Irritable Bowel Syndrome - Spleen-Stomach Deficiency Pattern

Dr. Li Wei, DACM

Irritable Bowel Syndrome · Spleen-Stomach Deficiency Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Abdomen

Pattern Overview

Spleen-Stomach Deficiency is a common pattern in IBS, characterized by digestive enzyme insufficiency, abdominal pain, diarrhea, poor appetite, and fatigue. The core pathogenesis is Spleen Qi deficiency failing to transform and transport food, leading to incomplete digestion, loose stools, and abdominal discomfort.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Abdominal pain, diarrhea, poor appetite, fatigue |

| Associated Symptoms | Bloating, loose stools, pale complexion, cold limbs |

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

| Pathogenesis | Spleen Qi deficiency failing to transform and transport |

| Etiology | Irregular eating habits, overwork, chronic illness, poor nutrition |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

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

| Pishu (BL20) | Lower back, 1.5 cun lateral to T11 | Back-Shu point of Spleen meridian; strengthens Spleen Qi |

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

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

| Taibai (SP3) | Medial foot, behind the base of the 1st metatarsal | Source point of Spleen meridian; strengthens Spleen Qi |

Clinical Recommendation: Filiform needle, reinforcing method; moxibustion may be applied to Pishu and Zusanli to warm and tonify Spleen Qi.

Herbal Formula

Base Formula: Shen Ling Bai Zhu San (参苓白术散)

Composition:

Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Dioscorea (Shan Yao), Hyacinth Bean (Bian Dou), Coix Seed (Yi Yi Ren), Amomum (Sha Ren), Licorice (Gan Cao)

Action: Strengthens Spleen, supplements Qi, and stops diarrhea.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe diarrhea | Add Shan Yao, Yi Yi Ren to strengthen Spleen and stop diarrhea |

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

| Poor appetite | Add Mai Ya, Gu Ya to strengthen the Stomach and promote digestion |

| Cold limbs | Add Gui Zhi, Sheng Jiang to warm the meridians |

Western Mechanism Reference

Digestive enzyme insufficiency causing incomplete food digestion, altered intestinal osmotic pressure, diarrhea, and reduced intestinal barrier function. Spleen-Stomach Deficiency corresponds to IBS with malabsorption and impaired intestinal barrier function, where reduced digestive capacity and increased intestinal permeability contribute to symptoms.

References

  1. Internal Medicine of TCM - Diarrhea with Spleen-Stomach Deficiency.

  2. DB-XJB: Shen Ling Bai Zhu San.

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

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