GERD/Acid Reflux - Liver-Stomach Disharmony Pattern

TCM differentiation and treatment for GERD/acid reflux

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

epigastric pain |

Associated Symptoms

nausea, worse with stress |

Tongue and Pulse

rapid pulse |

Pathogenesis

causing rebellious Stomach Qi |

Etiology

habits |


Acupuncture Point Prescription

Point Location Function
Taichong (LR3)

metatarsals | Source point of Liver meridian; soothes Liver Qi |

Neiguan (PC6)
Relieves chest tightness and harmonizes the Stomach
Zhongwan (RN12) 4 cun above the umbilicus

Stomach; harmonizes the Stomach |

Zusanli (ST36)

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.


Explore More

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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.