EPIGASTRIC PAIN

 Epigastric pain indicates pain in the stomach area. Pain may radiate towards the right or left costal margins. 

External Pathogenic factors for epigastric pain:-

1. Cold:- It invades the stomach directly, by passing the skin and muscles energetic layers. Since the cold contract so it causes acute and severe epigastric pain accompanied by vomiting. 

Tongue- Thick white coat.

2. Dampness:- It can also invade Stomach directly. Dampness may be combined with either cold or heat according to season. It obstruct the descending of stomach Qi(vital energy) and causes dull pain and nausea. It can cause feeling of oppression and heaviness of the epigastrium area.

Tongue- Sticky coating (white or yellow according to cold or heat).

3. Diet:- Diet is the most important factor in stomach disorders. Stomach rots and ripen food, the Spleen trasform and transport the refined food upwards towards lungs, and stomach sends the waste down to the Intestine.

The stomach perform downward movement and the Spleen perform upward movement. In disease, Qi(Vital energy) easily flow in the wrong direction, in case of stomach, it may flow upwards leading to nausea, vomiting, hiccups or belching. 

4. Quantity of food:- Eating too little can cause dull epigastric pain, Tiredness and weak muscles. Eating too much leads to retention of food so that Stomach Qi cannot descend. This causes sour regurgitation, epigastric pain and fullness, belching and foul breath.

5. Nature of food:- Foods are classified according their nature(hot,warm,cold or neutral), and according to their taste(sour,bitter,sweet, pungent, or salty)

The four categories of foods are- 

a) Cold food- These are raw vegetables, salad, fruits,cold drinks, ice cream. An Excessive consumption of cold food will tend to create cold in the Spleen , stomach and epigastric pain.

b) Sugar and sweets- An Excessive consumption of sugar and sweets may tend to produce both Dampness and heat in the stomach.

c) Hot spicy food- These include curries, spices, lamb,beef,and alcohol. An Excessive consumption of hot and spicy food causes stomach heat which may cause burning epigastric pain, thirst, yellow tongue coating. 

d) Greasy food- fried food,dairy food- An Excessive consumption leads to formation of phlegm or Dampness in the stomach. 

Food and water are often contaminated with residue of chemical pesticides and fertilizers. All these can cause stomach disorders. 

6) Conditions of eating:- 

Some eating habits which cause stomach disorders are:-

a) Eating too fast or on the run:- This cause Stagnation of Qi(vital energy) and retention of food in the stomach. Eating on run means eating quick while working or eating just in few minutes or eating while driving. 

b) Eating when emotionally upset:- It can cause Stagnation of Qi in the stomach and liver and sometimes stomach heat. 

c) Going straight back to work after eating:- It can cause stomach Qi deficiency. 

d) Discussing work while eating:- It can cause Stagnation of Qi in the stomach. And impairs the function of Spleen and stomach. 

e) Eating late in the evening or night:- Evening and night time are the time of Yin predominance. It can cause Stomach Yin deficiency. This may manifests on the tongue with wide midline crack. After many years of eating late the tongue may loose its coating and become red.

f) Eating while reading or watching TV- This causes Stagnation of Qi in the stomach and retention of food because reading divert Qi away from the stomach to the eyes and can cause headaches in forehead.

g) Eating Irregular amount from day to day- It can cause stomach Qi deficiency. 

h) Not eating breakfast:- Breakfast is the probably the most important meal of the day. Stomach has its peak of activity between 7am to 9am. It provides nourishment to sustain us throughout the day. Not eating breakfast causes stomach Qi def and also blood deficiency in women.