How to Differentiate Between Deficiency and Excess in Stomach Heat

Gastric heat is divided into two types: excess heat and deficiency heat, whose identification mainly relies on the patient's clinical symptoms, tongue appearance, and pulse condition.

Gastric excess heat is commonly caused by emotional disharmony, unhygienic diet, long-term emotional suppression, or excessive consumption of spicy foods. It presents with symptoms such as bad breath, thirst with preference for cold drinks, constipation, dark yellow or reddish urine, a red tongue with a yellow greasy coating, and a slippery-rapid pulse. Gastric deficiency heat, on the other hand, is primarily caused by prolonged illness damaging the yin, such as lengthy febrile diseases or excessive vomiting and diarrhea, leading to deficiency of body fluids and internal retention of deficient fire. Symptoms include poor appetite, abdominal fullness or distension, feeling hungry yet having no desire to eat, dry mouth without desire to drink, dark yellow urine, and constipation.

Gastric excess heat can be treated under a doctor's guidance with herbal medicines such as Coptis (Huang Lian), Scutellaria (Huang Qin), and Anemarrhena (Zhi Mu), or with patent herbal formulas such as Niuhuang Qingwei Pills. Gastric deficiency heat is usually managed with yin-nourishing and fire-clearing formulas such as Zhibai Dihuang Pills.

Between the two, gastric excess heat tends to be more severe, whereas gastric deficiency heat generally presents with milder symptoms. During diagnosis, a comprehensive assessment of the patient's overall condition, including constitution, lifestyle, and medical history, is necessary for accurate differentiation.