Epigastric pain

Chief Complaint: Epigastric pain

Medical History: Male, 29
At age 16 the patient realized he couldn't eat fried, greasy or rich foods on the same day as playing soccer without experiencing a burning sensation from the stomach to the throat. Began taking pepsid with a little improvement. At age 21, while in Sri Lanka he ate some yogurt which made burning so bad that the pepsid did not work. Accompanying symptoms included slight fever, irritability, and profuse diarrhea with a fetid odor and a burning sensation. Upon return to the U.S. he was diagnosed with Giardia and Amoebas. Prescribed Flagal which stopped diarrhea. Prescribed Prilosec for reflux which helped. At age 22, he stopped Prilosec and began managing the reflux with Chinese herbs.

Questioning exam: Currently.
epigastric pain from stomach to bottom of throat. worse after eating rich, fried or greasy foods. worse with alcohol and stress. better with heat. no improvement with acupuncture. Sleep-good, urination-normal, bowel movements-loose, appetite-good, avoids irritating foods

Pulse exam: wiry, slippery
slow (55 bpm)

Tongue exam: TB: puffy, slt. purple,
TC: thin white,

OM Diagnosis: Liver invading Spleen w/ Stomach qi counterflow

Treatment Principle: calm liver, tonify relieve pain

Point Prescription: Lv 3, 13, 14 ; PC6, Ren 12, Sp 4

Herbal Formula: Chai Hu Shu Gan San

Lifestyle prescription: avoid aggravating foods.
manage stress level.
avoid overeating raw foods

Results: after 3 acupuncture treatment and two weeks with the herbs the diarrhea stopped and the epigastric pain was significantly lower. patient left for vacation and upon retun there was no pain.

Synopsis: this is a chronic disease and difficult to eliminate completely. perhaps the most important factors to prevent it's re-occurance are to make lifestyle and dietary changes.