What should I do if I always have burps due to liver qi affecting my stomach?

In traditional Chinese medicine, liver qi invading the stomach is also known as liver-stomach disharmony syndrome, which is usually caused by long-term bad emotions. Of course, there may be other reasons, such as staying up late for a long time, depression, tension or anger, but this disease is not caused in one or two days. So when our liver qi attacks the stomach and we always have hiccups, how should we differentiate and treat it?

Differential Diagnosis

Liver qi invading the stomach and liver-stomach disharmony are both related and different. Liver qi invading the stomach falls under the category of liver-stomach disharmony, which has a broader meaning. Any disorder in the physiological connection between the liver and stomach, and clinically, any patient who has liver failure to release, stomach failure to harmonize and descend, and abnormal stomach reception and digestion function, are all symptoms of liver-stomach disharmony. The syndrome of liver qi invading the stomach and the syndrome of liver-spleen disharmony are both caused by liver qi invading the middle burner. Both may cause clinical manifestations such as fullness and pain in the chest and flanks, depression, or irritability. However, the spleen is responsible for transportation and transformation, and its Qi is responsible for ascending; the stomach is responsible for receiving and its Qi is responsible for descending. Therefore, the symptoms of liver qi attacking the stomach are often accompanied by symptoms such as fullness and pain in the epigastric region, hiccups, belching, acid reflux, vomiting, and other manifestations of stomach Qi rising up; while the symptoms of liver-spleen disharmony are often accompanied by symptoms such as poor appetite, abdominal distension, and loose stools, which are symptoms of spleen dysfunction.

Treat according to syndrome differentiation

1. Vomiting due to liver qi attacking the stomach

Symptoms: vomiting or dry retching, frequent acid regurgitation and belching, depression, irritability or sadness and crying, chest and flank distension, stomach discomfort, symptoms aggravated by any stimulation or emotional fluctuations, pale tongue with thin or thin and greasy coating, and wiry pulse. Treatment principle: Soothe the liver and regulate qi, harmonize the stomach and reduce counterflow. Main prescription: Banxia Houpu Decoction combined with Zuojin Pills with modifications.

2. Stomach pain caused by liver qi attacking the stomach

Symptoms: Distension and pain in the epigastric region, extending to the chest and flanks, wandering Qi movement, triggered or aggravated by emotional distress, accompanied by decreased appetite, depression or insomnia, thin white tongue coating, and wiry pulse. Treatment method: Soothe the liver and regulate qi, harmonize the stomach and relieve pain. Main prescription: Chaihu Shugan San combined with Xiangsu San with modifications.

3. Distension and fullness caused by liver qi attacking the stomach

Symptoms: abdominal distension and discomfort, relieved by belching or flatulence, extending to the chest and flanks, accompanied by irritability, easy anger, and sighing, aggravated by emotional frustration. The tongue is pale with thin coating and the pulse is stringy. Treatment principle: Soothe the liver and regulate qi, relieve depression, and eliminate abdominal distension. Main prescription: Chaihu Shugan San combined with Banxia Houpu Tang with modifications.

4. Hiccups due to liver qi attacking the stomach

Symptoms: Frequent hiccups, accompanied by distension and discomfort in the abdomen and flanks, or nausea, abdominal distension, poor appetite, intestinal rumbling and flatulence, etc. The tongue is pale, the coating is thin, and the pulse is stringy. Treatment principle: Soothe the liver and regulate Qi, reduce adverse reactions and stop hiccups. Main prescription: Xuanfu Daizhe Decoction with modifications.