Chronic Constipation - Cold Constipation Pattern

Dr. Li Wei, DACM

Chronic Constipation · Cold Constipation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Abdomen

Pattern Overview

Cold Constipation is a severe deficiency pattern in chronic constipation, characterized by hypothyroidism-related constipation, cold pain, cold intolerance, and slow intestinal transit. The core pathogenesis is Kidney Yang deficiency failing to warm the intestines, leading to decreased intestinal motility and prolonged colonic transit.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Constipation, cold pain in the abdomen, cold intolerance |

| Associated Symptoms | Frequent urination, fatigue, cold extremities, pale complexion |

| Tongue and Pulse | Pale and swollen tongue with thin white coating, deep and weak pulse |

| Pathogenesis | Kidney Yang deficiency failing to warm the intestines |

| Etiology | Aging, hypothyroidism, chronic illness, cold food intake |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| Guanyuan (RN4) | 3 cun below the umbilicus | Warms Yang and supplements Qi |

| Shenque (RN8) | Center of the umbilicus | Warms the interior and supplements Yang |

| Tianshu (ST25) | 2 cun lateral to the umbilicus | Front-Mu point of Large Intestine; regulates bowel function |

| Zhigou (TE6) | 3 cun above the wrist crease, on the dorsal forearm | Treats constipation and regulates the Triple Energizer |

| Shenshu (BL23) | Lower back, 1.5 cun lateral to L2 | Back-Shu point of Kidney meridian; warms Kidney Yang |

Clinical Recommendation: Filament needle, reinforcing method; heavy moxibustion is strongly recommended at Guanyuan and Shenque to warm Yang.

Herbal Formula

Base Formula: Da Huang Fu Zi Tang (大黄附子汤)

Composition:

Rhubarb (Da Huang), Aconite (Fu Zi), Asarum (Xi Xin), Cistanche (Rou Cong Rong)

Action: Warms Yang, disperses Cold, and promotes bowel movement.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe cold intolerance | Add Rou Gui, Gan Jiang to warm Yang |

| Fatigue | Add Huang Qi, Dang Shen to supplement Qi |

| Frequent urination | Add Yi Zhi Ren, Sang Piao Xiao to astringe the Kidneys |

| Dry stools | Add Huo Ma Ren, Yu Li Ren to moisten the intestines |

Western Mechanism Reference

Hypothyroidism-related constipation with decreased intestinal motility and prolonged colonic transit time. Cold Constipation corresponds to constipation associated with hypothyroidism, where reduced metabolic rate and decreased intestinal motility contribute to slow colonic transit.

References

  1. Internal Medicine of TCM - Constipation with Cold Constipation.

  2. DB-TCMJB: Kidney Yang Deficiency.

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

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