Chronic Constipation - Cold Constipation Pattern

TCM differentiation and treatment for chronic constipation

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

intolerance |

Associated Symptoms

extremities, pale complexion |

Tongue and Pulse

coating, deep and weak pulse |

Pathogenesis

intestines |

Etiology

intake |


Acupuncture Point Prescription

Point Location Function
Guanyuan (RN4) 3 cun below the umbilicus

supplements Qi |

Shenque (RN8) Center of the umbilicus

supplements Yang |

Tianshu (ST25) 2 cun lateral to the umbilicus

of Large Intestine; regulates bowel function |

Zhigou (TE6)
Treats constipation and regulates the Triple Energizer
Shenshu (BL23) Lower back, 1.5 cun lateral to L2

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

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.


Explore More

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health.

research papers and clinical case studies on TCM digestive health.


Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.