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Epigastric Pain

How Chinese medicine differentiates epigastric (upper abdominal) pain, the six patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment.
General Acupuncture Points

Acupuncture points traditionally used for epigastric pain — 11 key points, used across most of the patterns below rather than tied to just one.

PointKey action
LIV-3Subdues Liver-Yang, promotes the smooth flow of Liver-Qi.
P-6Opens the chest, moves Qi and Blood, harmonizes the Stomach.
Ren-12Tonifies Stomach and Spleen, regulates Stomach-Qi.
ST-36Benefits Stomach and Spleen, tonifies Qi and Blood.
Ren-8Rescues Yang, strengthens the Spleen. (Moxa only, not needled.)
SP-6Strengthens the Spleen, resolves Dampness, promotes the smooth flow of Liver-Qi.
KI-3Tonifies the Kidneys, strengthens Essence.
ST-21Moves Stomach-Qi, stops pain, clears Stomach-Heat.
ST-44Clears Heat, regulates the Intestines, resolves Damp-Heat.
ST-34Subdues rebellious Stomach-Qi, removes obstructions from the channel.
SP-9Resolves Dampness, benefits the Lower Burner.
The Six Patterns

reinforcing   reducing   even method — technique below follows standard Excess/Deficiency treatment principle for each pattern, not tied to a specific point-by-point source.

1. Liver-Qi Stagnation Invading the Stomach View full pattern →

Clinical manifestations: Distending epigastric pain radiating to the ribs; worse with emotional stress, greasy or fried food, sedentary habits, or premenstrually; eased by relieving stress, gentle exercise, deep breathing, warmth, or small light meals.
Tongue: Normal to slightly Red body, possibly Redder at the sides, thin white coating. Pulse: Wiry.
Treatment principle: Soothe the Liver, harmonize the Stomach.

2. Stomach Deficient and Cold View full pattern →

Clinical manifestations: Dull, cold, aching epigastric pain eased by warmth; worse with cold or raw food, cold weather, overwork, or skipping meals; eased by a warm compress, warm cooked meals, rest after eating, or warm ginger tea.
Tongue: Pale, puffy, tooth-marked body, white slippery coating. Pulse: Deep, Slow, Weak.
Treatment principle: Warm and tonify Stomach-Yang.
Note: moxa applicable; Ren-8 is moxa only, not needled.

3. Stomach-Yin Deficiency View full pattern →

Clinical manifestations: Dull, burning epigastric pain with dry mouth and gnawing discomfort; worse with greasy or fried food, alcohol, overwork, dry weather, or emotional stress; eased by cool, moistening food, small light meals, or adequate sleep.
Tongue: Red, thin body, dry centre, little or no coating, possibly cracked. Pulse: Fine, Rapid.
Treatment principle: Nourish Stomach-Yin.
Note: no moxa (Yin deficiency).

4. Food Stagnation in the Stomach View full pattern →

Clinical manifestations: Distending epigastric pain with fullness, worse after eating, eased by vomiting; worse with overeating, greasy food, alcohol, pressure on the abdomen, or eating late; eased by vomiting, passing gas, skipping a meal, gentle massage, or warm ginger tea.
Tongue: Normal body, thick greasy curd-like coating, thickest at the centre. Pulse: Slippery, Full.
Treatment principle: Reduce food stagnation, harmonize the Stomach.

5. Cold Invading the Stomach View full pattern →

Clinical manifestations: Sudden, sharp or cramping epigastric pain after cold food, eased by warmth; worse with cold or raw food, cold weather; eased by a warm compress, warm drinks, rest and staying warm, or moxibustion.
Tongue: Pale body, moist thin white slippery coating. Pulse: Tight, Slow.
Treatment principle: Warm the Stomach, dispel Cold.
Note: reducing method with moxa (Excess-Cold — expel the pathogen while warming).

6. Damp-Heat in the Stomach View full pattern →

Clinical manifestations: Burning epigastric pain with a bitter taste, nausea and heaviness; worse with greasy or fried food, alcohol, hot humid weather, overeating, or rich food; eased by light cooling meals, cool rest, plenty of water, or gentle exercise.
Tongue: Red body, possibly swollen with prickles at the centre, thick yellow greasy coating. Pulse: Slippery, Rapid.
Treatment principle: Clear Heat, resolve Dampness.
Note: no moxa.
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