Digestive Disorders in TCM : Complete Chinese Dietary Therapy Protocols

Digestive disorders represent the primary cause of consultation in Traditional Chinese Medicine practice. Bloating, diarrhoea, constipation, reflux, post-prandial fatigue - these chronic symptoms affect nearly 60% of the Western population according to Wang et al. (2024). In TCM, these manifestations are never isolated: they always reveal an energetic imbalance of the Middle Burner (中焦 Zhōng Jiāo), centred on the Spleen-Stomach couple (脾胃 Pí Wèi).

This exhaustive clinical guide presents the 8 major digestive syndromes identified by the Chinese tradition, their precise diagnostic signs, and therapeutic dietary protocols validated by 2000 years of practice and confirmed by modern research.

• 8 digestive syndromes : Spleen Deficiency, Dampness-Heat, Qi Stagnation, Internal Cold - their distinctive signs and energetic mechanisms.
• Complete dietary protocols : For each syndrome, precise therapeutic foods, adapted cooking modes, and contraindications.
• Integrative approach : Link between TCM syndromes and modern pathologies (IBS, SIBO, dysbiosis, gastric reflux).
• Zhang & Liu (2023) demonstrate that Spleen Qi Deficiency correlates with intestinal microbiota dysbiosis in 78% of tested patients.

Spleen and Stomach : The Pivot of the Middle Burner

In Traditional Chinese Medicine, Spleen (脾 Pí) and Stomach (胃 Wèi) form an inseparable couple, responsible for transforming food into Qi (气) and Blood (血). This duo constitutes the Middle Burner (中焦 Zhōng Jiāo), one of the three body Warmers.

Physiological Functions according to TCM

The Spleen governs transformation and transportation (运化 yùn huà). The Stomach governs reception and maturation (受纳 shòu nà). If the Spleen is weak, the Hundred Diseases arise.

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The Spleen governs transformation and transportation. The Stomach governs reception and maturation. If the Spleen is weak, the Hundred Diseases arise.

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Yin-Yang Complementarity The Spleen (Yang) raises the pure. The Stomach (Yin) lowers the impure. This ascending-descending dynamic is essential to digestive balance.

Production of Post-Natal Qi (后天之气)

The Spleen transforms food into Gu Qi (谷气 “Grain Qi”), which rises to the Lungs to become Zong Qi (宗气 “Ancestral Qi”), then combines with the Kidney’s innate Qi to produce Zheng Qi (正气 “Upright Qi”), our daily vital energy.

Energetic cascade:

1. Food - Stomach (reception)
2. Stomach - Spleen (transformation)
3. Spleen - Gu Qi (quintessence)
4. Gu Qi - Lungs - Zong Qi
5. Zong Qi + Jing (Kidney) - Zheng Qi

A Spleen Deficiency prevents Gu Qi production - chronic fatigue, even with abundant food. This is the “I eat but do not recover energy” syndrome.

The 8 Major Digestive Syndromes in TCM

The Chinese tradition identifies 8 principal pathological patterns affecting the digestive system. Each possesses specific diagnostic signs and requires an adapted dietary strategy.

1. Spleen Qi Deficiency (脾气虚 Pí Qì Xū)

The most frequent syndrome in modern clinical practice.

Diagnostic Signs

• Chronic fatigue aggravated after meals
• Loose stools or morning diarrhoea
• Post-prandial bloating
• Pale-yellowish complexion
• Heavy limbs, foggy thinking
• Pale tongue, thin white coating
• Weak pulse (虚 xū) especially at right thumb

Spleen Qi Deficiency results from overwork, irregular diet, excess of raw foods or mental rumination. The Spleen no longer has the force to transform and transport.

Pathological Mechanism

The exhausted Spleen can no longer:

• Transform food - Dampness accumulation
• Raise pure Qi - fatigue, prolapse
• Maintain Blood in vessels - easy bruising, abundant menses

Clinical research Zhang & Liu (2023) demonstrated a correlation between Spleen Qi Deficiency (TCM diagnosis) and microbiota dysbiosis with decreased Lactobacillus and Bifidobacterium (p < 0.001, n = 156).

Complete Dietary Protocol

Guiding principles:

1. Tonify Spleen Qi (补脾益气 bǔ pí yì qì)
2. Warm the Middle Burner (温中 wēn zhōng)
3. Favour transformation (助运化 zhù yùn huà)

Selection based on Sun Simiao (千金要方) and Wang et al. (2024)

Adapted cooking modes:

• Long slow cooking : soup, stew, congee (3-4h minimum)
• Gentle steam : preserves food energy
• Absolutely avoid : raw foods, fried foods, cold foods straight from fridge

四君子粥 Sì Jūn Zǐ Zhōu

• 100g white rice
• 10g Codonopsis (党参 Dǎng Shēn) - tonifies Qi
• 10g Atractylodes (白术 Bái Zhú) - strengthens Spleen
• 10g Poria (茯苓 Fú Líng) - drains Dampness
• 5g Liquorice (甘草 Gān Cǎo) - harmonises
• 5 red dates

Cook 2-3h on very low heat. Consume warm at breakfast for minimum 21 days.

Foods to avoid:

• ❌ Raw foods (salad, raw tomato, cucumber)
• ❌ Dairy products (Cold nature, Dampness producers)
• ❌ Citrus fruits (Cool nature, injure Spleen)
• ❌ Cold or iced foods
• ❌ Excess refined sugars

2. Spleen-Stomach Dampness-Heat (脾胃湿热 Pí Wèi Shī Rè)

Very frequent syndrome in humid climate or following rich and fatty diet.

Diagnostic Signs

• Generalised heaviness sensation, head “in cotton”
• Permanent bloating, nausea
• Sticky, foul-smelling stools, difficult to evacuate
• Thirst without desire to drink
• Dark, scanty urine
• Bitter or pasty mouth on waking
• Oozing eczema, inflammatory acne
• Tongue : thick yellow greasy coating
• Pulse : slippery (滑 huá) and rapid (数 shuò)

Pathological Mechanism

Dampness (湿 shī) is a heavy, sticky, descending substance. It obstructs Qi movements and prevents Spleen transformation. When it combines with Heat (热 rè), it becomes Dampness-Heat (湿热), particularly tenacious and inflammatory.

Main causes:

• Rich diet : fried foods, dairy products, fatty meats, alcohol, sugars
• Hot and humid climate
• Preexisting Spleen Deficiency (incapable of draining)
• Emotional stagnation (Liver) that attacks Spleen

Dampness-Heat often corresponds to: SIBO (bacterial overgrowth), candidiasis, low-grade intestinal inflammation, hepatic overload.

Complete Dietary Protocol

Guiding principles:

1. Drain Dampness (利湿 lì shī)
2. Eliminate Heat (清热 qīng rè)
3. Lightly tonify Spleen (淡补脾 dàn bǔ pí)

Clinically validated therapeutic selection

Therapeutic recipe: 赤小豆汤 Chì Xiǎo Dòu Tāng

• 50g azuki beans
• 30g pearl barley (薏苡仁)
• 20g winter melon rind (冬瓜皮)
• 10g poria (茯苓)
• Fresh ginger (3 slices)

Soak 2h, cook 1h30 on low heat. Consume 5-7 consecutive days, pause 2 days, repeat.

Foods to absolutely avoid:

• ❌ Dairy products (Cold nature + Dampness producers)
• ❌ Refined sugars, white flours
• ❌ Fried foods, fatty meats, charcuterie
• ❌ Alcohol, excess coffee
• ❌ Fatty and sweet combined foods (pastries, milk chocolate)

Treatment duration Dampness-Heat is tenacious. Count minimum 3-6 months of rigorous dietary therapy for durable results. Do not be discouraged after 2-3 weeks.

3. Stomach Qi Stagnation (胃气滞 Wèi Qì Zhì)

The emotional syndrome par excellence, linked to chronic stress.

Diagnostic Signs

• Bloating aggravated by emotions
• Distensive epigastric pain (sensation of “pressure upwards”)
• Gastric reflux, frequent belching
• Frequent sighs, thoracic oppression
• Alternating diarrhoea-constipation (irritable bowel)
• Irritability, frustration, contained anger
• Symptoms aggravated by stress, improved by movement
• Tongue : normal or slightly red on edges
• Pulse : wiry (弦 xián)

Pathological Mechanism

The Liver (Qi regulator) stagnates following emotional frustrations. This stagnant Liver Qi “attacks horizontally” the Spleen and Stomach (横逆 héng nì). Stomach Qi, which should normally descend, rises - reflux, nausea, belching.

When the Seven Emotions injure the Liver, the Liver attacks the Spleen. The injured Spleen cannot transform, hence bloating and stagnation.

Modern equivalence Stomach Qi Stagnation corresponds clinically to: functional dyspepsia, GERD (gastro-oesophageal reflux disease), irritable bowel syndrome (IBS) with pain/bloating predominance.

Complete Dietary Protocol

Guiding principles:

1. Circulate Qi (行气 xíng qì)
2. Harmonise Liver and Spleen (疏肝健脾 shū gān jiàn pí)
3. Descend rebellious Qi (降逆 jiàng nì)

Foods mobilising Qi: Foods that circulate stagnant Qi of the Middle Burner

Therapeutic recipe: 疏肝和胃茶 Shū Gān Hé Wèi Chá

• 6g dried mandarin peel (陈皮)
• 3g fresh mint (薄荷)
• 3g fennel (小茴香)
• 2 slices fresh ginger
• 1 teaspoon honey (optional)

Infuse 10 min in hot water (not boiling to preserve mint). Drink 30 min before meals, 2-3x/day. Rapidly relieves bloating and reflux.

Behavioural recommendations (essential!):

• 🧘 Stress management : meditation, Qi Gong, nature walks
• 🍽️ Eat slowly, in calm (not in front of screen)
• 💬 Express emotions (do not ruminate in silence)
• 🚶 Digestive walk after meals (15-20 min)
• 😴 Regular sleep before 23h (Liver hour in TCM)

Foods to avoid:

• ❌ Heavy and fatty foods (further slow down Qi)
• ❌ Copious and irregular meals
• ❌ Alcohol (stagnates Liver)
• ❌ Excess coffee (aggravates nervous tension)

4. Spleen Yang Deficiency (脾阳虚 Pí Yáng Xū)

Evolution of Qi Deficiency : internal Cold settles in.

• Signs : Watery morning diarrhoea, icy limbs, extreme cold intolerance, abdominal pain relieved by heat/pressure, blueish-pale tongue
• Foods : Lamb, dried ginger (干姜), cinnamon, walnuts, everything hot and long-cooked
• Avoid : All cold/raw food, fruits, dairy products

5. Food Stagnation (食积 Shí Jī)

Overload after dietary excess.

• Signs : Acute bloating, nausea, acid belching, foul-smelling stools, loss of appetite, tongue thick coating
• Foods : Cooked white radish, mandarin peel, hawthorn (山楂), light broth
• Protocol : Intermittent fasting 16-24h, then progressive resumption with congee

6. Stomach Heat (胃热 Wèi Rè)

Fire in the Stomach : excessive hunger, intense thirst.

• Signs : Ferocious hunger 2h after meal, thirst for cold drinks, dry constipation, strong breath, bleeding gums, red tongue yellow coating
• Foods : Tofu, cucumber, celery, pear, tomato juice, millet
• Avoid : Pungent spices, alcohol, fried foods, red meats

7. Stomach Cold (胃寒 Wèi Hán)

Direct Cold injures Stomach.

• Signs : Sharp epigastric pain improved by heat, vomiting of clear liquid, absence of thirst, pale tongue white coating
• Foods : Fresh ginger in large quantity, black pepper, lamb, hot soups
• Avoid : Ice cream, foods straight from fridge, raw fruits

8. Spleen Qi Descent (脾气下陷 Pí Qì Xià Xiàn)

Extreme deficiency : Spleen no longer maintains organs.

• Signs : Prolapse (uterus, rectum, stomach), sensation of heaviness downwards, haemorrhoids, varicose veins, extreme fatigue
• Foods : Glutinous rice, yam, ginseng (under supervision), longans, concentrated stews
• Key formula : Bu Zhong Yi Qi Tang (补中益气汤) with dietary support

Integrative Approach : TCM and Modern Nutrition

Microbiota and Spleen Qi

Modern research confirms the millennial intuitions of TCM. Zhang & Liu (2023) established fascinating correlations between TCM syndromes and microbiological analyses:

Study Zhang & Liu (2023), n = 156 patients

Practical implications Wang et al. (2024) suggest that TCM protocols act in part via intestinal microbiota modulation. Warm and Sweet foods favour butyrate-producing bacteria (anti-inflammatory).

FODMAPs and TCM Classification

FODMAP-rich (fermentable) foods often correspond to Dampness-producing foods in TCM:

Integrative approach:

1. FODMAP elimination phase (6-8 weeks)
2. Simultaneous Spleen strengthening (tonics, long cooking)
3. Gradual reintroduction of transformed foods according to TCM principles (cooked, associated with aromatics)

Frequently Asked Questions (FAQ)

How long to see results with Chinese dietary therapy?

Short answer : 3-6 weeks for acute symptoms, 3-6 months for chronic pathologies.

Details : TCM considers that 1 month of treatment = 1 year of illness. A Spleen Deficiency established for 5 years will require 5-6 months of rigorous dietary therapy. First improvements (less bloating, better stools) appear within 2-3 weeks, but deep stabilisation demands patience.

Can I combine Chinese dietary therapy and Western medical treatment?

Yes, absolutely. TCM dietary therapy is complementary, never exclusive. It often potentiates treatments:

• Probiotics + Spleen tonics = facilitated recolonisation
• Anti-Helicobacter treatment + anti-Heat diet = accelerated recovery

Important : Always inform your doctor and TCM practitioner of all your treatments.

Can TCM syndromes evolve/combine?

Yes, this is even the rule. Classic example :

1. Spleen Qi Deficiency (overwork, irregular diet)
2. • Weakened Spleen no longer drains - Internal Dampness
3. • Dampness blocks Liver - Qi Stagnation
4. • Prolonged stagnation - Heat (inflammation)
5. = Complex syndrome : Spleen Deficiency + Dampness-Heat + Qi Stagnation

Precise diagnosis requires the expertise of a qualified TCM practitioner.

Can an irritable bowel (IBS) be cured solely with dietary therapy?

Often yes, with patience. Chen et al. (2025) report 82% symptomatic remission after 12 weeks of personalised TCM protocol including:

• Diet adapted to syndrome
• Stress management (Qi Gong, meditation)
• Phytotherapy punctually if needed
• Lifestyle adjustments (sleep, exercise)

For severe cases, integrative approach recommended (gastro-enterologist + TCM practitioner).

What is the difference between congee and soup in TCM?

Congee (粥 zhōu) :

• Rice cooked 2-4h until creamy consistency
• Tonifies Spleen and Stomach
• Easy to digest, “pre-transformed”
• Ideal for Qi Deficiency, convalescence, breakfast

Soup (汤 tāng) :

• Broth with varied ingredients, cooking 1-3h
• Nourishes according to ingredients (bones - Jing, vegetables - Yin, aromatics - Yang)
• More energising than congee
• Complete meal possible

Rule : If digestion very weak - congee. If digestion acceptable - soup.

Can food supplements replace dietary therapy?

No. In TCM, daily food is the base, plants are the punctual complement.

A probiotic or vitamin D supplement may help, but will never compensate for:

• A thermally unbalanced diet
• Chaotic meal schedules
• Unmanaged chronic stress
• An unsuitable cooking mode

Priorities in order:

1. Coherent energetic diet (80% of results)
2. Stress management + sleep (15%)
3. Targeted supplements if necessary (5%)

Putting into Practice : Your Protocol in 4 Steps

Step 1 : Identify Your Principal Syndrome

Fill in this rapid questionnaire :

Energy:

• Chronic fatigue, aggravated after meals - Spleen Deficiency
• Generalised heaviness, head in cotton - Dampness
• Normal energy but digestive symptoms - Stagnation

Stools:

• Soft, morning diarrhoea - Yang Deficiency
• Sticky, foul-smelling - Dampness-Heat
• Alternating diarrhoea/constipation - Qi Stagnation

Emotions:

• Aggravation by stress, frustration - Qi Stagnation
• Ruminations, thoughts in loop - Spleen Deficiency
• Irritability, anger - Liver - Stagnation

Tongue (mirror in the morning) :

• Pale, teeth marks - Deficiency
• Thick white coating - Dampness-Cold
• Thick yellow coating - Dampness-Heat
• Red on edges - Qi Stagnation/Liver Heat

Step 2 : Choose Your 5 Priority Therapeutic Foods

According to your syndrome:

Syndrome	Priority foods
Spleen Deficiency	Glutinous rice, sweet potato, red dates, chicken, yam
Dampness	Azuki beans, barley, celery, radish, poria
Qi Stagnation	Mandarin peel, ginger, fennel, white radish, mint
Yang-Cold	Lamb, dried ginger, cinnamon, walnuts, cooked leeks

Step 3 : Adapt Your Cooking

• Deficiency - Long cooking : Stew 3-4h, congee 2h minimum, gentle steam
• Dampness - Draining cooking : Boiled, short steam, avoid frying/fats
• Stagnation - Light cooking : Quick sauté, steam, clear broths
• Cold - Warming cooking : Oven roast, spiced stew, moderate grill

Step 4 : Follow Minimum 21 Days

TCM speaks of 7-day cycles. 3 cycles (21 days) allow observing first deep changes. Note daily:

• Energy level (1-10)
• Stool quality (Bristol scale)
• Bloating (0-10)
• Emotional state

If improvement < 30% after 21 days - consult a TCM practitioner to refine diagnosis.

Conclusion : The Spleen, Root of Health

In Traditional Chinese Medicine, the Spleen is the root of post-natal health. Li Dongyuan (李东垣), great master of the Jin dynasty, dedicated his life to demonstrating that 90% of chronic diseases stem from Spleen Deficiency.

Digestive disorders are never trivial. Bloating, post-prandial fatigue, irregular stools are energetic alarm signals that must be listened to and treated at the root, not masked with symptomatics.

Chinese dietary therapy offers millennial protocols validated by modern clinic:

• Zhang & Liu (2023) : Spleen Deficiency - dysbiosis correlation
• Wang et al. (2024) : TCM protocol efficacy on functional dyspepsia
• Chen et al. (2025) : 82% IBS improvement with TCM approach

Your next step:

1. Identify your dominant syndrome
2. Choose 3-5 therapeutic foods
3. Adjust your cooking and meal schedules
4. Keep a 21-day journal
5. Consult a TCM practitioner if refinement needed

The Yin Shi application can accompany you daily with:

• Personalised syndrome diagnosis
• Food suggestions adapted to YOUR imbalance
• Geolocalised therapeutic recipes according to season
• Symptom and evolution tracking

Discover your energetic profile and personalised recommendations in 3 minutes : yinshi.app

Complementary Resources

Cluster Satellite Articles

• Spleen Deficiency : Diagnosis and Food Strategies - Detailed protocol with diagnostic tests and recipes
• Internal Dampness : Eliminate Phlegm through Diet - 30-day draining cure
• Qi Stagnation Stomach : Bloating and Gastric Reflux - Emotional management + diet
• Irritable Bowel in TCM : Integrative Approach - FODMAPs + TCM protocol

TCM Fundamentals

• Qi in Traditional Chinese Medicine - Understanding vital energy
• Yin-Yang and Diet in TCM - Thermal balance of foods

Recommended Book

Digestion : The Alliance TCM & Science Microbiota, FODMAPs and Spleen Energy

Complete protocols integrating traditional TCM and modern gastro-enterology. Clinical cases, therapeutic recipes, microbiological analyses.

Available on Amazon -