Disease and Condition Overview
Chronic gastroenteritis is characterized by various factors that cause the lining of the intestine to suffer chronic inflammation or gastrointestinal motility disorder. The symptoms are increased of bowel movements and loose stools often accompanied by abdominal pain around and below the navel. In Chinese medicine, chronic gastroenteritis is caused by irregulation of spleen and stomach functions and dysfunction of intestine transmission. Most of the syndromes are a mix of deficiency and excess.

Pair-point Treatment Combinations

(1) Pishu (BL20), Weishu (BL21) (Fig 23)
Pishu (BL20) is the spleen back-shu point and Weishu (BL21) is the stomach back-shu point. Spleen governs the ascent of nutrients while stomach is in charge of the descent and harmonizing of the turbid. This pair point combination, one elevating and one lowering, regulates and strengthens spleen and stomach so that normal function of intestine and stomach can be restored. This treatment is appropriate for chronic gastroenteritis caused by spleen and stomach qi dysfunction.

Needling techniques:
Pishu (BL20) perpendicular insertion to a depth of 1.5 cun.
Weishu (BL21) perpendicular insertion to a depth of 1.5 cun.
Use warm needle, or after needling, apply moxibustion for 15 minutes.

(2) Pishu (BL20), Pangguangshu (BL28) (Fig 98)
Pishu (BL20): on the back, below the spinous process of the eleventh thoracic vertebra (T11), 1.5 cun lateral to the posterior midline.
Panggoangshu (BL28): on the sacrum, 1.5 cun lateral to the median sacral crest, on the level of the second posterior sacral foramen.
Pishu (BL20) is the back-shu point of the spleen whose main function is to transform fluid and dampness. Pangguangshu (BL28) is the back-shu point of the bladder whose primary function is to unobstruct and resolve dampness. This pair point combination, one transporting and one resolving, treats both root causes and symptoms simultaneously. This treatment is appropriate for chronic gastroenteritis with excess fluid and dampness.

Needling techniques:
Pishu (BL20) perpendicular insertion to a depth of 1.5 cun.
Pangguangshu (BL28) perpendicular insertion to a depth of 1.5 cun.
Use warm needle or after needling, apply moxibustion for 15 minutes.

(3) Guanyuan (RN4), Xiajuxu (ST39) (Fig 99)
Guanyuan (RN4): on the lower abdomen, on the anterior midline, 3 cun inferior to the umbilicus.
Xiajuxu (ST39): on the anteriolateral side of the lower leg, 9 cun inferior to Dubi (ST35), one finger breadth (middle finger) lateral to the anterior crest of the tibia.
Guanyuan (RN4) is the front-mu point of small intestine and Xiajuxu (ST39) is the lower he-sea point of small intestine. In conjunction, they regulate the function of small intestine, restore transportation and clear turbid and fluids. This treatment is appropriate for chronic gastroenteritis accompanied by distention around the navel and frequent diarrhea.

Needling techniques:
Guanyuan (RN4) perpendicular insertion to a depth of 1 cun, after needling, apply moxibustion for 15 minutes.
Xiajuxu (ST39) perpendicular insertion to a depth of 1.5 cun.

(4) Hegu (LI4), Zusanli (ST36) (Fig 100)
Hegu (LI4): on the dorsum of the hand, midway between the unction of the first and second metacarpal bones.
Zusanli (ST36): on the anteriolateral side of the lower leg, 3 cun inferior to Dubi (ST35), one finger breadth (middle finger) lateral to the anterior crest of the tibia.
Hegu (LI4) is the yuan-source point of the hand-yangming channel. Zusanli (ST36) is the lower he-sea point of the stomach. This pair point combination elevates the clear, lowers turbid, regulates stomach and intestine, regulates qi and stops pain. This treatment is appropriate for chronic gastroenteritis accompanied by constant indigestion, lack of appetite, abdominal distension and irregular stools.

Needling techniques:
Hegu (LI4) point needle to a depth of 1 cun.
Zusanli (ST36) needle to a depth of 2 cun, manipulate for 2 minutes.

Commentaries
Acupuncture treatment for chronic gastroenteritis has excellent results; however, because the causes of chronic gastroenteritis are often complex and the disease course is long, symptoms may return during treatment. Persistence is important.
For irregularity of ascending and descending of qi, select Pishu (BL20), Weishu (BL21).
For excess fluid and dampness and difficulty in separating the clear and turbid, select Pishu (BL20), Pangguangshu (BL28) to clear and resolve fluid and dampness.
For cases accompanied by indigestion or other symptoms in the middle jiao, select Hegu (LI4) and Zusanli (ST36).