HIATUS HERNIA

Clinical Manifestations
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Chest and abdominal distention
  • A stifling sensation in the chest and abdomen
  • Fixed pain in the hypochondria
  • Belching with a fetid odor
  • Nausea
  • Vomiting
  • Epigastric and abdominal fullness and pain
  • Acid reflux
  • Mild coughing with copious sputum
  • Reduced appetite
  • Indigestion
  • T: Normal
  • C: Thin and white or Greasy or Slippery,
  • P: Wiry and taut or Running
Treatment Principle
  • Regulates Qi in the Spleen and Stomach
Herb Formulas
Points
Clinical Manifestations
  • Intermittent or continuous abdominal distention, fullness and discomfort
  • Distention is improved by warmth and pressure and worse when eating raw or cold foods
  • Intermittent, chronic acid reflux and heartburn which are worse with hard to digest or raw foods, bending or any increase in abdominal pressure
  • May wake during the night with heartburn
  • Mild epigastric pain or discomfort which is better with warmth and pressure
  • Hypersalivation
  • Drooling
  • Sour belching
  • Poor appetite
  • Easily satiated
  • Fatigue
  • Weak, tired limbs
  • Loose stools or
  • Diarrhea or
  • A tendency toward sluggish bowel movements
  • Puffiness around the eyes or in the fingers
  • Rapid weight fluctuations
  • A pale, sallow face and lips
  • Shortness of breath
  • Reluctance to speak
  • A weak, soft voice
  • Intolerance of Cold
  • Cold extremities
  • T: Pale or Pale and swollen with teeth marks
  • C: White
  • P:Weak and thready or Deficient or Big and Weak
Treatment Principle
  • Tonify Qi
  • Strengthen the Spleen
  • Facilitate the Raising of Qi and the descent of the turbid
Herb Formulas
  • Bu Zhong Yi Qi Tang modified
  • Xiang Sha Liu Jun Zi Tang  modified
  • Chinese Patent Medicines:
    Bu Zhong Yi Qi Wan
    Xiang Sha Liu Jun Zi Wan
    Jian Pi Wan
    With Qi Stagnation: Xiang Sha Yang Wei Wan
    With Yang Deficiency: Li Zhong Wan
    With Excess acid: Wei Te Ling (combine with any of the above)
    For symptomatic relief: Xiang Lian Wan (combine with any of the above)
Points
Clinical Manifestations
  • Focal distention and discomfort in the epigastrium and upper abdomen
  • Distention worse after eating
  • Anorexia
  • Decreased sense of taste
  • Only able to eat a little at a time
  • Generalized weakness
  • T: Pale
  • C: Thick and white
  • P: Slippery, deep and wiry
Treatment Principle
  • Strengthen the Spleen
  • Harmonize the Stomach
  • Dry Dampness
  • Transform Phlegm
  • Relieve distention
Herb Formulas
Points
Clinical Manifestations
  • A sensation of blockage, distention, fullness and discomfort in the epigastrium
  • When palpated, feels soft and without pain
  • Nausea
  • Vomiting or
  • Dry retching
  • Borborygmus with diarrhea
  • Poor appetite
  • T: Normal
  • C: Greasy and yellow
  • P: Soft, slippery, slightly wiry and maybe rapid
Treatment Principle
  • Harmonize the Stomach
  • Descend Qi
  • Disperse Accumulation
Herb Formulas
Points
Clinical Manifestations
  • Severe, unrelenting or intermittent abdominal distention that is progressively worse as the day goes on which may be difficult to bear in the evening
  • The abdomen may appear swollen or the patient may feel that the clothing is tight
  • The distention is worse with eating, exposure to Cold and when fatigued
  • Mild constant epigastric or abdominal pain which is relieved by warmth and pressure
  • Cold intolerance
  • Anorexia
  • Easily satiated
  • Abdominal pain and fullness after meals
  • Nausea / vomiting
  • Loose, unformed stools or
  • Diarrhea with undigested food in the stools or
  • Sluggish bowel movements with no urge to defecate
  • Excessive salivation
  • Cold limbs
  • Fatigue
  • Lassitude
  • Weakness
  • Exhaustion
  • Sallow or pale, dull complexion
  • Puffiness around the eyes or in the fingers
  • Quick weight fluctuations
  • Maybe edema
  • Maybe scanty urination
  • Maybe clear, watery, copious vaginal discharge
  • T: Pale or Pale and swollen with teethmarks
  • C: White and greasy
  • P: Deep, thready and forceless or Deep, weak and slow
Treatment Principle
  • Warm Yang
  • Strengthen the Spleen
  • Warm the Center
  • Dispel Cold
Herb Formulas
Points
Clinical Manifestations
  • Severe, constant abdominal distension
  • Relentless belching
  • Severe hiccup
  • Relentless acid reflux
  • Unremitting regurgitation
  • Unremitting nausea and vomiting of saliva and Phlegm
  • Vomiting soon after eating
  • Hard epigastric distention
  • Poor appetite
  • Edema
  • Chest and hypochondriac distension
  • Dizziness
  • Thirst but doesn't wish to drink
  • Maybe no thirst
  • Palpitations
  • Shortness of breath
  • Frequent salivation
  • Frequent urination
  • T: Pink
  • C: Thick, white and slippery or White and smooth
  • P: Slippery and full and maybe wiry or Wiry and deficient or Wiry, taut and feeble
Treatment Principle
  • Eliminate Dampness
  • Resolve Phlegm
  • Descend Qi
Herb Formulas
Points
Clinical Manifestations
  • Chronic acid reflux, hyperacidity and heartburn
  • Symptoms may be worse in the evening and with stress
  • The patient may wake with symptoms during the night which may be temporarily relieved by eating
  • Mild, dull epigastric or hypochondriac pain or discomfort
  • Anorexia or
  • Intermittent gnawing hunger
  • Dry mouth and throat
  • Dry stools or
  • Constipation
  • T: Red and dry
  • C: Little or None
  • P: Thready, wiry and rapid
Treatment Principle
  • Nourish and supplement Liver and Stomach Yin
  • Regulate Qi
  • Descend Qi
  • Harmonize the Stomach
Herb Formulas
  • Yi Guan Jian  modified
  • Chinese Patent Medicines:
    Gu Ben Wan
    With Excess acid: Wei Te Ling (combine with any of the above)
    For symptomatic relief: Xiang Lian Wan (combine with any of the above)
Points
Clinical Manifestations
  • Focal distention in the chest and epigastrium with or without nodules which is painful when pressed
  • Coughing up yellow, viscous sputum
  • Constipation
  • A bitter taste in the mouth
  • T: Normal
  • C: Yellow and greasy
  • P: Slippery and floating or Slippery and rapid
Treatment Principle
  • Clear Heat
  • Transform Phlegm
  • Expand the chest
  • Dissipate Stagnation
Herb Formulas
Points
Clinical Manifestations
  • Recurrent acid reflux (worse when emotionally upset)
  • Epigastric pain (worse when emotionally upset)
  • Frequent belching with acid regurgitation
  • Nausea in the morning
  • Vomiting
  • Anorexia
  • Hypochondriac or epigastric distention, pain, tenderness ache or discomfort
  • Epigastric or abdominal bloating
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Moodiness
  • Anxiety
  • Frequent worrying
  • Inappropriate anger
  • Dizziness
  • Tension headaches
  • Shoulder and neck tension
  • Cold fingers and toes
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • Alternating constipation and loose stools
  • T: Pink or Darkish
  • C: Thin and white
  • P: Wiry
Treatment Principle
  • Soothe the Liver
  • Harmonize the Stomach
  • Descend Stomach Qi
Herb Formulas
  • Si Ni San  modified
  • Chai Hu Shu Gan Tang  modified
  • For women: Xiao Yao San + Zuo Jin Wan
  • Chinese Patent Medicines:
    Chai Hu Shu Gan Wan
    Xiao Yao Wan
    With epigastric pain: Shu Gan Wan
    With stagnant Heat:Jia Wei Xiao Yao Wan
    For symptomatic relief of heartburn: Wei Te Ling (combine with other appropriate formulas)
Points
Clinical Manifestations
  • Hypochondriac pain and distention
  • Indeterminate gnawing hunger
  • Epigastric distention and pain
  • Vomiting
  • Acid regurgitation
  • Belching
  • Bitter taste
  • Dry mouth
  • Nausea
  • Dry lips
  • Hiccups
  • T: Red
  • C: Yellow
  • P: Wiry and rapid
Treatment Principle
  • Clear Liver Heat (Fire)
  • Descend Rebellious Qi
  • Stop vomiting
Herb Formulas
Points

Clinical Manifestations
  • Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed
  • Recurrent acid reflux, heartburn or regurgitation
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest and epigastrium
  • Belching
  • Nausea
  • Vomiting
  • Dry mouth and throat
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • T: Pink
  • C: Thin and white or Greasy and white
  • P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle
  • Spread Qi
  • Resolve Phlegm
Herb Formulas
Points