Understanding Constipation in Traditional Chinese Medicine

Understanding Constipation in Traditional Chinese Medicine

A Differential Diagnosis Approach

Constipation, a common digestive issue, is viewed in Traditional Chinese Medicine (TCM) as a symptom of an imbalance in one or more organ systems. These imbalances involve excesses, deficiencies, or stagnations of Qi, Blood, or Yin. 

Understanding the Role of Organs in Constipation (TCM Perspective)

  • Stomach: Aids in descending Qi and fluid production, both essential for bowel movements.
  • Large Intestine: Receives fluids, reabsorbs some, and excretes stools.
  • Spleen: Though Spleen-Qi ascends, it also governs transformation and transportation. A deficient Spleen may fail to move stools.
  • Liver: Governs Qi movement, which influences bowel movement.
  • Kidneys: Affects constipation in two ways: deficient Kidney-Yang fails to move stools, while deficient Kidney-Yin causes dryness.
  • Lungs: Controls Qi, which relates to the Large Intestine. Deficient Lung Qi fails to descend to the intestines, often causing constipation in the elderly.

General Acupuncture Points for Constipation Treatment

  • Common Points: ST25, SP15, UB25, ST37, REN10, ST27, REN6.
  • For Kidney-Yang Deficiency: BL23, REN4, UB25.
  • For Liver Qi Stagnation: LV3, REN6, SP15, UB18.
  • For Blood Deficiency: REN4, ST36, SP6, LV8.
  • For Yin Deficiency: REN4, KI3, SP6.

Let's explore the key TCM patterns of constipation, highlighting their key differentiations and corresponding treatments!

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1. Constipation Due to Stomach and Large Intestine Heat

Key Differentiation: Constipation, dry stools, abdominal pain, feeling of heat.

  • Other Symptoms: Thirst, scanty urination, red complexion, dry mouth.
  • Tongue/Pulse: Red tongue with yellow coating, rapid and slippery pulse.
  • Treatment Points: LI 4, LI 11, SJ 6, SP 14, SP 15, ST 44, ST 28, ST 29.
  • Formula: Ma Zi Ren Wan.

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2. Constipation Due to Heat in Liver

Key Differentiation: Constipation, dry stools, irritability, red eyes.

  • Other Symptoms: Thirst, dark urination, headache, red complexion.
  • Tongue/Pulse: Red tongue with yellow dry coating, wiry and rapid pulse.
  • Treatment Points: LI 4, LI 11, SJ 6, LV 2, SP 6, SP 14, SP 15, ST 44, ST 28, ST 29.
  • Formula: Dang Gui Long Hui Wan.

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3. Constipation Due to Stomach and Large Intestine Fire

Key Differentiation: Constipation, dry stools, abdominal pain, profuse sweating, feeling of heat, fever.

  • Other Symptoms: Thirst, scanty urination, red complexion, dry mouth.
  • Tongue/Pulse: Red tongue with yellow dry coating, deep, full, rapid pulse.
  • Treatment Points: SJ 6, SP 15, LI 11, ST 44, LI 4, ST 28, ST 29.
  • Formula: Da Cheng Qi Tang.

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4. Constipation Due to Liver Qi Depressed Knot

Key Differentiation: Constipation, stool shaped like pebbles.

  • Other Symptoms: Abdominal distention, irritability.
  • Tongue/Pulse: Wiry pulse.
  • Treatment Points: REN 10, GB 34, REN 6, LV 3, SJ 6, SP 15.
  • Formula: Liu Mo Tang.

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5. Constipation Due to Qi Deficiency

Key Differentiation: Constipation, feeling exhausted after bowel movement, thin and long stools.

  • Other Symptoms: Pale complexion, fatigue.
  • Tongue/Pulse: Pale tongue, deficient pulse.
  • Treatment Points: UB 21, UB 25, SP 15, ST 36, REN 6, SP 6, LU 7, UB 13.
  • Formula: Huang Qi Tang.

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6. Constipation Due to Yang Deficiency

Key Differentiation: Constipation, sweating and feeling exhausted after bowel movement.

  • Other Symptoms: Sore back and knees, chills, frequent urination.
  • Tongue/Pulse: Pale, moist tongue, deep, weak pulse.
  • Treatment Points: ST 36, SP 6, UB 23, UB 25, REN 4, KD 7 (moxibustion may be used).
  • Formula: Ji Chuan Jian.

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7. Constipation Due to Blood Deficiency

Key Differentiation: Constipation, dry stools, numbness of limbs.

  • Other Symptoms: Dull complexion, dizziness, blurry vision.
  • Tongue/Pulse: Pale tongue, choppy pulse.
  • Treatment Points: ST 36, SP 6, REN 4, SP 15, UB 23, UB 20, UB 25.
  • Formula: Run Chang Wan.

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8. Constipation Due to Yin Deficiency

Key Differentiation: Constipation, dry stools, night sweating.

  • Other Symptoms: Thirst, dry mouth, dry throat, sore back and knees, dizziness, tinnitus.
  • Tongue/Pulse: Sparse cracks on the tongue, superficial deficient pulse.
  • Treatment Points: ST 36, SP 6, REN 4, KD 3, KD 6, UB 23, UB 25, SP 15 (No moxibustion).
  • Formula: Zeng Ye Tang.

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9. Constipation Due to Spleen and Kidney Yang Deficiency with Cold

Key Differentiation: Constipation, abdominal cramps, cold limbs.

  • Other Symptoms: Pale urination, pale complexion, chills.
  • Tongue/Pulse: Pale tongue with thick white moist coating, deep, slow, full, tight pulse.
  • Treatment Points: REN 6, REN 8, KD 18, UB 23, UB 25, UB 26.
  • Formula: Da Huang Fu Zi Tang.


Learning TCM differential diagnosis is simple, fun, and easy!

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