Chronic Constipation - Heat Constipation Pattern

TCM differentiation and treatment for chronic constipation

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

abdominal distension |

Associated Symptoms

irritability |

Tongue and Pulse

and rapid pulse |

Pathogenesis

fluid depletion |

Etiology

consumption, external heat invasion |


Acupuncture Point Prescription

Point Location Function
Tianshu (ST25) 2 cun lateral to the umbilicus

of Large Intestine; regulates bowel function |

Shangjuxu (ST37)

to the tibial crest | Lower He-Sea point of Large Intestine; treats

intestinal disorders |

Quchi (LI11) Lateral end of the elbow crease

Large Intestine; clears Heat |

Hegu (LI4)

metacarpals | Source point of Large Intestine; regulates Qi and relieves

pain |

Zhigou (TE6)
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

intestines |

Abdominal distension

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.


Explore More

Personalized herbal protocols and acupressure tools for digestive

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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.