Coptis and Peony Combination).
If your pain is helped by exercise, then that is another symptom of Liver Qi stagnation, since the whole problem is due to a lack of movement of the Qi energy in the body. Moving the body in exercise or any activity tends to help this problem.
Liver Qi stagnation is very well treated with acupuncture. For the other symptoms that follow the Liver Qi stagnation, the herbal formulas vary widely, depending on the symptoms. For instance, for pain in the guts due to Qi stagnation, we use a formula called Si Ni San (Frigid Extremities Powder). One of the indications for Qi stagnation is cold hands and feet, hence the name. There are other formulas used for other digestive problems secondary to Liver Qi stagnation. A practitioner of traditional Chinese medicinal herbalism can help you find the right formula for you.
All of the formulas mentioned in this article are widely available at Chinese medicine pharmacies, though the so-called patent medicines that you'll find there aren't always as strong as they could be. These formulas come in a variety of different forms and strengths and your friendly neighborhood herbalist can assist you in obtaining them as is appropriate.
You can purchase any of the formulas mentioned in this article by simply clicking on their names. Another option is to obtain this formula modified for your unique situation from Beyond Well Being.
If you have any of the following symptoms, you'll benefit by reading the Liver attacking Spleen page.