Abdominal Distension San Francisco CA

Abdominal distension refers to the sensation of fullness in the abdomen. Usually there is distention and swelling in the abdomen. The main cause lies in conditions that lead to accumulation of gas in the gastrointestinal tract such as dyspepsia, intestinal infection, severe constipation, peritonitis, enteroparalysis, intestinal obstruction, and severe deficiency in potassium. Others conditions result in ascites, swollen masses in the liver, hepatomegaly, and ovarian cysts, etc. In traditional Chinese medicine, this disease belongs to the category of epigastralgia, which is pain in the mass at the right hypogastrium.

Symptoms of abdominal distension and epigastralgia may occur in all conditions leading to disturbances in ascending and descending functions of the stomach and spleen. Such disturbances include the entering of exogenous pathogens into the spleen and stomach; stasis and retention of liver qi invading transversely to the spleen and stomach; lack of control in the diet, damaging and exhausting Middle-Jiao; or weakness of the spleen and stomach in bodily constitution resulting in less capability in transportation and transformation.

52 cases of functional dyspepsia were treated with Chai Hu Shu Gan Yin. This formula consisted of Chai Hu (Bupleurum), Chuan Xiong (Cnidium), Ru Xiang (Mastic), Zhi Qiao (Aurantium Fruit), Hou Pu (Magnolia Bark), Bai Shao (White Peony Root), and Gan Cao (Licorice). The formula was modified according to symptoms of the individual patient. After boiling the herbs in water, one dose per day was administered. During the period of treatment, patients were asked to maintain a positive mood, a diet devoid of heavy grease, strong flavor, and pungent, raw, cold, and indigestible foods. One month comprised one course of treatment. The results showed that 29 cases had marked improvement, 19 cases showed some effectiveness, and 4 cases had no improvement.(1)

32 cases of abdominal distension induced by functional dyspepsia were treated with He Wei Tong Qi Tang (decoction for regulating stomach and dispersing qi). This formula used the following single herbs: Su Geng (Perilla Stalk), Fu Pi (Betelnutpalm Pericarp), Shen Qu (Leaven), Shan Zha (Crataegus), Xiang Fu Zi (Cyperus Seed), Yu Jin (Curcuma Root), Mu Xiang (Saussurea), Dang Gui (Chinese Angelica Root), Chuan Xiong (Cnidium), Sha Ren (Amomum Fruit), Gan Cao (Licorice), and Bai Shao (White Peony Root). Each dose was prepared into a decoction and was divided into 3 portions to be administered at three separate times during the day. The results showed that 21 cases had marked improvement, 10 cases had some improvement, and 1 case had no improvement. The total effectiveness rate was 96%.(2)

146 cases of abdominal distension originating from atonia of the stomach were treated with Yi Qi Yang Zhong Tang (a decoction for invigorating qi to smooth Middle-Jiao). The formula consisted of Huang Qi (Astragalus), Dang Shen (Codonopsis), Fu Ling (Poria), Hou Bu (Magnolia), Su Geng (Perilla Stalk), and Chai Hu (Bupleurum). The total effectiveness rate was 99.3%.(3)

65 cases of abdominal distension caused by the liver were treated with Shu Gan Xiao Zhang Tang (a decoction for dispersing liver and reducing fullness). The formula consisted of Chai Hu (Bupleurum), Bai Shao (White Peony Root), Chen Pi (Citrus), Chuan Xiong (Cnidium), Ze Lan (Lycopus), Xiang Fu (Cyperus), Ji Nei Jin (Membrane of Chicken's Gizzard), Hu Zhang (Giant Knotweed Rhizome), and Gan Cao (Licorice). The formula was modified according to the patients' symptoms. One dose of this decoction was administered per day. After 6 weeks of treatment, 23 cases showed marked improvement, 35 cases showed some improvement, and 7 cases had no improvement. The total effectiveness rate was 89.2%.(4)

69 cases with a mass in the right hypochrondrium were treated with Yun Pi Xiao Pi Tang (a decoction for promoting transportation function of spleen to disperse the mass). The formula contained Dang Shen (Codonopsis), Chao Lai Fu Zi (cooked Raphanus), Fo Shou (Finger Citron), Bai Zhu (White Atractylodes), Zhi Shi (Immature Bitter Orange) Salvia (Dan Shen), Yu Jin (Curcuma), Shi Chang Pu (Grassleaved Sweetflag Rhizome), and Gan Cao (Licorice). The formula was modified according to individuals' symptoms. One dose consisted of 300 ml of a decoction, which was taken in two administrations daily. Western medications were avoided during the treatment. After 35 to 65 days of treatment, 38 cases were resolved, 16 cases had marked improvement, 13 cases improved, and 2 cases showed no change. The total effectiveness rate was 97.1%.(5)

45 cases of abdominal distension induced by injury were treated with Xin Zhi Xiao Zhang Fang (a formula for relieving stasis to remove fullness). The formula contained Chen Pi (Citrus), Hou Pu (Magnolia), Mu Xiang (Saussurea), Xuan Fu Hua (Inula), Lai Fu Zi (Raphanus), and Bin Lang (Areca Seed). The formula was modified according to each patient's symptoms. A decoction was administered 30 to 50ml per hour. 8 hours constituted one dose. The results showed that all cases were resolved.(6)

46 cases of post-operative abdominal distension were treated with Da Huang Mu Dan Tang. 8 to 12 hours after administration, 34 cases had an intestinal gurgling sound with exsufflation and defecation. In 10 cases, exsufflation and defecation occurred 12 to 24 hours after the formula was taken. The total effectiveness rate was 95.5%.(7)

Chu Zhang He Ji (a mixture for removing fullness) was used to treat abdominal distention. The formula consisted of Dang Shen (Codonopsis), Bai Zhu (White Atractylodes), Fu Ling (Poria), Mu Xiang (Saussurea), Bin Lang (Areca Seed), Hou Pu (Magnolia), Lai Fu Zi (Raphanus), Chai Hu (Bupleurum), Shou Da Huang (cooked Rhubarb), and Gan Cao (Licorice). It was processed into an oral solution, and then taken 10ml, 3 times a day. For the first administration, the dosage was doubled. The treatment lasted for 6 consecutive days. In the control group, a Bo He solution (10ml) was given to 30 cases. The results for the two groups showed the following: marked effectiveness in 62, 2 cases, some effectiveness in 45,12 cases, and no effectiveness in 13, 16 cases. The total effectiveness rates were 89.2% and 46.7% (P<0.01).(8)

Treatment by external application of Chinese herb
22 cases of obstinate abdominal distension of liver origin were treated by local application on the umbilical region with Mu Xiang Shun Qi Wan. The formula was ground into a powder and mixed with vinegar to make a paste. This paste was applied once every 2 to 3 days and 3 treatments constituted one therapeutic course of treatment. The results showed that 7 cases had significant improvement, 10 cases had some improvement, and 5 cases had no improvement. The total effectiveness rate was 77.27%.(9)

49 cases of gastrointestinal gas distension were treated by local application of an herbal paste on the umbilical region. The herbs used were powdered Lai Fu Zi (Raphanus), Pu Xiao, and Cong Bai. The paste applied was 0.5cm thick and the area was covered with gauze and bandaged. If necessary, the herbal dressing was changed every 4 hours. The results showed that after 1 to 3 sessions, 47 cases showed exsufflation and defecation with subsidence of abdominal distension. 2 cases had no improvement. The total effectiveness rate was 95.9%.(10)

30 cases of abdominal distension, which occurred after apoplexy, were treated by regional application of an herbal paste. The paste included 10g of Lai Fu Zi (Raphaus) powder, which was then mixed with rice wine. The paste was made into a cake shape with a diameter of 3 cm. After routine sterilization, the herbal cake was placed on the umbilical region and fixed with gauze. The herbal cake was changed every 12 hours. The effectiveness of this treatment was measured in the reduction of abdominal distension. The results were: 19 cases showed effectiveness within 12 to 48 hours after treatment, 8 cases showed effectiveness within 48 to 72 hours, and 3 cases showed no effectiveness. The total effectiveness rate was 90%.(11)

Enema treatment
An enema was used in 20 cases for prevention and treatment of post-operative abdominal distension. Tong Fu Tang was used. This formula consisted of Da Huang (Rhubarb), Yuan Min Fen, Zhi Shi (Immature Bitter Orange), Hou Pu (Magnolia), Chi Shao (Peony Red), Dan Pi (Moutan), Sheng Di (Rehmannia Root), Huang Qi (Astragalus Root), Dang Shen (Codonopsis), Tao Ren (Persica), and Gan Cao (Licorice). These herbs were immersed in 500ml water for an hour and boiled for 30 minutes. This mixture was then decocted until the total volume was reduced to 200ml. This resulting mixture was boiled for 15 minutes and then 100ml of the mixture was taken and then 10g of powdered Yan Hu Suo (Corydalis) was added. The mixture was used as an enema. The tube for the enema was inserted into the rectum 15 to 18cm. The flow rate of enema fluid was 80 to 120 drops per minute and the temperature of the fluid was 39 to 40 degrees. No drugs were used in the control group of 20 cases. The results showed that exsufflation and spontaneous defecation in the enema group occurred earlier than the control group (P<0.05,P<0.01).(12)

Combined treatment of acupuncture and herbs
34 cases of abdominal distension of liver origin were treated by acupuncture on the points Qi Men (Liv14), Zhong Wan (Ren 12), Zu San Li (S36), Tai Chong (Liv3), Gan Shu (B18), Pi Shu (B20), and San Yin Jiao (Sp6) by the enforcing and reduction method. The needles were retained for 30 minutes, once a day. Also, Xiao Zhang San (a powder of relieving fullness) was externally applied to the umbilical region. The formula contains Chen Xiang (Aquilaria), Da Huang (Rhubarb), Zhi Shi (Immature Bitter Orange), and Bing Pian (Borneol). The herbal application was changed every other day. 14 days constituted one course of treatment. 34 cases in the control group were treated with an oral administration of Xiao Zhang Pian (a tablet form of Xiao Zhang San) for removing fullness. After therapy of 2 to 3 courses, the results for the treatment and control groups were respectively: marked improvement in 25 and 16 cases, some improvement in 8 and 10 cases, and no improvement in 1 and 8 cases. The total effectiveness rates were 97% and 76.5% (P<0.05).(13)

Massage treatment
30 cases of abdominal distension were treated by a chiropractic technique that included kneading and massaging the muscles forcefully with the thumb, index finger, and middle finger of both hands. The massage began at the sacrum, moving upward along the vertebral column to the point Da Zhui. This procedure was repeated 6 times. 7 days constituted one course of treatment. The kneading and pulling the spinal muscles and skin upward while moving right and left slightly resulted in, preferably, regional redness and warming sensations. The results showed that 18 cases had recovered after 2 courses of therapy, and 12 cases had improved. The total effectiveness rate was 100%.(14)