TCM & Irritable Bowl Syndrome

In Traditional Chinese Medicine (TCM), irritable bowel syndrome is considered to be primarily a disorder of the Qi pertaining to the Liver and Spleen Zang Organs.

During periods of emotional turmoil or disharmony, the Liver Zang's Qi, which is responsible for the free flow of Qi in the body, may become stagnant. This stagnation may cause constipation, abdominal pain, and cramping, which is considered to be an intestinal Wind. Factors such as overwork, poor diet, insufficient rest, or excessive worry may cause the Spleen Qi to become weakened, which can lead to diarrhea, abdominal pain, and distention.

Either of these factors can contribute to the symptoms of irritable bowel syndrome. When the Liver Zang's Qi is stagnant or the Spleen Zang is weak, it is commonly said that the Liver Qi will invade and overwhelm the Spleen Qi, leading to a combination of alternating diarrhea and constipation, accompanied by the other symptoms that characterize irritable bowel syndrome.

Likewise, the Qi Stasis and Qi Deficiency that underlie these symptoms can generate Dampness or Damp-Heat, which can cause mucus in the stools.

Traditional Chinese Medicine Categories of Irritable Bowel Syndrome

As the primary factors involved in irritable bowel syndrome are related to the Qi of the Liver and Spleen, TCM diagnostic categories focus on these two Zang Organs and the relationship between them:

  • Liver Qi Stasis: Symptoms include abdominal pain and distention, constipation (frequently with small stools), frustration, a high stress level, and irascibility. There also may be hypochondriacal discomfort. The tongue usually is normal to dusky in color with distended sublingual veins and the pulse is wiry.
  • Spleen Qi Deficiency: Symptoms include abdominal distention and discomfort, diarrhea or loose stools, tendency to worry, fatigue, and poor appetite. The tongue usually is pale and may have teeth marks on the side. The pulse usually is weak.
  • Liver Invading the Spleen: Symptoms for this presentation include all those listed under Liver Qi Stasis and Spleen Qi Deficiency, with alternating diarrhea and constipation. The tongue usually is pale and dusky with a thin white coat. The pulse is wiry and weak, sometimes wiry on one side and weak on the other.

If there is mucus in the stool in any of these Patterns of Disharmony, Dampness or Damp-Heat has been generated from Qi Stasis and/or Qi Deficiency. In the case of Dampness, the tongue has a greasy white coating and the pulse has a slippery quality. In the case of Damp-Heat, the greasy coating is yellow and the pulse has a slippery-rapid quality.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 01 Jan 2001

Last Modified: 22 Sep 2015