Chronic Abdominal Pain - Liver-Qi Stagnation Pattern

Dr. Li Wei, DACM

Chronic Abdominal Pain · Liver-Qi Stagnation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Abdomen

Pattern Overview

Liver-Qi Stagnation is a common pattern in chronic abdominal pain, characterized by stress-related visceral hypersensitivity, abdominal pain, distension, frequent sighing, and aggravation with stress. The core pathogenesis is emotional stress causing Liver-Qi stagnation, leading to autonomic dysfunction, altered gut motility, and visceral hypersensitivity.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Abdominal pain, distension, sighing, worse with stress |

| Associated Symptoms | Chest tightness, irritability, depression, premenstrual tension |

| Tongue and Pulse | Pale red tongue with thin white coating, wiry pulse |

| Pathogenesis | Liver-Qi stagnation causing autonomic dysfunction and visceral hypersensitivity |

| Etiology | Chronic stress, emotional distress, anxiety, depression |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Qimen (LR14) | On the chest, 4 cun lateral to the midline, below the nipple | Front-Mu point of Liver meridian; regulates Liver-Qi |

| Taichong (LR3) | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; soothes Liver-Qi |

| Neiguan (PC6) | 2 cun above the wrist crease, between the tendons | Relieves chest tightness and calms the spirit |

| Zusanli (ST36) | 3 cun below the patella, 1 finger-width lateral to the tibial crest | Strengthens Spleen and Stomach; regulates Qi |

Clinical Recommendation: Filament needle, reducing method; combine with stress reduction techniques and counseling.

Herbal Formula

Base Formula: Chai Hu Shu Gan San (柴胡疏肝散)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Immature Bitter Orange (Zhi Ke), Cyperus (Xiang Fu), Chuanxiong (Chuan Xiong), Tangerine Peel (Chen Pi), Licorice (Gan Cao)

Action: Soothes Liver-Qi, regulates Qi flow, and relieves abdominal pain.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe pain | Add Yan Hu Suo, Chuan Lian Zi to regulate Qi and stop pain |

| Distension | Add Mu Xiang, Sha Ren to regulate Qi and relieve distension |

| Irritability | Add Zhi Zi, Dan Pi to clear Liver Heat |

| Insomnia | Add Suan Zao Ren, Yuan Zhi to calm the spirit |

Western Mechanism Reference

Stress-related visceral hypersensitivity with autonomic dysfunction, altered gut motility, and pain sensitization. Liver-Qi Stagnation corresponds to chronic abdominal pain with stress-related exacerbation, where autonomic dysfunction and visceral hypersensitivity contribute to pain and distension.

References

  1. Internal Medicine of TCM - Abdominal Pain with Liver-Qi Stagnation.

  2. Zang-Fu Pattern Differentiation: Liver-Qi Stagnation → Pivot Layer.

  3. WHO. (2023). Digestive health. World Health Organization.

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