Acupuncture for Functional Constipation

Functional constipation & Acupuncture

A recent review study into the use of electro acupuncture (EA) for treatment of the medical condition Functional Constipation (FC) was published in the BMJ in 2017.

This joint review was carried out in 2016 by Sheng-Li Zhou, Xiu-Lai Zhang and Jing-Hua Wang from The Second Affiliated Hospital of Zhejiang, University College of Medicine, China.

Earlier systematic reviews have failed to reach definitive conclusions. However, the aim of the recent study was to conduct an updated systematic review and meta-analysis, assessing the effectiveness of electroacupuncture (EA) relative to conventional medication in functional constipation (FC).

People from all around the world suffer with this distressing condition. But what is functional constipation (FC)? It’s constipation that does not have a physical (anatomical) or physiological (hormonal or other body chemistry) cause, it may have a neurological, psychological or psychosomatic cause.

The characteristics and symptoms of FC are hard stools, incomplete and infrequent defecation and straining during defecation.

This is a very common condition in Europe and America, with a huge economic burden and extensive hospital costs.

Medical intervention for FC is often unsuccessful and can have adverse side-effects. Often conventional treatments include lifestyle and dietary changes, with medication in the form of stool softeners, stimulant laxatives and bulking agents.

The ineffective outcome of these measures have led to the increasing use for alternative treatment options, which includes the use of acupuncture.

Acupuncture has been used to treat functional gastrointestinal diseases, including FC, in Traditional Chinese Medicine for many years.

A number of studies and clinical trials have been carried out and show promising results where acupuncture has been used for treatment. For instance EA and manual acupuncture (MA) have been seen to be effective for analgesia and in early post-operative inflammatory small bowel obstruction. EA has also been shown to accelerate the recovery of gastrointestinal motility and improve the quality of life in patients with colorectal cancer resection.

This review looked at a number of randomised control trials with adults diagnosed with FC using treatment with either EA or anti-constipation medication. Trials in which the control group received sham EA, at non-acupuncture points, as well as medication were excluded.

The review involved the gathering of data where patients in the control groups were treated with anti-constipation medications. Acupuncture was performed at a single acupuncture point in six trials and at multiple points in four.

They looked at the primary outcome measure: increased number of weekly spontaneous bowel movements, alongside response rate and reduction in symptoms. The number of patients in the studied treatment groups ranged from 19-356 and 21-140 in the control groups. Patients ages ranged from 22-67. The duration of constipation ranged from 3-20 years. The time point for the outcome measurement ranged from 4-64 weeks.

Five trials reported changes in frequency of spontaneous bowel movements.

The results of this review is encouraging and concluded that electro acupuncture (especially with deep needling) was more effective than anti-constipation medication at improving spontaneous bowel movements, total response rate and reducing the symptoms associated with functional constipation.