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Acupuncture for Constipation - Treatment Protocols

Acupuncture for Constipation - Treatment Protocols

Below you will find some of the more common tcm diagnoses and acupuncture treatment protocols for constipation. There are many ways to approach the treatment of this condition within TCM. Our presentation describes foundational approaches that would need to be further tailored in most cases to be effective for a given individual.

Etiology & Pathology:
- Constipation: prolonged period (3-5 days) between defecation where bowel movements are dry a/or hard, possibly difficult to pass, usually accompanied with feelings of distention a/or fullness in the lower abdomen.
- Etiology:
  - Valaskatagis & Xinnong (CAM) Differentiations:
  - Hot Constipation
    
    Internal Heat - acute febrile disease effecting organ leading to the fluids drying up.
    
    Heat - more chronic, emotionally related.
  - Qi Constipation - LV overacting on the LI due to emotional causes.
  - Wind Constipation - exterior pathogen effecting the bowel functions (LU/LI relationship) - not very common.
  - Food Constipation - stagnation of food due to overeating, pain w/constipation.
  - Cold Constipation - yang deficient internal cold that has congealed and led to constipation.
  - Blood Deficiency - in elderly or after illness, fluid deficiencies can dry up the intestines and cause constipation.
  - Maciocia Differentiations:
  - Qi Deficiency Constipation - Qi deficiency usually leads to diarrhea, but it can lead to constipation.
  - Yin Deficiency Constipation - lack of fluids.
- General Point Selection (in all Valaskatagis/Xinnong prescriptions):
  - ST 25 - LI Mu
  - UB 25 - LI Shu
  - SP 15 - augments ST 25
  - ST 44 - ST Water Point, cools heat in the ST & Intestines and moves the stools
  - Other Generally Useful Points:
  - TH 6 - constipation, esp. w/heat involvement
  - KD 6 - nourish yin/fluids
- Differentiation:
  - Hot Constipation (Maciocia Cold)
    
    Signs & Symptoms:
    
    Hard, dry stools, likely to feel warm or thirsty, foul breath, irritability, mouth ulcers possible.
    
    Tongue: Red, yellow coat
    
    Pulse: Rapid w/strength (if heat is beginning to damage fluids Rapid w/o strength)
    
    Treatment Points:
    
    TH 6 - clear heat and conduct qi downwards
    
    LI 11 - cools heat in intestines
    
    KD 6 - nourish fluids, moisten stools
    
    Plus, common points:
    
    ST 25 - LI Mu
    
    UB 25 - LI Shu
    
    SP 15 - augments ST 25
    
    ST 44 - ST Water Point, cools heat in the ST & Intestines and moves the stools
  - Qi Constipation
    
    Signs & Symptoms:
    
    Distention, costal pain a/or tenderness, belching, emotional involvement.
    
    Tongue: Normal or purplish
    
    Pulse: Deep, wiry
    
    Treatment Points:
    
    CV 6 - moves Qi in the lower abdomen
    
    GB 34 - w/CV 6 moves Qi in the lower abdomen
    
    LV 1 - move Qi in the genital area (LV related constipation)
    
    Plus, common points:
    
    ST 25 - LI Mu
    
    UB 25 - LI Shu
    
    SP 15 - augments ST 25
    
    ST 44 - ST Water Point, cools heat in the ST & Intestines and moves the stools
  - Wind Constipation
    
    Signs & Symptoms:
    
    Not seen very often.
    
    Acute onset, fever, dry cough, sore throat, dry skin
    
    Tongue: Red tip a/or thin, yellow coat
    
    Pulse: Floating
    
    Treatment Points:
    
    LI 4 - release the exterior
    
    LU 7 - release the exterior
    
    UB 12 - expel wind
    
    Plus, common points:
    
    ST 25 - LI Mu
    
    UB 25 - LI Shu
    
    SP 15 - augments ST 25
    
    ST 44 - ST Water Point, cools heat in the ST & Intestines and moves the stools
  - Food Constipation
    
    Signs & Symptoms:
    
    Etiology - poor dietary habits (eating too much, too little, too fast, etc.).
    
    Pain and distention in the abdomen (more distention than pain), dry mouth/lips, stuffy sensation in the chest, flatulence, nausea, desire to vomit.
    
    Tongue: Thick, greasy coat
    
    Pulse: Slippery, tight
    
    Treatment Points:
    
    CV 12 - conduct Qi downwards
    
    ST 36 - conduct Qi downwards
    
    LV 13 - SP Mu - good for masses in the abdomen a/or constipation
    
    Plus, common points:
    
    ST 25 - LI Mu
    
    UB 25 - LI Shu
    
    SP 15 - augments ST 25
    
    ST 44 - ST Water Point, cools heat in the ST & Intestines and moves the stools
  - Cold Constipation (not in CAM or Maciocia but seen clinically)
    
    Signs & Symptoms:
    
    Deficiency leading to cold in the lower warmer and stagnation.
    
    Abdominal pain, pain is better with the application of heat, pale face, objective sensation of cold.
    
    Tongue: Pale
    
    Pulse: Slow, deep
    
    Treatment Points:
    
    CV 4 - with moxa, warm the lower abdomen
    
    SP 6 - with moxa, warm the lower abdomen
    
    Plus, common points:
    
    ST 25 - LI Mu
    
    UB 25 - LI Shu
    
    SP 15 - augments ST 25
    
    ST 44 - ST Water Point, cools heat in the ST & Intestines and moves the stools
  - Blood Deficient Constipation
    
    Signs & Symptoms:
    
    Dizziness, palpitations, insomnia, dry mouth, weakness.
    
    Tongue: Pale, dry possibly peeled (peel more red - moving towards yin def, more pale - blood def).
    
    Pulse: Thin, choppy
    
    Treatment Points:
    
    UB 17 - Hui Meeting of the Blood
    
    UB 18 - LV Shu, tonify LV Blood
    
    UB 20 - SP Shu, tonify SP
    
    Plus, common points:
    
    ST 25 - LI Mu
    
    UB 25 - LI Shu
    
    SP 15 - augments ST 25
    
    ST 44 - ST Water Point, cools heat in the ST & Intestines and moves the stools
  - Qi Deficient Constipation (Maciocia)
    
    Signs & Symptoms:
    
    Thin, long stools, difficult defecation, pale complexion, tiredness.
    
    Tongue: Pale
    
    Pulse: Empty
    
    Treatment Points:
    
    UB 25 - LI Shu
    
    SP 15 - move bowels
    
    ST 36 - tonify Qi
    
    SP 6 - tonify Qi
    
    CV 6 - tonify Qi
    
    UB 21 - ST Shu
  - Yin Deficient Constipation (Maciocia)
    
    Signs & Symptoms:
    
    Dry stools, thirst, dry mouth/throat, night sweats.
    
    Tongue: Red w/o coat, cracks
    
    Pulse: Floating, empty
    
    Treatment Points:
    
    UB 25 - LI Shu
    
    SP 15 - move bowels
    
    ST 36 - tonify Qi
    
    SP 6 - tonify Qi
    
    CV 6 - tonify Qi
    
    UB 23 - KD Shu, tonify KD Yin

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were consulted within this section:

St. John, Meredith: New England School of Acupuncture, Etiology and Pathology Lecture Notes
Valaskatgis, Peter: New England School of Acupuncture, Etiology and Pathology Lecture Notes

Relationships

TCM Patterns (6)

Conditions / Symptoms (1)

Constipation

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Acupuncture for Constipation - Treatment Protocols