The four causes of bloating (abdominal distention) according to Chinese medicine

What is abdominal distention?

Abdominal distention is a sense of fullness, discomfort, blockage, or obstruction affecting the upper abdomen predominantly, or experienced across the abdomen as a whole. 

What causes abdominal distention?

Diet, food stagnation, emotional factors, spleen and stomach deficiency, and constipation can all cause abdominal distention.

Diet, food stagnation, and abdominal distention

Consuming more food than the Spleen and Stomach can cope with, either because too much is being consumed or because the Spleen is already weak, obstructs the qi dynamic and results in food stagnation, a common component of abdominal distention. Once the qi dynamic is obstructed, complications such as constipation can further aggravate the distention.

• Food stagnation
• Qi deficiency
• Yang deficiency
• Phlegm-dampness

Emotional factors and abdominal distention

Liver qi constraint caused by repressed emotions like frustration, anger, and resentment is a common component of recurrent abdominal distention. These emotions, especially when chronically unexpressed, cause a low grade spasm and tension in the smooth muscle of the gut, disrupting the qi dynamic of the middle burner. In addition, emotions such as worry, obsessive thinking, and prolonged concentration, combined with a sedentary lifestyle and prolonged concentration, weaken Spleen qi, predispose it to invasion by Liver qi.

• Liver qi constraint
• Spleen qi deficiency

Spleen and Stomach deficiency and abdominal distention

Spleen and Stomach weakness is at the root of many causes of abdominal distention; distention is the primary symptom for weakness of the Spleen. Spleen deficiency can contribute to all patterns. In simple cases, the Spleen is weak and unable to process food adequately; food qi not sent to the Lungs accumulates in the middle burner, causing distention. Similarly, Stomach qi may fail to descend, compounding the distention and contributing to constipation. This is a deficiency type of qi dynamic disruption. 

• Qi deficiency
• Yang deficiency
• Phlegm-dampness

Constipation and abdominal distention

Chronic constipation is a common contributing factor to abdominal distention, either generally over the abdomen as a whole, or specifically over the site of the constipated stool. Constipation itself can be related to qi obstruction - if qi is not descending there is no impetus behind the stool to move it forward and out; similarly, if the stool isn't moving, qi will back up behind the obstruction.

• Damp-heat
• Food stagnation