Title : Damjeok Syndrome: A novel gastrointestinal disease based on Traditional Korean Medicine(TKM)
Abstract:
Dyspepsia is a common gastrointestinal complaint, affecting approximately 21% of the global population. Most cases are classified as Functional Dyspepsia (FD),a representative upper Functional Gastro Intestinal Disorder (FGID) characterized by chronic upper abdominal discomfort not explained by structural abnormalities. Although conventional therapies, such as acid suppressants, prokinetic agents, and neuromodulators, provide temporary symptom relief,many patients experience frequent relapse or remain refractory to treatment, leading to a markedly reduced quality of life and increased healthcare expenditures.These challenges highlight the limitations of current diagnostic and therapeutic approaches in addressing refractory dyspepsia.
Meanwhile, Traditional Korean Medicine (TKM) has long recognized a distinct subgroup of patients with chronic dyspepsia who exhibit a palpable hardness in the upper abdomen, often accompanied by systemic symptoms such as fatigue, headache, chest tightness, and neck stiffness. This pattern is identified as Damjeok Syndrome (DJS), which is rooted in the TKM concept of phlegm accumulation (Damjeok) resulting from impaired digestive function and disturbed fluid metabolism.
DJS is characterized by three standardized diagnostic features: (1) unexplained epigastric symptoms (fullness, pain, or burning) that interfere with daily life; (2) a palpable lump-like hardness in the upper abdomen, typically around CV12 (Zhongwan), graded through a standardized palpation scale; and (3) one or more extra-gastrointestinal symptoms aggravated by dyspepsia, such as headache, chest discomfort, neck and shoulder stiffness, fatigue, or anxiety/depression.
Recent case–control studies have identified physiological correlates of DJS, including reduced parasympathetic activity on Heart Rate Variability (HRV) analysis and elevated plasma 5-Hydroxyindoleacetic Acid (5-HIAA) levels, suggesting autonomic imbalance and altered serotonin metabolism. These findings imply that DJS may represent a distinct subtype within the spectrum of FGIDs.
Therapeutically, the treatment for DJS focuses on resolving phlegm accumulation through herbal medicine and alleviating abdominal hardness through physical interventions. A multimodal approach including acupuncture, pharmaco-acupuncture, moxibustion, and targeted upper abdominal stimulation is employed to relax the hardened abdominal tissue, enhance local circulation, and promote digestive restoration.
By integrating palpation-based diagnosis, biomarker assessment, and physiological analysis, DJS offers a new lens for understanding refractory dyspepsia bridging traditional Korean medical wisdom with modern gastroenterological science and paving the way for evidence-based, patient-centered innovation in integrative medicine.
