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Acupuncture and Chinese Medicine can be beneficial for the symptoms of Irritable Bowel Syndrome (IBS). IBS can be a detrimental and debilitating health condition with an unknown cause. It is usually characterised by abdominal pain, bloating and alternating constipation and diarrhoea. (1)

Acupuncture for Bloating and Constipation 

Acupuncture can benefit those who suffer from symptoms of IBS by improving abdominal pain and distension, the sensation of incomplete defecation, times of defecation per day, and the state of stool (2). It can also regulate lipid metabolism, attenuate oxidative stress, and modulate inflammatory responses (7). Acupuncture can also have effects on acid secretion, gut motility, and visceral pain; as well as averting the long-term side effects and resistance of drugs in patients with “bad digestion” (5). It is also a therapy that has shown no serious adverse reactions (2), or no serious side effects (11). One study reported that acupuncture might modulate pain in IBS by two actions: By modulation of the serotonin pathway at the insula; and by modulation of mood and affection in the higher cortical brain centre via the ascending pathway at the pulvinar and medial nucleus of the thalamus (2). A research review showed that acupuncture was significantly more effective than pharmacological therapy (pinaverium bromide and trimebutine maleate) and significantly more effective than having no specific treatment (4,11). Acupuncture can also alter the gut-brain axis and can have regulatory effects on gastrointestinal motility, visceral hypersensitivity, brain-gut axis, neuroendocrine, and immunity (3,6). It has shown to modulate neurotransmitter activity in rat models (6). Acupuncture can also help to attenuate depression during IBS and can be used as adjuvant therapy for this (8).

Electro-Acupuncture to Support Gut-brain Axis 

Electro-acupuncture (EA) can help modulate the gut-brain axis in rat models. The results show that it could lower the severity and frequency of abdominal pain, diarrhoea, abdominal distension, and increase the quality of life in patients with Diarrhea Dominant IBS (D-IBS); as well as supporting good regulation on the important influencing factors of IBS, such as anxiety, conflict behaviour, dietary restriction and social response (6)

Moxibustion for Decreasing Gut Pain 

Moxibustion can improve the symptoms of D-IBS by decreasing rectal sensitivity, possibly dysregulating the pain control centre of the gut-brain axis as seen in brain MRI (10).A meta-analysis revealed and that moxibustion on its own is the sole most effective method within the Chinese medicine repertoire (8).

Chinese Herbal Medicine for a Stressed Gut 

A meta-analysis reveals that the combination of acupuncture alongside Chinese herbal medicine (CHM) and moxibustion show the best effects, and that they can be used as adjuvant therapy for depression during IBS (8). Acupuncture combined with CHM for D-IBS has displayed a synergistic effect on strengthening the curative effect, shortening the course of treatment, prolonging the duration of efficacy, and reducing side effects. It can alleviate the general symptoms, especially those related to physical strength, sleep, and diet (9)

By Dr Oscar Moreno 

References:

1. Department of Health & Human Services, State Government of Victoria, Australia. (2019). Irritable bowel syndrome (IBS). Accessed November 15, 2019 from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/irritable-bowel-syndrome-ibs

2. Guan-Qun, C., Shuo, Z. (2014). Effectiveness of acupuncture to treat irritable bowel syndrome: A meta-analysis. World Journal of Gastroenterology 2014 February 21; 20(7): 1871-1877 ISSN 1007-9327 (print) ISSN 2219-2840 (online)

3. Ma, XP., et. al. (2014). Acupuncture-moxibustion in treating irritable bowel syndrome: How does it work?. World Journal of Gastroenterology. 2014 May 28; 20(20): 6044-6054

4. Manheimer, E., et. al. (2013). Acupuncture for treatment of irritable bowel syndrome. Cochrane Database Syst Rev. ; 5: CD005111. doi:10.1002/14651858.CD005111.pub3.

5. Pang, Bo., et. al. (2016). Acupuncture for Functional Dyspepsia: What Strength Does It Have? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine Volume 2016, Article ID 3862916, 17 pages http://dx.doi.org/10.1155/2016/3862916

6. Sun, J., et. al. (2015). Electro-acupuncture decreases 5-HT, CGRP and increases NPY in the brain-gut axis in two rat models of Diarrhea-predominant irritable bowel syndrome(D-IBS). Sun et al. BMC Complementary and Alternative Medicine (2015) 15:340 DOI 10.1186/s12906-015-0863-5

7. Wang, et. al. (2019). Mechanisms of Acupuncture Therapy for Simple Obesity: An Evidence-Based Review of Clinical and Animal Studies on Simple Obesity. Evidence-Based Complementary and Alternative Medicine Volume 2019, Article ID 5796381, 12 pages https://doi.org/10.1155/2019/5796381
8. Wu. I. X. Y., (2019). Acupuncture and related therapies for treating irritable bowel syndrome: overview of systematic reviews and network meta-analysis. Therapeutic Advances in Gastroenterology, 2019, Vol. 12: 1–34
9. Yan, J., et. al. (2019). Acupuncture plus Chinese Herbal Medicine for Irritable Bowel Syndrome with Diarrhea: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine Volume 2019, Article ID 7680963, 16 pages https://doi.org/10.1155/2019/7680963
10. Zhu, Y., et. al. (2014). Brain regions involved in moxibustion-induced analgesia in irritable bowel syndrome with diarrhea: a functional magnetic resonance imaging study. Zhu et al. BMC Complementary and Alternative Medicine 2014, 14:500 http://www.biomedcentral.com/1472-6882/14/500
11. Zhu, L., et. al. (2018). Acupuncture for Diarrhoea-Predominant Irritable Bowel Syndrome: A Network Meta-Analysis. Evidence-Based Complementary and Alternative Medicine Volume 2018, Article ID 2890465, 12 pages https://doi.org/10.1155/2018/2890465
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