Does stomach pain cause pain in other parts of the body?

Patient's question:

Irregular eating habits

Doctor's answer:

Analysis of the Condition: The common causes of stomach pain include invasion of cold pathogens into the stomach, dietary injury, liver qi invading the stomach, and spleen-stomach deficiency. The stomach governs the reception and transformation of food and drink. If cold pathogens invade the stomach, cold stagnation fails to dissipate, obstructing qi flow, which can lead to stomach qi disharmony and pain. Alternatively, irregular diet, excessive hunger or fullness, or overeating greasy and sweet foods can cause food stagnation, obstruct qi flow, and lead to stomach pain due to the stomach's failure to descend properly. The liver has a regulatory function over the spleen and stomach. If due to anger or depression, qi stagnation damages the liver, the liver fails to flow smoothly, and invades the stomach, stomach pain may also occur. If due to overexertion or internal injury, chronic spleen-stomach deficiency, or congenital insufficiency, middle yang deficiency, the stomach lacks warmth, internal cold arises, and middle jiao coldness causes pain. There is also qi stagnation for a long time, blood stasis accumulates internally, qi and blood stagnation obstruct middle jiao qi flow, leading to stomach pain. In summary, the pathogenesis of stomach pain is divided into two aspects: excess (solid) and deficiency (empty). Excess is characterized by qi flow obstruction, where no flow leads to pain; deficiency is characterized by the stomach being lacking in warmth or nourishment, where lack of nourishment leads to pain.
Causes of Stomach Pain: There are two main causes of stomach pain:
1. Due to worry, anger, or emotional distress, liver qi is disrupted, invades the stomach, and thus causes pain. Treatment should focus on soothing the liver and regulating qi.
2. Due to spleen deficiency and impaired stomach descent, warm and tonifying methods should be used to restore the function of the spleen and stomach.
Additional Causes of Stomach Pain: Many factors can lead to stomach pain, including excessive work stress, irregular eating times, working or exercising immediately after meals, excessive alcohol consumption, overeating spicy foods, and frequently consuming indigestible foods. Stomach pain may be caused by several factors, but most are due to acid reflux, where stomach fluids flow back into the esophagus. These digestive fluids contain hydrochloric acid, a corrosive substance used industrially to clean metals. Although the stomach has a protective lining to prevent acid erosion, the esophagus lacks this protection.
Guidance on Treatment: To treat stomach pain, first identify its nature—whether it is excess, deficiency, cold, or heat—as well as whether the issue lies in qi or blood. Then, examine the symptoms to determine the cause and provide appropriate treatment. Generally, acute, severe, and localized pain that resists pressure is often excess; chronic, dull, and relieving with pressure is often deficiency. Cold pain is relieved by warmth and worsened by cold, while heat pain is relieved by coolness and worsened by heat. (distending pain) or pain radiating to the chest and flanks, which varies with emotional changes, is often due to qi stagnation. Fixed, stabbing pain is often due to chronic blood stasis. If there is restlessness, thirst, a red tongue with little coating or moisture, it may indicate insufficient stomach yin.
Treatment Principles for Stomach Pain: Although ancient principles state "no pain when flow is smooth," treatment is not limited to this method. Use the four diagnostic methods and eight principles to carefully examine the patient's condition and establish appropriate treatment based on individual circumstances.
### 1. Liver Qi Invading the Stomach
This condition can be divided into three types: qi stagnation, fire stagnation, and blood stasis.
#### (1) Qi Stagnation
Main Symptoms: Distending pain in the stomach area, frequent belching, poor appetite or vomiting, pain relief after vomiting, greasy tongue coating, and slippery or forceful pulse.
Analysis: Food stagnation in the stomach disrupts transmission, causing pain and distension. Stagnated food leads to upward qi reversal, causing belching or vomiting. Pain relief after vomiting indicates the removal of stagnation. Greasy tongue coating suggests food stagnation, while a slippery or forceful pulse indicates qi and food conflict.
Treatment Principle: Resolve food stagnation.
Selected Acupoints: Spleen Shu (SP6), Triple Energizer Shu (TE8), Liangmen (ST13), Tianhu (ST25), Hand Three Conductor (LI11), and Foot Three Conductor (ST36).
Recommended Techniques: Heavy kneading on the back and waist for pain relief, twisting and manipulating Shu points for qi regulation, pinching the back muscles for qi regulation, and rubbing the abdomen for digestion. If pain is severe with belching and vomiting, add bilateral Neiguan (PC6) and Neiting (PC4) for qi regulation and pain relief. If vomiting acid water and constant discomfort occur, and considering the interplay between the liver and gallbladder, dry mouth and bitter taste may appear due to liver-qi stagnation and heat. A yellow tongue and wiry, rapid pulse indicate liver-gastric heat.
Treatment Principle: Soothe the liver, drain heat, and harmonize the stomach.
Selected Acupoints: Liver Shu (BL18), Stomach Shu (BL21), Triple Energizer Shu (TE8), Large Intestine Shu (BL25), Zhangmen (LR13), Hand Three Conductor (LI11), and Foot Three Conductor (ST36).
Recommended Techniques: Heavy kneading on the back and waist for pain relief, pinching the back to aid digestion, rubbing the abdomen for digestion, pressing Yangming for heat clearance, and adding twisting the chest and flanks for liver regulation (see fever). For severe pain, use thumb and index fingers to pinch both sides of Xuehai (SP10) and Liangqiu (ST34). If pain subsides but liver-spleen disharmony remains, use both thumbs to massage and press bilateral Triple Energizer Shu (TE8) and a single thumb to press Zhongwan (CV12) for qi regulation.
#### (3) Blood Stasis
Main Symptoms: Fixed, pressing pain, often sharp, worsening after meals, or hematemesis and melena. Severe cases may show a purple tongue and thready pulse.
Analysis: Chronic pain damages meridians, causing hematemesis and melena. Stasis is an obstructive mass, so pain is fixed and pressing. Food and stasis combine, worsening pain after meals. Stasis obstructs blood flow, causing a purple tongue and thready pulse.
Treatment Principle: Promote blood circulation and resolve stasis to unblock meridians and relieve pain.
Selected Acupoints: Liver Shu (BL18), Spleen Shu (SP6), Stomach Shu (BL21), Zhangmen (LR13), Neiguan (PC6), Laogong (PC8), Liangqiu (ST34), and Neiting (PC4).
Recommended Techniques: Heavy kneading on the back and waist for pain relief, twisting and manipulating Shu points for qi regulation, pinching the back muscles for qi regulation, and rubbing the upper abdomen to dispel cold. Pair with pressing Yangming for heat clearance and add distal induction for pain relief (both thumbs on bilateral Neiguan, Laogong, Liangqiu, and Neiting). If vomiting and hematochezia persist, prioritize medication. Manual techniques may be applied after stabilization.
### 2. Pathogen Obstruction
#### (1) Dietary Obstruction
Main Symptoms: Distending pain in the stomach area, belching rotten food, poor appetite or vomiting, pain relief after vomiting, greasy tongue coating, and slippery or forceful pulse.
Analysis: Food stagnation in the stomach disrupts transmission, causing pain and distension. Stagnated food leads to upward qi reversal, causing belching or vomiting. Pain relief after vomiting indicates the removal of stagnation. Food stagnation irritates the stomach, causing a greasy tongue coating and a slippery or forceful pulse.
Treatment Principle: Resolve food stagnation.
Selected Acupoints: Spleen Shu (SP6), Triple Energizer Shu (TE8), Liangmen (ST13), Tianhu (ST25), Hand Three Conductor (LI11), and Foot Three Conductor (ST36).
Recommended Techniques: Pinching the back to aid digestion, rubbing the abdomen for digestion, pinching and trembling for stagnation resolution, paired with pressing the back and waist for pain relief and pressing Yangming for heat clearance.