Distension Stomach

The gastric phase is elicited by the presence of food in the stomach. Distension of the stomach wall, as well as the presence of protein, caffeine, and alcohol, enhances gastric secretion. This phase is mediated by the intrinsic nerves, the vagus nerve, and gastrin. Each of these mechanisms promotes secretion of HC1 and pepsinogen. 

The basal rate of proton secretion is around 10% of maximal but the perception of food (smell, taste, sight or even just the thought of it) increases secretion. This is the cephalic effect of food. Nervons signals from the brain canse release of acetylcholine, histamine and gastrin to stimnlate acid secretion from the parietal cells. When food actnally reaches the stomach, distension, proteins, peptides and amino acids farther stimulate the release of gastrin. 

This formula is able to drain fire-toxin and dry dampness. It is used to treat excess heat in the Heart, which causes high fever, irritability, restlessness, flushed face, red eyes and dark urine in a severe case, there may be delirious speech. It can also treat damp-heat in the stomach and intestines, which manifests as stomach distension, diarrhea and dysenteric disorders. 

Bai Zhu is sweet and warm, and enters the Spleen meridian. It can tonify the Spleen-Qi directly and its bitter and warm property can dry dampness. It is often selected as deputy in the formula to enhance the ability of the chief as well as to dry dampness in the Middle-Jiao. It can effectively treat poor appetite, fullness in the stomach, distension in the abdomen, diarrhea and heaviness of the limbs. 

Gastric Phase. Gastrin is the main mediator of acid secretion. Acid secretion occurs h response to both the presence of nutrients and the physical distension produced by food entering the stomach. Distension-induced gas.-trie acid secretion, relative to the total amount of acid released, is species dependent (human = 20% dog = 50% rat = 38%). The chemical constituents of a meal are the strongest stimulant of gastrin release and acid output during... 

Figure 3.1 A schematic representation of the control mechanism that stimulates gastric acid secretion, and the intervention points used to treat ulcers. The parietal cells and gastric cells form part of the epithelial cell lining of the stomach. Histamine release is usually triggered as part ofthe enteric nervous system response to distension of the stomach when food is eaten.

The stomach receives food from the buccal cavity, it partially digests protein, fat and carbohydrate and it then delivers the resulting mixture (chyme) into the small intestine. The inner surface of the stomach is folded into ridges, to allow for distension after a meal, they contain gastric pits into which several gastric glands discharge their secretions (Table 4.1). 

The vagus nerve is a major connection between central and peripheral components. It contains both afferent (80%) and efferent (20%) pathways from and to the upper GIT. These include both cholinergic and non-cholinergic nerve fibres the non-cholinergic neurones may have serotonin as transmitter. Two types of vagal afferent receptors are involved in the emetic response (1) mechanoreceptors, iocated in the muscular wall of the distal stomach and proximal duodenum, which are activated by distension or contraction of the gut wall and (2) chemoreceptors located in the gut mucosa of the upper small bowel. These monitor the... 

Chen Pi is pungent, bitter and slightly warm. It enters the Stomach and Spleen meridians and is effective in regulating the Qi of these organs. Its aromatic smell can stimulate the Spleen, transform dampness and soothe the Stomach-Qi. It is often used in an exterior condition if there are symptoms such as distension and pain in the abdomen, reduced appetite, fullness in the stomach, nausea and vomiting. 

Zhi Ke is bitter and slightly cold, and enters the Spleen and Stomach meridians. It can regulate the Spleen-Qi and Stomach-Qi in a gentle and slow way. It moves horizontally in the Upper- and Middle-Jiao, opens the chest and reduces distension. In an exterior syndrome it is used to treat Qi stagnation in the chest, stomach and hypochondria, which causes distension in the upper abdomen, a stifling sensation in the chest, reduced appetite, irritability and depression. 

Hu Huang Lian is bitter and cold. It can reduce the deficient heat and improve digestion as it enters the Stomach and Large Intestine meridians. This herb is especially effective in treating nutritional impairment in children. The disorder shows poor digestion with abdominal distension and afternoon fever. 

When dampness blocks the movement of Qi, patients may suffer from distension in the stomach and abdomen. 

Fo Shou is also able to spread the Liver-Qi and is more suitable for treating distension in the stomach and hypochondriac regions, and patients with a depressive mood. 

Xiao Hui Xiang, Cao Dou Kou and Hua Jiao can all warm the Middle-Jiao and expel damp-cold. These three herbs are pungent and warm, and enter the Spleen and Stomach meridians. They are used to treat abdominal pain, distension, poor appetite, vomiting and diarrhea. 

Mu Xiang enters the Liver, Spleen, Stomach and Large Intestine meridians, and can effectively release pain in the hypochondriac region and in the whole abdomen, especially when distension and irregular bowel movement exist. 

Poor appetite, fullness in the stomach and distension of the abdomen after eating, soft stool, tiredness and weakness of the limbs. These symptoms start and get worse under conditions of changing diet or after taking heavy food. 

Reduced appetite with distension of the stomach add Chen Pi (Citri reticulatae pericarpium) and Ban Xia (Pinelliae rhizoma) to soothe the Stomach-Qi. 

Fu Ling is sweet, bland and neutral, and enters the Heart, Spleen, Stomach, Lung and Kidney meridians. It is able to drain out dampness by promoting urination. It can also tonify the Spleen and calm the mind. Because it is sweet and bland, it drains out dampness without the side effect of injuring the Yin and Yang of the body. In the condition of Spleen-Yang deficiency, it is often used as an assistant for treating accumulation of water and dampness in the Middle-Jiao. The manifestations are heaviness of the body, distension of the abdomen and difficult urination. 

Hou Po is bitter, pungent and warm. Bitterness can descend the Qi pungent and warm can disperse and dry the dampness. It is a very effective herb to transform dampness and phlegm, and to descend the Qi, thereby reducing the fullness in the chest and distension in the abdomen. Since it enters the Spleen, Stomach, Lung and Large Intestine meridians, it can be used to treat Qi obstruction due to dampness and phlegm in the Upper-, Middle- and Lower-Jiao. 

This formula can dry dampness and stimulate the Spleen, regulate the Qi and soothe the Stomach. It treats accumulation of dampness in the Middle-Jiao that obstructs the Qi movement of the Spleen and Stomach. The symptoms are distension and fullness in the epigastria and abdomen, reduced appetite, nausea, vomiting, belching and acid regurgitation, heaviness of the limbs and reluctance to move. A white, sticky or thick tongue coating and a slow and soft pulse indicate the accumulation in this syndrome. In this formula ... 

This formula can clear heat, transform dampness and reduce jaundice. It is used to treat damp-heat in the Spleen, Stomach, Liver and Gall Bladder which obstructs bile secretion. The manifestations are jaundice with a fresh tangerine color, slight abdominal distension, thirst and difficult urination, a yellow, sticky tongue coating and a deep, rapid pulse. 

When food accumulates in the Stomach, the Qi in the Middle-Jiao is blocked. Patients may feel fullness and distension, sometimes with pain in the stomach and abdomen. 

Hou Po is pungent, warm and bitter, and enters the Spleen, Stomach, Large Intestine and Lung meridians. It can effectively regulate the Qi in the chest and the whole abdomen, and reduce distension. It can also remove phlegm and dampness. 

Bai Zhu is sweet and warm, and can tonify the Spleen-Qi. However, as it is also bitter and warm, it can dry dampness. It is used to treat chronic food accumulation caused by Spleen-Qi deficiency where poor appetite, diarrhea and distension of the stomach and abdomen may exist. 

Zhi Shi is used as deputy to descend the Qi in the Stomach and intestines, remove the accumulation and reduce distension. 

---