Acupuncture, Irritable Bowel Syndrome

Irritable Bowel Syndrome – Information:

Irritable Bowel Syndrome (IBS) is a condition that has become increasingly common over the years. It is characterised by having imbalanced contractions of intestinal muscles which can produce abdominal pain, constipation and or diarrhoea. Simplistically speaking these contractions are usually regulated by the nervous and hormonal systems and internal electrical activity within the muscular walls of the intestines.

 

Acupuncture Irritable Bowel Syndrome theory:

Acupuncturists primarily view IBS as an imbalance within Spleen and Liver meridians. The Spleen meridian is responsible for ensuring transformation and transportation of food, and therefore has a very strong connection with the digestive system but more specifically at the intestines level. When there is Spleen deficiency common signs and symptoms may include soft or loose stools, muzzy head and tiredness. This meridian is easily affected through excessive mental activity, irregular eating habits or damp foods such as wheat and dairy products.

The liver meridian ensures free flow of energy within the body and in doing so aids the function of the spleen meridian. When the Liver meridian is out of balance, stagnation can occur causing abdominal pain, constipation and frustration. The biggest factors for an imbalance within this meridian is due to lack of exercise, unexpressed anger or resentment.

From a western perspective acupuncture is thought to help IBS through somehow interacting and harmonizing the hormonal and nervous system. Acupuncture and can be very successful in the treatment for IBS and is usually combined with dietary and lifestyle advice. More recent studies have shown that both sham acupuncture and traditional acupuncture provide significant improvement of symptoms and symptoms (Lombo et al, 2009).  This has been associate with increase levels of osteoprotegerin in both groups and TWEAK (TNF-related weak inducer of apoptosis) more so in sham acupuncture group (Kokkotou, 2010).

Research

Neurogastroenterol Motil.2010 Mar;22(3):285-e81. Epub 2009 Dec 22.Serum correlates of the placebo effect in irritable bowel syndrome.

Kokkotou E, Conboy LA, Ziogas DC, Quilty MT, Kelley JM, Davis RB, Lembo AJ, Kaptchuk TJ.

 This study followed Conboy et al (2009) (see below) The new study involved testing a panel of 10 serum biomarkers at enrolment and at the third week of intervention. Patients who received placebo treatment showed more changes over time in serum levels of osteoprotegerin (OPG) compared with the waitlist group. In addition, serum levels of OPG at baseline were found to be higher in patients who subsequently achieved adequate relief (AR) of IBS symptoms, irrespective of their treatment group. Serum levels of another protein called TWEAK (TNF-related weak inducer of apoptosis) were also higher at baseline in patients who reported AR and in particular in those who reported AR with placebo treatment. The authors conclude that knowledge of such predictors of the placebo response could improve the design of clinical trials.
Gastroenterol Nurs. 2009 Jul-Aug;32(4):243-55.Symptom management for irritable bowel syndrome: a pilot randomized controlled trial of acupuncture/moxibustion.Anastasi JK, McMahon DJ, Kim GH After 4 weeks of twice-weekly Acu/Moxa treatment, average daily abdominal pain/discomfort improved whereas the control group showed minimal reduction. This between-group difference adjusted for baseline difference was statistically significant. The intestinal gas, bloating, and stool consistency composite score showed a similar pattern of improvement. The findings indicate that Acu/Moxa treatment shows promise in the area of symptom management for IBS.
Am J Gastroenterol. 2009 Jun; 104(6): 1489-97.A treatment trial of acupuncture in IBS patients.

Lembo AJ, Conboy L, Kelley JM, Schnyer RS, McManus CA, Quilty MT,  Kerr CE, Drossman D, Jacobson EE, Davis RB.

 In this study both traditional acupuncture and sham acupuncture groups improved significantly compared with the waitlist control group.(see Conboy et al 2010 follow up study, above)