IRRITABLE BOWEL SYNDROME (SPASTIC COLON)

Clinical Manifestations
  • Abdominal pain (triggered by eating, relieved by defecation)
  • Constipation or
  • Diarrhea
  • Bloating
  • Flatulence
  • Nausea
  • Mucus in the stool
  • A feeling of incomplete defecation
  • Pain in the anus or rectum
  • Headache
  • Fatigue
  • Lassitude
  • Depression
  • Anxiety
  • Poor concentration
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Previous history of Yin, Jin Ye, or Blood Deficiency
  • Previous history of Yang Ming
  • Fluid and Yin depleted
  • Anhidrosis
  • Numbness
  • Weakness
  • Dryness
  • Constipation
  • T: Red
  • C: Yellow and dry
  • P:  Weak and thready
Treatment Principle
  • Moisten and Lubricate
  • Nourish Yin and Fluids
Herb Formulas
Points
Clinical Manifestations
  • Alternating chills and fever
  • Restlessness
  • Irritability
  • Anorexia
  • Sometimes fatigue
  • Nausea
  • Occasional vomiting
  • Headaches (side of head)
  • Hypochondriac pain
  • Rib pain
  • Achiness
  • Ear infection
  • Hearing difficulty
  • Red eyes
  • Stiff shoulders
  • Throat pain
  • Hip pain
  • T: Normal with bumps or dots on side
  • C: Thin white
  • P: Wiry
Treatment Principle
  • Harmonize the Liver and Gall Bladder
Herb Formulas
Points
Clinical Manifestations
  • Nausea
  • Clear, frequent urination
  • Lack of thirst
  • Anorexia
  • Vomiting of clear fluid
  • Abdominal distension and pain (sharp)
  • Diarrhea or loose stool
  • Prefers warmth
  • T: Pale or pink
  • C: White
  • P: Slow and tight or Soft
Treatment Principle
  • Regulate the middle
  • Warm the Middle Jiao
  • Disperse Cold
  • Relieve pain
Herb Formulas
Points
Clinical Manifestations
  • Clear, frequent urination
  • Abdominal distension
  • Anorexia
  • Nausea
  • Vomiting clear fluid
  • Dull abdominal pain
  • Diarrhea or loose stools
  • Prefers warmth and pressure
  • T: Pale
  • C: White
  • P: Slow and sinking or Soft and weak
Treatment Principle
  • Regulate the Middle
  • Warm the Middle Jiao
  • Disperse Cold
Herb Formulas
Points
Clinical Manifestations
  • Delirium
  • Heat in upper body
  • Cold in lower body
  • Sensation of Qi rushing to the chest
  • Vomits worms
  • Persistent thirst
  • Feverishness
  • Anorexia (hungry but can't eat)
  • Chronic diarrhea
  • Cold extremities
  • Maybe edema
  • Vertex headache
  • Vomits food
  • Cardiac Heat with pain
  • T: Red or pink or pale and flabby
  • C: Thick and greasy or thin
  • P: Deep, thready and weak or wiry
Treatment Principle
  • Clear worms
  • Clear Heat (Do not purge, create diaphoresis, or create emesis)
  • Revive Yang
Herb Formulas
Points
Clinical Manifestations
  • Diarrhea with tenesmus which intensifies after defecation
  • Frequent stools which are small in quantity
  • Stools are yellow or brown, thin, watery, with foul smell or sticky and pasty like jam or sticky fluid or containing pus and Blood
  • Burning hot sensation in anus
  • Abdominal pain
  • Urine short and red
  • Sustained fever despite profuse perspiration or
  • Raging fever in the afternoon
  • Severe cases:
    High fever and coma
  • Mouth dry but no desire to drink
  • Body heavy
  • Limbs tired
  • Fullness in chest
  • Lump in epigastrium
  • Anorexia
  • Vomiting
  • T: Red
  • C: Yellow and greasy
  • P: Slippery and rapid
Treatment Principle
  • Clear Heat
  • Transform Dampness
  • Stop dysentery
Herb Formulas
Points
Clinical Manifestations
  • Constipation
  • Difficulty in passing stools
  • Dull pains and cold sensations in abdomen
  • Preference for warmth; dislike of Cold
  • Cold hands and feet
  • Abundant clear urine
  • T: Pale
  • C: Thick, white and moist
  • P: Deep and slow
Treatment Principle
  • Warm the Cold
  • Relieve constipation
Herb Formulas
Points
Clinical Manifestations
  • Knotted constipation or
  • Watery, thin diarrhea (Heat knots or flows)
  • A sensation of fullness in the chest and upper abdomen
  • Burning hot sensation in the anus
  • Abdominal distention and pain (dislikes pressure)
  • Worse with pressure
  • High fever or infantile tidal fever
  • Hands and feet dripping with perspiration
  • Vomiting
  • Irritating thirst
  • Irritability
  • Scanty urination
  • Delirium
  • T: Pink, maybe prickles (swollen papillae on the tongue that look like thorns and are very sensitive to the touch) or Red
  • C: Thick, yellow and dry
  • P: Deep and Excess or Rapid and slippery
Treatment Principle
  • Clear Excess Heat with bitter, cold, strong purgative herbs
Herb Formulas
Points
Clinical Manifestations
  • Dry stools
  • Knotted constipation or bowel movements once a day
  • Difficulty passing stools
  • Dizziness
  • Bad breath
  • Mouth and throat dry
  • T: Red
  • C: Little
  • P: Thready and rapid
Treatment Principle
  • Lubricate the Intestines
  • Relieve constipation
Herb Formulas
Points
Clinical Manifestations
  • Pale, sallow complexion and lips
  • Fatigue
  • Weakness
  • Fatigue may increase after eating
  • Anorexia
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools
  • Maybe diarrhea with mucus
  • The diarrhea may be may be constant or intermittent and aggravated by fatigue, over exertion or food sensitivity
  • Maybe alternating diarrhea and constipation
  • Easy satiety
  • Decreased sense of taste
  • The bowels move soon after eating
  • Nausea
  • Shortness of breath
  • Puffiness around the eyes and fingers
  • T: Pale and flabby - may have teethmarks
  • C: White
  • P: Even, forceless and Deficient or Weak, thready, deficient and moderate
Treatment Principle
  • Strengthen the Spleen
  • Benefit Qi
  • Dry Dampness
Herb Formulas
Points
Clinical Manifestations
  • Prolapse of one or more organs
  • Sallow complexion
  • Anorexia
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools
  • Shortness of breath
  • T: Pale and flabby - may have teethmarks
  • C: White
  • P: Even or Soft and thready
Treatment Principle
  • Strengthen the Spleen
  • Benefit Qi
  • Reinforce the Center
  • Invigorate Yang
Herb Formulas
Points
Clinical Manifestations
  • Upper abdominal pain which is better with warmth and pressure and ingesting warm fluids
  • Waxy, pale or sallow lusterless complexion
  • Anorexia (maybe with vomiting)
  • Easily satiated
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools or watery stools containing undigested food
  • Occasionally constipation
  • Shortness of breath
  • Pain in the epigastrium with cold sensations relieved by warmth
  • Intolerance of Cold
  • Cold limbs
  • Feeling chilled
  • Lethargy
  • Fatigue
  • Mental fatigue
  • Depression
  • Low spirits
  • Copious, clear urine
  • Maybe scanty urine with edema
  • Maybe clear, watery vaginal discharge
  • T: Pale maybe swollen
  • C: White or Thin and white
  • P: Deep and weak or Deep, slow and thready
Treatment Principle
  • Warm the Center
  • Supplement Qi and Yang
  • Dispel Cold
  • Strengthen the Spleen and Stomach
Herb Formulas
Points
Clinical Manifestations
  • Distention and fullness of epigastrium and abdomen
  • Dull abdominal pain which is better with warmth but worse with pressure
  • Nausea
  • Vomiting
  • Anorexia
  • Loose stools
  • Diarrhea
  • Reduced sensation of taste
  • Anorexia
  • No thirst or preference for hot drinks
  • Sticky sensation in mouth
  • Borborygmus
  • Lassitude
  • Lethargy
  • Heavy head and body
  • Foggy-headedness
  • Clear urine
  • Tenesmus
  • Maybe edema
  • Maybe copious white vaginal discharge
  • Maybe cold limbs, fear of Cold, feeling chilled
  • T: Pink or Pale
  • C:Thick, white and greasy or sticky
  • P: Deep and slow or Soft and moderate or Soft and slippery
  • With remnants of External pathogens:
    Chills
    Mild fever
    Muscle aches
    Anhidrosis
    P: Floating
Treatment Principle
  • Warm Cold
  • Transform Dampness
  • Harmonize the Stomach
  • Strengthen the Spleen
  • Regulate Qi
Herb Formulas
Points
Clinical Manifestations
  • Anorexia
  • Abdominal distention and discomfort
  • Suffocating sensation in the chest
  • Epigastric mass
  • Maybe abdominal pain on palpation
  • Yang jaundice (sclera and skin are bright yellow)
  • Dislike of oily foods
  • Nausea
  • Vomiting
  • Lassitude
  • Scanty, dark urine
  • Maybe thirst or thirst with no desire to drink
  • Diarrhea with foul smell or
  • Constipation
  • Fever
  • Sweet sticky taste or bitter taste in mouth
  • T: Pink
  • C: Thick, yellow and greasy (maybe sticky)
  • P: Soft and rapid
Treatment Principle
  • Clear Heat
  • Benefit Dampness
Herb Formulas
Points
Clinical Manifestations
  • Relatively severe abdominal and epigastric distention, fullness and discomfort that is apparent upon waking
  • Fatigue
  • Lethargy
  • Tiredness
  • Above symptoms are worse in the morning
  • Increased desire to sleep
  • Heaviness in the body
  • Heavy, tired limbs
  • Foggy-headedness
  • Anorexia
  • Loss of the sense of taste
  • Nausea and vomiting often worse in the morning
  • Belching
  • Acid reflux
  • Loose stools
  • Dizziness that can be triggered by strong smells
  • Headaches that can be triggered by strong smells
  • Stifling sensation in the chest
  • Maybe chronic mucus production from the sinuses and Lungs
  • Greasy skin
  • Musty body odor
  • Tendency toward obesity
  • Pear shape
  • T: Possibly swollen or flabby
  • C: Thick, greasy and white
  • P: Slippery or Wiry or Moderate
Treatment Principle
  • Dry Dampness
  • Transform Phlegm
  • Regulate Qi
  • Harmonize the Stomach
Herb Formulas
Points
Clinical Manifestations
  • Chronic, intermittent, dull abdominal pain which is better with warmth and pressure and ingesting warm fluids
  • Waxy, pale or sallow lusterless complexion
  • Anorexia (maybe with vomiting)
  • Easily satiated
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools or watery stools containing undigested food
  • Shortness of breath
  • Pain in the epigastrium with cold sensations relieved by warmth
  • Intolerance of Cold
  • Cold limbs
  • Feeling chilled
  • Lethargy
  • Fatigue
  • Mental fatigue
  • Depression
  • Low spirits
  • Maybe scanty urine with edema
  • Maybe clear, watery vaginal discharge
  • T: Pale maybe swollen
  • C: White or Thin and white or White and greasy
  • P: Deep, thready and forceless or Deep and weak or Thready and weak
Treatment Principle
  • Strengthen the Spleen
  • Warm Yang
  • Warm the Center
  • Dispel Cold
Herb Formulas
Points
Clinical Manifestations
  • Epigastric focal distention
  • Fullness and tightness with very slight or no pain
  • Dry heaves
  • Vomiting
  • Borborygmus
  • Diarrhea
  • Anorexia
  • Stomach pain
  • Abdominal pain
  • Subcardiac distention
  • Heartburn
  • Resistance below the Heart
  • Soft epigastrium
  • Nausea
  • Ascites
  • Gurgling sounds
  • T: Normal or with a red tip
  • C: Thin, yellow and greasy
  • P: Wiry and rapid or Wiry, tight and rapid
Treatment Principle
  • Harmonize the Stomach
  • Descend Rebellious Qi
  • Disperse clumping
  • Eliminate focal distention due to Cold and Heat factors
Herb Formulas
Points
Clinical Manifestations
  • Chronic, relentless dysenteric diarrhea which is thin, watery and mucoid
  • Diarrhea may contain pus and Blood
  • Diarrhea is worse with exposure to Cold and cold foods
  • Body cold
  • Limbs icy
  • Complexion white and shiny or sallow
  • Aversion to Cold
  • Watery cough
  • Dizziness
  • Anorexia
  • Fatigue
  • Listlessness
  • Depression
  • Exhaustion
  • Low back, knees and abdomen feel cold and painful
  • Mild, persistent abdominal pain worse with Cold and better with warmth and pressure
  • Lower abdomen feels cold and painful
  • Mild tenesmus or
  • A dragging sensation in the lower abdomen which is relieved by the diarrhea
  • Loose stools containing undigested food
  • “Cock-crow” diarrhea (occurs at about 5 am)
  • Edema of face and limbs
  • Heaviness and aching of the limbs and head
  • Palpitations
  • Dysuria
  • Scanty urination
  • Severe:
    Abdominal ascites
    Incontinence of stools
    Rectal prolapse
  • T: Pale, moist and swollen
  • C: Thin and white or White and greasy
  • P: Deep, thready, weak and maybe slow
Treatment Principle
  • Warm and Reinforce the Spleen and Kidneys
  • Promote urination
Herb Formulas
Points
Clinical Manifestations
  • Diarrhea with undigested food
  • Aversion to Cold or
  • Daybreak (Cock Crow) diarrhea
  • Cold and stiff extremities
  • Back pain
  • Reduced appetite
  • Fullness in the epigastrium and abdomen (likes pressure)
  • Lack of thirst
  • Vomiting
  • Loose stools
  • Trismus
  • T: Pale, may be moist
  • C: White
  • P:Deep, slow and weak
Treatment Principle
  • Warm and Tonify the Spleen, Stomach and Kidneys
  • Dispel Cold
  • Replenish Yang
Herb Formulas
Points
Clinical Manifestations
  • General signs and symptoms:
    Epigastrium cold with pain
    No thirst
  • Mild cases:
    Constant pain
  • Severe cases:
    Sudden bouts of sharp pain
    Pain is aggravated by Cold and pressure and relieved by warmth and hot drinks
    Cold hands and feet
  • Cold Penetrates the Stomach and Intestines:
    Pain is sudden and sharp
    Pain is relieved by warmth
    Nausea
    Diarrhea
    Loose stools
    T: Pink
    C: White
    P: Deep and tight or Wiry or Tight and slow
  • Retention of Fluid in the Stomach due to Cold:
    Pain is dull
    Pain is relieved by warmth
    Succussion sound in the epigastrium on palpation
    Vomiting of clear, watery fluid
    Hypersalivation
    T: Pink
    C: White and sticky
    P: Thready or Thready and slow
  • Stomach Deficiency with Stagnation of Cold:
    Pain is dull
    Pain is relieved by warmth and pressure
    Vomiting clear, watery fluid
    T: Pale
    C: Thin and white
    P: Deep and slow or Deep and thready
  • If accompanied by Wind-Cold Damp:
    Fever and chills
    Myalgia
    Headache
    P: Floating and tight
Treatment Principle
  • Warm the Stomach
  • Warm Cold
  • Stop pain
Herb Formulas
Points
Clinical Manifestations
  • Chronic epigastric discomfort
  • A sensation of blockage and distention in the epigastrium
  • Anorexia
  • Nausea
  • Vomiting or
  • Dry retching
  • Borborygmus
  • Diarrhea
  • T: Normal
  • C: Thin, yellow and greasy
  • P: Soft and/or rapid
Treatment Principle
  • Harmonize the Stomach
  • Regulate Qi
  • Descend Qi
Herb Formulas
Points
Clinical Manifestations
  • Abdominal pain, especially in stressful situations
  • Lower abdominal pain
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • A sense of fullness in the chest and hypochondrium
  • Tendency to sigh
  • Melancholy
  • Depression
  • Anorexia
  • Irritability
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • Irregular bowel movements
  • Maybe diarrhea alternating with constipation
  • T: Pink
  • C: Thin and white
  • P: Wiry
Treatment Principle
  • Soothe Liver
  • Clear Stagnation
  • Stop abdominal pain
Herb Formulas
  • Chai Hu Shu Gan Tang
  • Chai Hu Shu Gan Tang + Liu Mo Tang
  • With chronic sluggish stools or constipation: Liu Mo Tang
  • With Food Stagnation and sluggish bowels: Mu Xiang Shun Qi Wan
  • Chinese Patent medicines:
    Shu Gan Wan
    Chai Hu Shu Gan Wan
    With significant heartburn: + Wei Te Ling
    With sluggish or incomplete bowel movements: Mu Xiang Shun Qi Wan
    With constipation: Chen Xiang Hua Qi Wan
    With Spleen Deficiency and dampness: Xiao Yao Wan
    With stagnant Heat: Jia Wei Xiao Yao Wan
Points
Clinical Manifestations
  • Abdominal and epigastric distention, fullness, discomfort and pain worse with stress or emotional upset
  • Hypochondriac discomfort, ache or tightness, generally worse on the right side
  • Gas
  • Belching
  • Frequent sighing
  • Borborygmus
  • Anorexia
  • Indigestion
  • Acid reflux
  • Heartburn
  • Painful diarrhea worse with stress or emotional upset
  • Alternating constipation and diarrhea
  • Distention and pain in the chest, sides or flanks
  • Suffocating sensation in the chest
  • Melancholy
  • Depression
  • Irritability
  • Moodiness
  • Fatigue
  • Lack of strength
  • Cold hands and feet
  • Orthostatic hypotension
  • Easy bruising
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • T: Pink or Pale, dark and maybe swollen
  • C: White and greasy or Thin and white
  • P: Slippery and wiry or Thready and wiry or Wiry
Treatment Principle
  • Soothe the Liver
  • Regulate Qi
  • Strengthen the Spleen
  • Tonify Qi
  • Disperse accumulation
  • Ease distention
Herb Formulas
Points
Clinical Manifestations
  • Spasmodic epigastric pain, distention, fullness and discomfort (worse when emotionally upset)
  • Belching with acid regurgitation
  • fullness and tightness in the chest
  • Frequent sighing
  • Flatulence
  • Nausea
  • Vomiting
  • Variable appetite
  • Bloating
  • Acid reflux
  • Heartburn
  • Tension headache
  • Dizziness
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Moodiness
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Irregular menstruation
  • Premenstrual syndrome
  • Breast distention and pain before and during menses
  • Dysmenorrhea
  • Poor circulation
  • Cold fingers and toes
  • Alternating constipation and diarrhea
  • With Heat:
    Burning epigastric pain
    Indeterminate, gnawing hunger
    Severe heartburn
    Severe restlessness and irritability
    A quick temper
    A bitter taste in the mouth
    Thirst
    Constipation
    Concentrated urine
  • T: Pink or Dark
    With Heat: Red or Red edges
  • C: Thin and white
    With Heat: Yellow and dry
  • P: Wiry
    With Heat: Wiry and rapid
Treatment Principle
  • Soothe the Liver
  • Harmonize the Stomach
  • Clear Heat
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
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • 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
  • P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle
  • Spread Qi
  • Resolve Phlegm
Herb Formulas
Points
Clinical Manifestations
  • Swelling and pain in scrotum as if testicles were being pulled downward or
  • Swollen or distended testicles or
  • Contractions and cold sensations of scrotum which are alleviated by warmth
  • Pain, distention, fullness and cold sensation in lower abdomen
  • Cold limbs
  • Dislike of cold and preference for warmth
  • Lower abdominal pain radiating to the testicles
  • May be localized sensation of Cold
  • Menstrual pain and hardness
  • Hypochondriac pain
  • Abdominal pain
  • Mobile abdominal masses
  • Flank pain
  • Leukorrhea
  • T: Pale
  • C: White or White no greasy
  • P: Deep and slow or Wiry and tight or Deep and wiry or Slow or Deep and Excess
Treatment Principle
  • Warm the Liver
  • Dispel Cold.
Herb Formulas
Points
Clinical Manifestations
  • Facial complexion pale and sallow
  • Both cheeks slightly red
  • Dizziness
  • Dry eyes
  • Blurred vision
  • Spots before the eyes
  • Numbness of limbs
  • Flaccid paralysis (Wei syndrome), weakness
  • Tinnitus, deafness
  • Forgetfulness
  • Low back and knees sore and painful
  • Throat dry and painful
  • Five sole Heat
  • Low-grade fever
  • Night sweats
  • Irritability
  • Insomnia
  • Stools difficult to pass
  • Constipation
  • Men:
    Spermatorrhea
  • Women:
    Irregular menses or
    Scanty menses or
    Amenorrhea
    Vaginal discharge
  • T: Red
  • C: None
  • P: Thready and rapid
Treatment Principle
  • Nourish and Reinforce the Liver and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Constipation
  • Dry throat
  • Thirst
  • Tuberculosis of the Colon
  • Hemorrhoids
  • Chronic pancreatitis
  • Erysipelas
  • T: Dark red
  • C: Dry and yellow
  • P: Sinking and weak
Treatment Principle
  • Nourish Yin
  • Clear Heat
Herb Formulas
Points
Clinical Manifestations
  • Chronic intermittent diarrhea with variable mixtures of pus and Blood
  • Triggered or aggravated by overexertion, colds fatigue and stress or
  • May be no obvious trigger
  • Active phase: Diarrhea may occur many times daily
  • Fatigue
  • Tiredness
  • Tenesmus
  • Abdominal distention
  • Mild abdominal pain which is better with warmth and maybe pressure
  • Anorexia
  • Loss of sense of taste
  • Long-standing cases:
    Emaciation
    Sallow or pale complexion
    Listlessness
    Lethargy
    Increased desire to sleep
    Intolerance of Cold
    Cold extremities
  • T: Normal or Pale or Red
  • C: Greasy
  • P: Thready and choppy or Soft and weak
Treatment Principle
  • Strengthen the Spleen
  • Tonify Qi
  • Regulate Qi
  • Clear Damp-Heat or
  • Clear Cold-Damp or
  • Clear Toxic Heat
Herb Formulas
Points