Liver Qi Stagnation: Depression of Qi of Liver

Woman Worrying - why does my stomach hurt?
Photo by Anh Nguyen on Unsplash

Liver Qi Stagnation is very common in both sexes, but probably slightly more so in women. This is such an important subject that we’ve actually got a page on just Qi stagnation, which helps to explain how it causes other more serious conditions.

 

Liver Qi Stagnation Symptoms include:

  • distension in the abdomen and
  • distending pain in the sides (the costal hypochondriac region)
  • distending sensation in the chest (sometimes people say their chest feels ‘stuffy’ or ‘blocked up’)
  • … and/or breasts ie before periods, your breasts feel stretched or bursting – and sometimes do get larger for a few days, uncomfortably
  • chest discomfort
  • belching
  • sighing
  • sensation of a foreign body – something ‘stuck’ – in the – throat
  • irregular menses

There is usually an emotional dimension too

A strong tendency to feel depressed with frequent sighing, self-doubt, crying and impatience, even outbreaks of temper. Also hypochondria, worrying that something is wrong with you.

Often bowel movements are uncomfortable or difficult, or there is pain in the bowels relieved by bowel movements. Pain tends to be tightening, drawing, pulling or it may move around from place to place.

Liver qi  stagnation tongue: colour may be normal or red at the sides, with a thin coating
Pulse: wiry

 

The key symptoms are this feeling of distension, or what some people call a ‘stuffy’ feeling, eg in the chest, and the emotional picture.

Mostly these sensations aren’t caused by any organic change in the liver organ itself. Instead, they’re from emotional factors, the main ones being anger or frustration. (However, other emotions can cause it too.) These cause dysfunction along the Liver acupuncture channel where the sensations are experienced. (Sometimes you get these sensations along the Gallbladder channel – the Liver’s paired organ – too.)

By the way, when you have Stagnant Liver Qi, you may not realise it. You’ll just be depressed, moody, angry or upset! (Others will notice, however.)

Apart from taking some exercise to help improve your condition, don’t try to treat yourself unless you really know what you’re doing!

Penny Brohn (she who started the Bristol Cancer Help Centre) once remarked that ‘sick people’ take ‘sick’ decisions. That definitely applies to anyone with Liver Qi Stagnation.

Bringing together what needs to be done is one of your Liver energy’s functions. When your Liver Qi isn’t flowing smoothly you’ll tend to do the wrong thing. Partly that will also be because your Gallbladder energy isn’t working properly, the Gallbladder being the ‘partner’ of your Liver.

Or you’ll feel powerless to decide what’s right for you.

Get someone else to treat you!

Acupuncturist taking the case
Acupuncture consultation

Other reasons for distension

Organic changes resembling Stagnant Liver qi can be caused by enlargement of the liver organ, hepatitis and cirrhosis…

Distension of the abdomen can also arise in many other conditions that include Stagnant Liver Qi as part of their symptom picture.

Just a few examples:

  • eating a diet too high in sugars or in foods that turn rapidly to sugar (high glycaemic foods) leads to excess lactic acid, which can produce distension, along with many other problems. Of course, the fact that you are eating this kind of food may be because you are feeling depressed or emotional. So, indirectly, this could also be due to Liver Qi stagnation, as well as cause or worsen it.
  • distension occurs from poor tone, over-eating and increase in ‘flab’ and fats in the abdomen
  • loss of vital fluids including blood can lead to flatulent bloating.

 

There are many more examples, but the distension related to Stagnant Liver Qi is usually dependent on emotional factors, so it comes and goes depending on how good you’re feeling about yourself.

Another pointer to it being Stagnant Liver Qi is that distension doesn’t always occur over the whole area of the abdomen. Instead it might just be over parts of it.  Palpating the distended area often makes the distension move elsewhere, like gas. (And yes, Liver Qi stagnation often does cause flatulence – ‘gas’!)

Stagnant Liver qi can affect other energy organs (the Chinese medical name for them is zang-fu) such as the StomachSpleenHeartLungs, and other channels and organs, such as the oesophagus.

In practice (ie clinically) you don’t often get all these symptoms at the same time. For example, distending pains in the costal (side) and hypochondria and lower abdomen seldom coexist.

How do you get Liver Qi Stagnation?

The main cause is mental ‘irritation’.

This is a nice term covering many mental and emotional conditions, including anger, resentment, fear, frustration and melancholy. Being urged to do something when there isn’t time for it is a classic for producing this syndrome – especially if you don’t want to do it, or can’t see why it should be done at all, either now, or by you.

One of the reasons Eastern philosophies emphasise the importance of a calm mind is to minimise the likelihood of Stagnant Liver Qi.

If Qi is flowing smoothly, then Liver Qi stagnation doesn’t occur. Any action or therapy which eases the flow of Liver Qi will ease Liver Qi stagnation. For example, taking exercise is often effective as it pushes Qi round the body, so it can’t stagnate.

Exercise moves Qi blocked by Liver Qi stagnation to move
Exercise – Photo by Aan Nizal on Unsplash

Problems arise where circumstances prevent free motion of Qi. For example, if someone is criticised by other people but dare not speak up despite his anger, you have a recipe for Stagnant Liver qi.

Effects on other organs

Where Stagnant Liver Qi ‘attacks’ the Stomach, the descending function of the Stomach will be disrupted and so there may be not only the usual Liver Qi stagnation symptoms such as distension and a stuffy feeling in the chest, but also nausea, sighing or belching.

If the chief pain is in your epigastrium (the area above  your belly-button and below your ribs) and is better for belching, always suspect Liver Qi stagnation first.

If Liver qi stagnation ‘attacks’ your oesophagus (the tube from your throat to your stomach), it will feel like a foreign object is stuck in your throat, blocking it. This is traditionally described as being like a stuck ‘plum-stone’, but you might feel it as the inability to swallow, or a tightness there. Often it can feel like phlegm in your throat – but you can’t hawk it up or swallow it down. Sometimes this feel temporarily better when eating, especially when swallowing solid food, but it soon returns.

A characteristic of Liver Qi stagnation is that, unless it has been around for a long time, the symptoms tend to go when the problem is solved or when you are not thinking about it.

It also eases when you are laughing, because laughing – assuming it is from something joyfully funny – moves your energy out of what is called your Wood phase and on into what is called your Fire phase. Find out more about these Wood and Fire phases in our page on the Five Elements, an important theory in Chinese medicine. Also, there’s far more about it in my book on Qi Stagnation, see below.

 

Menstrual problems

 

Heart Blood Yin Yang

 

When the Chong channel (sometimes called the Penetrating channel) is affected by this syndrome, you get irregular menses and abdominal pain. The Chong channel, one of the ‘extra-ordinary’ channels, is also called the ‘Sea of Blood’ and is intimately connected with the quantity, quality and flow of Blood.

Being intimately connected to the monthly cycle, the chong channel is also affected by Qi stagnation. Indeed, one could say that the monthly cycle can produce or exacerbate Liver Qi stagnation if there is the slightest trace of Qi stagnation around in the first place.

You can read even more about how Liver Qi Stagnation, this most vital of the Liver functions, affects your life, here.

Liver Qi Stagnation Exercise

To make Liver Qi stagnation worse, just don’t move! (So that makes anyone glued to their seat for hours more susceptible to Liver Qi stagnation. Office workers, beware!)

To make it better, move.

Is any particular movement best? No, but the more all parts of your body move, the better! So you would expect the following to be good:

  • walking
  • running
  • many forms of ‘abandoned’ dancing, jiving and twisting
  • swimming
  • many competitive sports, including football, tennis, squash, hockey, rugby
  • horse-riding
woman in black jacket riding brown horse during daytime: great for easing liver qi stagnation
Photo by Abbat

Ideally do it so you feel out of breath and hot. Then you know that your blood is being pushed round your body, clearing away stagnation.

Of course, if you are weak, old, ill or exhausted, take advice first, and build up your exercise gradually.

It is usually better not to exercise on an empty stomach. But it is also better not to exercise immediately after a large meal: give your stomach time to digest it.

After exercising, if you have become hot or perspiring, as you cool down keep clear of drafts, and cover up. Otherwise you’ll become susceptible to an invasion of Wind-Cold. You most definitely don’t want that.

Liver Qi Stagnation Diet

First, avoid what usually makes Liver Qi Stagnation worse!

If you come from a Western Christian background there’s a simple way to remember the list: just don’t eat anything you look forward to eating or drinking at Christmas. (This works, even for Brussels Sprouts, which are actually good for the Liver, but of course only peculiar uncles look forward to eating them, though turkey in the list below is the odd one out.)

General advice re Liver Qi Stagnation Diet

  • eat when relaxed and comfortable
  • Avoid eating when doing something else, like driving, reading, working, watching TV or in haste
  • CHEW slowly and well before swallowing
  • Eat cooked food that is warm when eaten
  • eat larger meals in the morning, smaller in the evening, and very little if tired
  • avoid eating inside the 3 hours before sleep
  • do not over-eat at any time; eat enough but not so much that you couldn’t eat more
  • eat organic produce if possible
  • learn about the Five Elements and the flavours that go with them, then try to eat at least some foods from each flavour (sour, bitter, sweet, pungent, salty) daily 
  • drink fluids that are warm to the touch. Avoid drinking too much water, especially if cold or chilled.

 

Next, AVOID –

caution! Foods to avoid if you have liver qi stagnation
Caution! Photo by Marvin Esteve
  • alcohol (However, a very little alcohol can help a bit. How much! Theoretically a few teaspoons but who’s going to stop there?! I suggest, half a glass of warm red wine, or half a glass of (not chilled) beer. No more!)
  • coffee  (Theoretically, about a thimble’s worth of coffee may help liver qi stagnation, but who’s going to stop there?! So probably better not to risk it, because too much makes it worse.)
  • most dairy food (milk, cheese, cream, ice-cream)
  • fried and fatty food
  • highly spiced food
  • processed and ‘junk’ foods
  • red meat
  • sugar and sweets including chocolate
  • turkey 

 

Foods for Liver Qi stagnation

As part of your liver qi stagnation diet, DO EAT regularly foods from this list:

  • green vegetables incuding
  • cabbage,
  • broccoli,
  • shard,
  • kale,
  • celery,
  • aubergine (egg-plant),
  • leeks
  • kelp – also:
  • plums
  • basil – small amounts, eg in salads or added to cooked dishes
  • coconut milk
  • simple white rice, eg basmati unless you are constipated, in which take more brown rice, well-cooked and chewed well

 

Liver Qi Stagnation Herbs

white neon light signage
Read the instructions! Photo by John Baker

Herbs have little nutrition, but can pack a big punch when they incline your metabolism to react in particular ways.

Unlike vegetables and most foods, of which you would have to eat lots before noticing ill-effects, herbs work fast.

Consequently, there are (tiresome) ifs and buts about using them. Hence, you’ll see  the name of the herb followed by some do’s and don’ts.

It’s important to observe these strictures. How did we arrive at them? From bitter experience over millennia! Don’t ignore this valuable source of experience!

Liver Qi stagnation nearly always generates Heat and Yang, so herbs for it are mostly cooling and taste bitter. 

Be careful to take small doses, as recommended by manufacturers: it is easy to over-dose then feel much worse than before! Then you’ll be casting about for someone to blame – well, don’t blame me!

Listed below are some cold, bitter herbs, which may be available in your country.

Of course, take them in warm water to offset their chilling properties.

And, before you rush out to buy them, please read my disclaimer!

Here’s a list of liver qi stagnation herbs!

  • Gentian (you get this for example in Swedish Bitters). However, avoid if you have diarrhoea from Spleen qi or yang deficiency. Decoction 4-8gm.
  • Centaury also known as Feverfewhowever centaury is contraindicated during pregnancy. Also, take it in small amounts (2-4 mls) on an empty stomach. 
  • Fringe tree root bark: usually safe to take, but read the instructions. Not easy to obtain, but you can pick it yourself, in season: in the UK it’s known as Old Man’s Beard (Chionanthus virginicus L.)
yellow flower on gray surface: a little turmeric helps some kinds of liver qi stagnation
Photo by Tamanna Rumee
  • Turmeric (Curcumin): however, avoid unless you also have Blood stagnation.  Also avoid if you have yin deficiency. Click to read more about when Turmeric is useful. Dose, in decoction 5-15g.
  • Wormwood. This (artemesia absinthium L.) is also called absinth, and there’s a delightful French alcoholic drink of the same name: it’s also in Vermouth. Unfortunately, these beverages include alcohol (well, obviously.)  You need very little wormwood, so be careful. Usually it comes in an infusion or tincture, taken before and after meals a few drops at a time in warm water. Don’t take it for more than 4 weeks at a time. Contraindicated during pregnancy and while breast-feeding. Also, avoid if you have cerebral congestion, or Stomach Heat.
  • Milk thistle seed (carduus marianus L.). Usually safe to take, but read the instructions. Dose 8-14g.

 

Syndromes of the Liver in Chinese Medicine

1. Liver Qi Stagnation (this page)

2. Liver Fire (‘flare-up of Fire in the Liver’)

3. Cold stagnation in the Liver channel

4. Stagnation of Liver Blood

5. Liver Wind (‘Stirring of Liver Wind by Heat’)

6. Damp-heat of Liver and Gall-Bladder

7. Liver Yin deficiency

8. Liver Yang rising

9. Liver Blood deficiency

Return from Liver Qi Stagnation to Liver Functions

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