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Lower Abdominal Cramping and Nausea
by Laura Zaranski, M.S., Dipl. Ac.
Fifty two year old, white female complained of intense, painful lower abdominal cramping that came in waves, lasted several hours to days, moved from the lower abdomen up into the epigastric region then progressed into vomiting clear fluid. Her pain was worse with pressure but better for warmth. She occasionally had nausea and had a plum pit sensation in her throat. She was diagnosed and treated for peri-anal cancer 2 years prior to her visit with me. Her symptoms started shortly after chemotherapy and radiation. She also complained of low energy, spontaneous sweating, occasional night sweats, low back pain, and becoming easily chilled. She said was extremely sensitive to hot and cold beverage whereby her body temperature would become very warm with hot drinks and very cold with cold drinks. She had mild edema in the left ankle, frontal headaches, pain under the left ribcage, frequent and scant urination, and dry, daily stools. She fell asleep easily but woke often (especially between 1-3am). She occasionally had heart palpitations and shortness of breath that generally occurred before giving a speech. Emotionally she had a fear of dying, mental fogginess and some depression. Her blood pressure was borderline hypertension: 138/88. Her tongue was scalloped and pale with a white coat on the edges, some cracks down the middle with a red tip. Her pulse felt deep, weak, and slow.
Diagnosis: Kidney qi deficiency with some kidney yin and kidney yang deficiency. Also, she exhibited some liver qi stagnation and spleen qi deficiency.
Treatment: Her cancer and surgery had left her extremely weak. I wanted to support all the major organs in the body. Acupuncture points included UB 13, UB 15, UB 17, UB 18, UB 20, UB 23, UB 53, K3, KD 1, CV 12, CV4, CV6, KD 16, ST 36, ST41, LIV 3, GB 34, P6, and LI 4. To help with plum pit, I also added CV 22 and performed sooji on related point. Moxa was applied to ming men or CV 6 depending on front or back treatment. A few treatments included ear acupuncture to help with her boarderline hypertension.
I suggested a blood building diet for her including leafy greens, meat soups/broths, orange & yellow vegetables, beets, black beans and warm, cooked foods in general. I also placed her on essential fatty acids, B vitamin complex, liquid chlorophyll, calcium and magnesium and asked her to moxa CV6 and ST 36 daily. I started her on jin qui shen qi wan to warm and tonify kidney yang. This formula contains herbs to tonify yin (it actually contains the formula liu wei di huang wan), and adds fu zi and gui zhi to tonify the yang. Jin gui shen qi wan also treats edema due to kidney yang deficiency.
Results: After the first treatment, she had significant reduction in the severity of pain associated with her abdominal cramping and only felt like vomiting. She felt more energetic, was sleeping a little better (only waking 2-3x/night) and had a better emotional outlook. By the third treatment, she had one major cramping and vomiting attack. She decided to take over-the-counter pain relievers and get into a warm bath. Her cramping and nausea were gone within a couple hours. She claimed her body temperature was no longer influenced by the intake of hot or cold beverages, and her edema in the left leg had decreased. Headaches and vomiting were gone.
By her fourth treatment (within a month), she remained free of cramping, vomiting and nausea, the lump in her throat was gone, low back pain was gone (except with some heavy exertion), and she was sleeping all night long. She will remain on jin gui shen qi wan for another month or two and will receive bi-monthly acupuncture treatments.
Comparison: Since she had some yin and yang deficiency, formulas like you qui wan or zuo gui wan may have been too warming or too cooling. They also help secure the essence and stop leakage. You gui wan is a variation of jin qui shen qi wan but with a few more warming herbs. Since her body temperature was easily influenced by the intake of hot or cold beverages, I wanted to stay with a more balanced formula like jin gui shen qi wan.
Zhen wu tang could be an alternative formula for alleviating vomiting due to yang deficiency and dampness. It also works to alleviate abdominal pain, urinary difficulty, heavy sensations in the head, palpitations, and coughing.
One reason I did not choose zhen wu tang was the lack of yin-supporting herbs. And, it could have been too draining. However, this formula does work well for relaxing spasms and alleviating abdominal pain when there is accumulation of damp-cold.
