Chronic Constipation - Heat Constipation Pattern

Dr. Li Wei, DACM

Chronic Constipation · Heat Constipation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Abdomen

Pattern Overview

Heat Constipation is a common pattern in chronic constipation, characterized by excessive colon water absorption, dry hard stools, abdominal distension, red face, and thirst. The core pathogenesis is accumulation of Heat in the Yangming channel, causing excessive fluid absorption in the colon, dry stools, and difficulty in defecation.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Dry hard stools, difficult defecation, abdominal distension |

| Associated Symptoms | Red face, thirst, foul breath, yellow urine, irritability |

| Tongue and Pulse | Red tongue with yellow dry coating, slippery and rapid pulse |

| Pathogenesis | Heat accumulation in the Yangming channel causing fluid depletion |

| Etiology | Excessive spicy and rich food intake, alcohol consumption, external heat invasion |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

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

| Shangjuxu (ST37) | 6 cun below the patella, 1 finger-width lateral to the tibial crest | Lower He-Sea point of Large Intestine; treats intestinal disorders |

| Quchi (LI11) | Lateral end of the elbow crease | He-Sea point of Large Intestine; clears Heat |

| Hegu (LI4) | Dorsum of the hand, between the 1st and 2nd metacarpals | Source point of Large Intestine; regulates Qi and relieves pain |

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

Clinical Recommendation: Filiform needle, reducing method; Quchi may be pricked to bleed to enhance Heat clearing.

Herbal Formula

Base Formula: Ma Zi Ren Wan (麻子仁丸)

Composition:

Rhubarb (Da Huang), Immature Bitter Orange (Zhi Shi), Magnolia (Hou Po), Hemp Seed (Ma Zi Ren), Apricot Kernel (Xing Ren), White Peony (Bai Shao)

Action: Clears Heat, moistens the intestines, and promotes bowel movement.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe dry stools | Increase Ma Zi Ren dosage to moisten the intestines |

| Abdominal distension | Add Hou Po, Zhi Shi to regulate Qi and relieve distension |

| Thirst | Add Tian Hua Fen, Zhi Mu to clear Heat and generate fluids |

| Foul breath | Add Huang Lian, Huang Qin to clear Heat |

Western Mechanism Reference

Excessive colonic water absorption leading to dry hard stools, and decreased intestinal motility. Heat Constipation corresponds to constipation with increased colonic water absorption and reduced motility, often seen in febrile illnesses or dehydration.

References

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

  2. DB-XJB: Ma Zi Ren Wan.

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

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