Acupuncture Treatment For Irritable Bowel Syndrome (IBS)

What is IBS?

Irritable bowel syndrome is a chronic functional bowel condition, which is characterized by abdominal pain and altered bowel habits, and is more than just a syndrome.

Symptoms of Irritable bowel syndrome can be debilitating in many individuals but may be mild or moderate in other patients. IBS is known to affect an individual’s quality of life considerably. Although the disease is not life-threatening and does not cause permanent harm, one should still take necessary precautions to avoid such condition from happening.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose prevalence is as high as 20% affecting the general population all over the world. IBS is characterized by chronic or recurrent abdominal pain or discomfort, altered bowel movements, abdominal distention and bloating. Many researchers find the pathophysiology behind the disease may be due to altered brain-gut interaction that in turn leads to alterations in intestinal motility, psychological factors, visceral hypersensitivity, and abnormalities in the processing of visceral information.

IBS is quite a complex disease that is known to be caused by multiple factors. IBS can affect at any age, and some factors that may lead to IBS include stress, early life events, diet, and psychosocial conditions. There are many medical therapies available in the market but they have not shown to alter its natural history. Systematic reviews of conventional medications for IBS have found that no drug is effective in treating all the symptoms of IBS. Many people are trying to find a solution for their IBS through complementary therapies like Acupuncture, Ayurveda, and Traditional Chinese medicine.

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Can Acupuncture cure IBS?

In US, just one-third of IBS patients show satisfaction with their existing therapies.Lack of effectiveness and related adverse effects are common reasons for dissatisfaction. In view of the treatment openings, some patients turn to conventional, complementary and integrative medicine (TCIM). Acupuncture and associated therapies, in addition to Chinese herbal medicine, have been extensively used for treating functional gastrointestinal disorders, including IBS.

Despite their wide use, existing clinical evidence on acupuncture is conflicting. In a Cochrane review of two trials, needle and sham acupuncture were found to be of similar impact in enhancing IBS symptoms. But, another meta-analysis revealed that needle acupuncture supplied stronger effects in IBS symptom relief compared to pharmacological therapies. The three other systematic reviews (SRs) indicated that needle acupuncture plus moxibustion was superior to pharmacological therapies for reducing IBS symptoms. Inconsistent evidence outlined in various SRs makes it tough to conclude whether acupuncture and related therapies might be utilised as a complement to, or another treatment option for IBS.

So as to deal with the uncertainty described above, a group of researchers conducted a synopsis of SRs to synthesize and critically appraise all clinical evidence on the relative effectiveness of acupuncture and related therapies used either independently, or as an add-on to alternative therapies, compared with other IBS treatments utilizing a system meta-analysis (NMA) approach. [5]

They reasoned that the combination of needle acupuncture and Geshanxiaoyao formulation is suggested to have the maximum probability of being the best treatment for enhancing global IBS symptoms. Clearly more research is necessary to conclusively prove that acupuncture is effective treatment for IBS.

Smaller studies show that acupuncture might help with abdominal bloating and other IBS symptoms. Larger studies are still needed. Dr. Philip Schoenfeld, MD, MSEd, MSc, co-authored the treatment guidelines published by the American College of Gastroenterology. He says the hard data demonstrating acupuncture’s effectiveness is not very great. Yet”that doesn’t indicate that acupuncture may not be useful,” he says. A lot of people say that they feel better after acupuncture. Out of all alternative possibilities, he suspects that acupuncture may help many people with IBS.[6].

Acupuncture therapy involves inserting very thin sterile needles at specific locations called meridians. These needles have the power to stimulate the electromagnetic signals in the body. These signals in-turn modulates the endorphin system of the body that encourages the release of a variety of hormones including the pain-killing hormones. Acupuncture for irritable bowel syndrome is also known to stimulate the somatic system that positively affects the brain-gut interaction and help control visceral hyperalgesia. Thus, Acupuncture aid in the natural healing of IBS alleviating the symptoms like pain with defecation, changes in stools, frequency of bowel movements and thus showing improvement in the quality of life of patients.

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Scientific studies in Acupuncture for IBS

1. In a scientific study named Acupuncture treatment in irritable bowel syndrome.[1]. included forty-three patients suffering from the symptoms of IBS who were treated with Acupuncture. Forty-three patients were randomly divided into two groups where one group (n=22) received Acupuncture treatment whereas the other group received Sham acupuncture treatment. The therapy was conducted with an average of two Acupuncture treatments per week which was continued for 10 sessions.

After 10 sessions of acupuncture treatment, the clinical assessment was carried out based on the improvement in the quality of life (QOL) of patients. QOL measurements were conducted based on the general quality of life questionnaire (SF-36) and functional digestive diseases quality of life questionnaire (FDDQL).

The results showed improved quality of life in patients of both the groups, with no differences between the groups. This effect was partially reversed three months later.

2. In another scientific study that was carried out on 86 patients suffering from IBS-Diarrhea was randomly divided into a control group and an observation group, with 43 cases in each group. [2]

Patients in the control group were given herbal medicines of 6-gram dose administered 3 times per day orally, after meals over a 30-day period. In addition, patients were given herbal medicine in the form of Xiao Yao Wan in 6-gram doses. The herbal pills were asked to be taken orally twice a day after breakfast and dinner.

Patients in the observation group received acupuncture therapy as well as the herbal medicines that are administered to the control group. Acupuncture therapy involved inserting of needles towards the abdomen for a duration of 30 minutes.

After completing the treatment, the results showed that both the groups reported improvement in IBS- D symptoms like abdominal discomfort Stool frequency, Shape, texture, and consistency of stool, Presence of mucus in the stool and feeling of incomplete relief after a bowel movement. However, the patients in the observation group performed better than those of the control group. The results indicated that acupuncture is an effective treatment modality for patients with IBS-D.

See: Ayurveda worked amazingly for all my digestive issues

Real world case reports for IBS

1. The Treatment of Constipation-Predominant Irritable Bowel Syndrome with Acupuncture and Moxibustion: A Case Report.[3].

This case study suggests that acupuncture and moxibustion can help reduce IBS symptoms such as abdominal pain, cramping, and constipation with little to no side effects. A 28-year-old woman suffering from constipation-predominant IBS from past one year was interested to undergo Acupuncture treatment. She complained about abdominal pain causing her great discomfort while passing stools. She was treated with acupuncture for over five months with a gap of one month in between. The general treatment strategy involved promoting the movement of qi, tonify the Spleen and harmonize the qi of the Liver. Initially, after four sessions of acupuncture treatment, she couldn’t find much relief and reported relief from the pain was just for two hours after the treatment and that her bowel movements also remained unchanged.

But after four months of treatment which involved a total of 16 acupuncture sessions – the patient reported having a bowel movement without any discomfort. Her stools were much softer and easier to pass.

2. A case study published in the article named Dysbiosis, Spleen Qi, Phlegm, and Complex Difficulties.[4].

Involved A 68-year-old woman, was suffering from frequent headaches after extensive air travel. She was admitted to the hospital into an emergency room and had a full checkup including head computed tomography, blood tests, and abdominal ultrasound, but nothing problematic was found. However, she revealed that she was diagnosed with irritable bowel syndrome, and suffering from a sensitive digestive system for many years, with a tendency toward periodic fluid retention. After investigation, she was administered with a number of acupuncture therapy sessions which focussed on balancing the Yang Ming. Along with acupuncture for her leaky gut, she was advised to take food that is more digestible, probiotics and herbs to tonify her Spleen Qi.

She found her headache to be reduced to almost 50% immediately after the first treatment and completely disappeared after 4 sessions of acupuncture treatment.

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Summary

Various clinical trials and scientific studies have shown that acupuncture for IBS may control symptoms of IBS. Research evidence also suggests that acupuncture may be effective in improving the quality of life in IBS patients if pharmacological treatment is challenging, with considerably lower side effects. IBS is known to arise from the alteration between the brain-gut axis, and in order to maintain a balance between them, acupuncture if followed with good lifestyle modification and dietary habits can do wonders in treating the disease. However, all the studies conducted are mostly on small sample size, that lack methodological rigor and a large scale trial is needed to investigate the effect of acupuncture on IBS.

Common Acupuncture pressure points for IBS

Some of the common Acupuncture pressure points for IBS are:

1. MHN3/Yin Tang

Location: Located between the medial extremities of the eyebrows exactly in midpoint.

Benefits: Helps in insomnia, anxiety, stress, sinusitis and improves brain and spleen function.

2. Baihui (GV20)

Location: Located in the area of the frontal lobe anterior precentral sulcus.

Benefits: IBS sufferers are prone to emotional disorders. Stimulating this point can help prevent emotional disorder

3. St25

Location: Located in the middle of the abdomen, two-thumb width away lateral to the umbilicus.

Benefits: Regulates the stomach, spleen and intestines. Helps in IBS by regulating Qi and Blood as well.

4. St 36

Location: Situated on the anterior aspect of the lower leg, four finger widths below the kneecap edge and one finger-breadth from the anterior crest of the tibia.

Benefits: Stimulating St 36 helps improve indigestion and irritable bowel syndrome and joint pain. It harmonizes and strengthens the spleen and stomach. In addition, it helps regulate shen and relaxes pain.

5. Sp4/Spleen 4

Location: Located on the medial aspect of inner foot right above the depression of the first metatarsal bone.

Benefits: Relieves symptoms of irritable bowel syndrome by strengthening the spleen and helps regulate menstruation.

6. UB25/Urinary Bladder 25

Location: Located at the back, 1.5 inches lateral to the lower edge of the spinal cord on the 4th lumbar vertebra.

Benefits: Regulates the large intestines, abdominal distension, constipation, strengthens the lower back, relieves from lumbar pain, and Urticaria.

7. St37/ Stomach Meridian 37 or the Upper Great Hollow

Location: Located on the anterior aspect of the lower leg, four finger widths below the kneecap.

Benefits: Regulates the intestines, stomach and spleen. Helps relieve acute appendicitis, abdominal pain and symptoms of IBS.

8. LI14/ Large Intestine 14 or the Upper Arm

Location: Located on the radial side of the upper arm, four finger widths below superior to the shoulder blade at the insertion of the deltoid muscle.

Benefits: Activates the meridian, treats acid regurgitation, stops the pain, benefits the eyes and dissipates phlegm nodules.

See: Ayurveda has helped me relieve anxiety and digestive issues

References