Day 7 - Learning & Living

Acupuncture for Irritable Bowel Syndrome (IBS)

Both the National Institutes of Health Consensus Panel[3] and the World Health Organization,[4] using different criteria, have identified many different conditions as appropriate for acupuncture treatments, including several that directly pertain to IBS:

Abdominal pain
Muscle cramping

In addition, acupuncture has also been deemed effective as a means of stress reduction, and at addressing related problems that are often triggers for IBS symptoms, such as:

Menstrual cramps
Premenstrual syndrome

At least one study has directly investigated the use of acupuncture versus relaxation therapy in IBS patients.[5] This research found that patients' quality-of-life and gastrointestinal symptom scores were equally improved in both groups, with a statistically significant reduction in abdominal pain. However, when the patients were followed for a 4-week period post-trial period, only in the acupuncture group did pain reduction persist. Furthermore, a significant reduction in stress perception was also observed in the acupuncture group, but not in the relaxation group. The conclusion drawn was that acupuncture is an effective form of treatment for IBS, particularly the pain and stress symptoms, and that its benefits exceed those of standard relaxation treatment.

While it is unquestionable that acupuncture can provide significant pain relief and help minimize other symptoms of IBS as well, from a Western medical standpoint (though certainly not from the traditional Chinese medicine point of view) no one quite knows how or why this is true. From the Western viewpoint, it may be that acupuncture affects the nervous system by stimulating the release of endorphins, naturally produced chemicals in the body that block pain signals in the brain and spinal cord. Research has shown that acupuncture results in changes in the conduction of electromagnetic signals in the brain, an alteration of blood circulation within the brain that increases blood flow to the thalamus (the area associated with relaying pain and other sensory impulses), and measurable differences in the brain's output of neurotransmitters such as serotonin, norepinephrine, and of inflammation-causing substances such as prostaglandins.

Why these changes occur is still considered a mystery by doctors and scientists who do not hold with the Chinese concept of chi. However, if you're suffering from chronic pain and associated diarrhea or constipation as a result of IBS, odds are you don't care why acupuncture works – just that it does work. It's the end result that counts here, not the underlying reasons for success.

On a related note, you've probably noticed by now that many of the most effective treatments for IBS, from meditation to Tai Chi to acupuncture, have well-established and measurable success rates, but no explanation behind their impressive results. You may be intrigued, you may not care. Personally, I am more than willing to give the benefit of the doubt to the concept of chi and simply accept that, for whatever reasons, these practices are truly effective. I have also been quite unimpressed by the Western approach to IBS, which until very recently dismissed it outright as a psychosomatic problem, and has not yet even come close to thoroughly understanding the underlying dysfunction or developing an effective form of treatment for it – let alone finding a cure. What matters most to me, and probably to you too, is results. So if something helps prevent or alleviate an IBS attack, then it is by definition a valid form of health care for this disorder. While it's certainly preferable to be able to ask and understand the reasons behind a treatment's effectiveness, in these circumstances it fortunately isn't required in order to reap the benefits (though I remain curious).

Still trying to decide if acupuncture is for you? Precautions are only necessary with this treatment if:

* You have an uncontrolled bleeding disorder or are taking an anticoagulant medication such as Coumadin (warfarin). Acupuncture needles do have the potential to draw blood.

* You are pregnant. The stimulation of certain acupuncture points, particularly those on or near the abdomen, can trigger uterine contractions and could induce premature labor and possibly miscarriage. Tell your acupuncturist if you are pregnant or even just think you may be.

* You have diabetes. Acupuncture should be used on your limbs only with extreme caution, as even small skin punctures in a person with diabetic neuropathy can result in severe infections. If you have any concerns in this area consult your physician.

* You have breast or other implants. Do not have needles placed in the area of the implant.

View all chapters of First Year: IBS.

[3] Acupuncture. National Institutes of Health. Consensus Statement 1997 Nov 3-5; 15(5):1-34.

[4] World Health Organization. Viewpoint on acupuncture. Geneva, Switzerland: World Health Organization, 1979.

[5] In a randomized, controlled trial of 27 patients with IBS diagnosed by their own criteria, the study treated the patients with acupuncture or relaxation sessions 3 times a week for a period of 2 weeks. A follow-up observation run was then performed for 4 weeks. (Lu B, Hu Y, Tenner S. A randomized controlled trial of acupuncture for irritable bowel syndrome. Program and abstracts of the 65th Annual Scientific Meeting of the American College of Gastroenterology; October 16-18, 2000, New York, NY.)

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