Rib Pain - Liver-Gallbladder Damp-Heat Pattern

Dr. Li Wei, DACM

Rib Pain · Liver-Gallbladder Damp-Heat Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 6 min

Body Area: Chest

Pattern Overview

Liver-Gallbladder Damp-Heat is a pattern in rib pain, characterized by cholecystitis-related pain, burning pain, bitter taste, and irritability. The core pathogenesis is accumulation of Damp-Heat in the Liver and Gallbladder meridians, causing biliary inflammation, increased pressure, and referred pain to the right rib area.

Key Symptoms and Differentiation Points

| Differentiation Dimension | Manifestations |

| :— | :— |

| Primary Symptoms | Burning pain in the right rib area, bitter taste, irritability |

| Associated Symptoms | Nausea, vomiting, yellow urine, constipation, fever |

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

| Pathogenesis | Liver-Gallbladder Damp-Heat causing biliary inflammation and rib pain |

| Etiology | Poor diet, alcohol consumption, gallstones, cholecystitis |

Acupuncture Point Prescription

| Point | Location | Function |

| :— | :— | :— |

| LR3 Taichong | Dorsum of the foot, between the 1st and 2nd metatarsals | Source point of Liver meridian; clears Liver Heat |

| GB34 Yanglingquan | Depression below the head of the fibula | He-Sea point of Gallbladder meridian; clears Gallbladder Heat |

| LR14 Qimen | On the chest, 4 cun lateral to the midline, below the nipple | Front-Mu point of Liver meridian; treats rib and chest pain |

| SP9 Yinlingquan | Below the medial condyle of the tibia | Transforms Dampness and drains Heat |

Clinical Recommendation: Filiform needle, reducing method; may combine with pricking at LR14 to drain Damp-Heat.

Herbal Formula

Base Formula: Long Dan Xie Gan Tang (龙胆泻肝汤)

Composition:

Gentian Root (Long Dan Cao), Scutellaria (Huang Qin), Gardenia (Zhi Zi), Bupleurum (Chai Hu), Alisma (Ze Xie), Akebia (Mu Tong), Angelica (Dang Gui), Rehmannia (Sheng Di), Plantago (Che Qian Zi), Licorice (Gan Cao)

Action: Clears Liver-Gallbladder Damp-Heat, drains Fire, and detoxifies.

Modifications

| Associated Symptoms | Additions/Subtractions |

| :— | :— |

| Severe burning pain | Add Jin Yin Hua, Lian Qiao to clear Heat and detoxify |

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

| Constipation | Add Da Huang to drain and purge heat |

Western Mechanism Reference

Cholecystitis-related pain with biliary inflammation, increased pressure, and referred pain to the right rib area. Liver-Gallbladder Damp-Heat corresponds to biliary pain, often seen in cholecystitis or cholangitis, where biliary inflammation and increased pressure cause referred pain to the right hypochondrium.

References

  1. Textbook Standard.

  2. WHO. (2023). Musculoskeletal pain. World Health Organization.

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