GERD/Acid Reflux - Liver-Stomach Disharmony Pattern

Dr. Li Wei, DACM

GERD/Acid Reflux · Liver-Stomach Disharmony Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Chest/Abdomen

Pattern Overview

Liver-Stomach Disharmony is the most common pattern in GERD/acid reflux, characterized by stress-induced LES dysfunction, heartburn, acid reflux, chest tightness, and epigastric pain. The core pathogenesis is emotional stress causing Liver Qi stagnation, which overacts on the Stomach, leading to rebellious Stomach Qi and acid reflux.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Heartburn, acid reflux, chest tightness, epigastric pain |

| Associated Symptoms | Irritability, belching, bitter taste, nausea, worse with stress |

| Tongue and Pulse | Red tongue with thin yellow coating, wiry and rapid pulse |

| Pathogenesis | Liver Qi stagnation overacting on the Stomach, causing rebellious Stomach Qi |

| Etiology | Chronic stress, emotional distress, irregular eating habits |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| 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 harmonizes the Stomach |

| Zhongwan (RN12) | 4 cun above the umbilicus | Front-Mu point of Stomach; harmonizes the Stomach |

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

| Yanglingquan (GB34) | Depression below the head of the fibula | Regulates Qi and relieves pain |

Clinical Recommendation: Filiform needle, reducing method; combine with stress reduction techniques and lifestyle modifications.

Herbal Formula

Base Formula: Chai Hu Shu Gan San (柴胡疏肝散) + Zuo Jin Wan (左金丸)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Immature Bitter Orange (Zhi Ke), Cyperus (Xiang Fu), Coptis (Huang Lian), Evodia (Wu Zhu Yu), Licorice (Gan Cao)

Action: Soothes Liver Qi, harmonizes the Stomach, and stops acid reflux.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe heartburn | Increase Huang Lian dosage to clear Heat |

| Nausea | Add Ban Xia, Sheng Jiang to descend rebellious Qi |

| Belching | Add Chen Pi, Hou Po to regulate Qi |

| Constipation | Add Da Huang to drain heat and relieve constipation |

Western Mechanism Reference

Stress-induced vagal dysfunction causing decreased LES pressure, delayed gastric emptying, and increased reflux. Liver-Stomach Disharmony corresponds to GERD associated with stress and emotional factors, where autonomic dysfunction and decreased LES pressure contribute to acid reflux.

References

  1. Internal Medicine of TCM - Acid Reflux with Liver-Stomach Heat.

  2. DB-XJB: Chai Hu Shu Gan San, Zuo Jin Wan.

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

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