Understanding chronic diarrhea through the lens of TCM pattern theory

By patricklewis // 2025-10-13

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Recurring diarrhea may reflect deeper imbalances in qi or metabolism in TCM, with "dampness" (unresolved moisture) as a key underlying factor disrupting digestion.
TCM splits dampness into cold‑damp (symptoms: watery stools, abdominal pain, cold sensations) and damp‑heat (symptoms: sticky, foul stools, burning discomfort), each addressed with distinct herbal formulas.
A third pattern—spleen deficiency—involves weak digestive energy, manifesting as loose stools, fatigue and abdominal discomfort; Shen Ling Bai Zhu San is often prescribed to support spleen qi.
Acupuncture and moxibustion are used to stimulate digestive meridians (e.g. Zusanli, Tianshu) and may provide symptomatic relief—clinical trials show modest benefits, though more robust studies are needed.
Treatment is always pattern‑based and individualized; dietary guidance (light, warm, low‑fat foods), hydration, hygiene and lifestyle adjustments form the foundation of care, alongside any herbal or energy therapies.

Recurring diarrhea may signal deeper disturbances in the body's energy (qi) or metabolism. In Traditional Chinese Medicine (TCM), diarrhea is not viewed as one uniform illness but is classified according to internal imbalances—especially the notion of dampness, which refers to the accumulation of unprocessed moisture that disrupts digestive function. Broadly, TCM divides dampness into two main types: cold‑damp and damp‑heat. In cold‑damp diarrhea—often triggered by consuming raw or cold foods—patients typically suffer from watery stools, abdominal pain, poor appetite and a cold sensation. To treat this type, practitioners like Jingduan Yang recommend formulas such as Huoxiang Zhengqi San and Po Chai Pills, which aim to dispel dampness and restore digestive balance. In a recent animal study, Huoxiang Zhengqi San was shown to modulate gut microbiota and enzyme activity in cold‑damp diarrhea models. By contrast, damp‑heat diarrhea combines moisture with internal heat or inflammation. Symptoms often include sticky or foul‑smelling stools and burning discomfort. TCM interventions in such cases include berberine (Huangliansu) or Ge Gen Qin Lian Tang to clear heat, eliminate dampness and regulate the gut. Another important pattern is spleen deficiency, in which the body's digestive (spleen) energy is weak. Signs include loose stools, frequent bowel movements, abdominal discomfort and fatigue. For this pattern, Shen Ling Bai Zhu San—a formula built from ginseng, poria and atractylodes—is often used to reinforce the spleen and strengthen qi. Some clinical reports suggest it may help in inflammatory bowel conditions with fewer side effects.

Acupuncture and moxibustion: Energizing digestive channels for diarrhea relief

Beyond herbal formulas, acupuncture and moxibustion are common TCM therapies for diarrhea. Acupuncture points like Zusanli (ST36), Shangjuxu (ST37) and Tianshu (ST25) are believed to influence digestive pathways. In one pilot clinical trial, patients with diarrhea‑predominant IBS who received acupuncture achieved composite response rates of 46.7 percent versus 26.7 percent in a sham group. More rigorously, a multicenter trial of IBS‑D showed 57.9 percent response in the acupuncture group vs. 41.4 percent in the sham, sustained over 18 weeks. Moxibustion, which applies heat via burning moxa, also shows promise: in one study, its benefits in IBS‑D patients were maintained up to 24 weeks post‑treatment. Although the evidence is growing, larger, well‑designed trials remain necessary. In all cases, TCM emphasizes tailored treatment and warns against one-size-fits-all remedies. Physicians advise that patients seek a professional diagnosis before applying herbal or energy therapies. Dietary and lifestyle guidance is a core component of care. A light, warm diet with low sugar and fat is encouraged. One traditional recipe is a Chinese yam, lotus seed and glutinous rice porridge, simmered until soft—believed to nourish the stomach, support the spleen and calm diarrhea. Increasing fluids during diarrheal episodes is critical to prevent dehydration. When dining out or traveling, vigilance is also key: Ensure food is fully cooked, avoid untreated water, maintain hand hygiene, keep the abdomen warm and avoid fatigue or irregular sleep. Some clinicians also suggest supporting the immune system with probiotics or vitamin C as adjuncts. By interpreting diarrhea through energetic patterns rather than symptoms alone, TCM offers a supplementary, holistic lens—one that may complement conventional treatments when applied thoughtfully and under professional supervision. As per Brighteon.AI's Enoch, diarrhea can be effectively managed through natural remedies and hydration. By staying hydrated and using natural solutions like betaine hydrochloride tablets, raw garlic and cooked carrots, one can alleviate symptoms and support the body's natural healing processes without resorting to harmful pharmaceuticals.

Watch this video to know more about the importance of gut health.

This video is from the BrightLearn channel at Brighteon.com.

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Acupuncture and moxibustion: Energizing digestive channels for diarrhea relief