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Lu and colleagues discussed the use of acupuncture, investigated in a randomized, controlled trial of 27
patients with IBS diagnosed by their own criteria and
assigned to receive acupuncture treatment or relaxation
sessions.
Using a crossover design method, the subjects
received both modalities. In addition to demographic
information and specific IBS symptoms reported, patients
also rated their overall quality of life on entry to and
exit from the study. The study authors 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. These investigators found that patients' quality-of-life and gastrointestinal symptom scores were improved equally in the 23 who completed both the acupuncture trial and the relaxation sessions. A statistically significant reduction in abdominal pain was observed in both groups at the end of the trial.
However, when the patients were followed for the
4-week period posttrial, only in the acupuncture group did
pain reduction persist (P < .05). Furthermore, a significant
reduction in stress perception was also observed in the
acupuncture group, but not in the relaxation group (P <
.05). It was concluded that acupuncture appears to be an
effective modality in the treatment of IBS, particularly for
pain and disease-related stress, and exceeds standard
relaxation treatment.
This intriguing finding is of particular interest because of the increasing attention paid to so-called alternative treatments for IBS by patients and the medical community itself. Additional studies will be needed to confirm these results. The work of Lu and colleagues, however, is an important step in this direction.
Clearly, acupuncture as well as other alternative modalities
deserve additional study in this disease setting.
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. Poster 268, p. 428.
http://listserv.nodak.edu/cgi-bin/wa.exe?A2=ind0103a&L=co-cure&O=D&P=2507
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Aliment Pharmacol Ther. 2006 Feb;23(4):465-71. Related Articles, Links
Systematic review: complementary and alternative medicine in the irritable bowel syndrome.
Hussain Z, Quigley EM.
Department of Medicine, Alimentary Pharmabiotic Centre, Cork University Hospital, Cork, Ireland.
Background Complementary and alternative medical therapies and practices are widely employed in the treatment of the irritable bowel syndrome. Aim To review the usage of complementary and alternative medicine in the irritable bowel syndrome, and to assess critically the basis and evidence for its use. Methods A systematic review of complementary and alternative medical therapies and practices in the irritable bowel syndrome was performed based on literature obtained through a Medline search. Results A wide variety of complementary and alternative medical practices and therapies are commonly employed by irritable bowel syndrome patients both in conjunction with and in lieu of conventional therapies. As many of these therapies have not been subjected to controlled clinical trials, some, at least, of their efficacy may reflect the high-placebo response rate that is characteristic of irritable bowel syndrome. Of those that have been subjected to clinical trials most have involved small poor quality studies. There is, however, evidence to support efficacy for hypnotherapy, some forms of herbal therapy and certain probiotics in irritable bowel syndrome. Conclusions Doctors caring for irritable bowel syndrome patients need to recognize the near ubiquity of complementary and alternative medical use among this population and the basis for its use. All complementary and alternative medicine is not the same and some, such as hypnotherapy, forms of herbal therapy, specific diets and probiotics, may well have efficacy in irritable bowel syndrome. Above all, we need more science and more controlled studies; the absence of truly randomized placebo-controlled trials for many of these therapies has limited meaningful progress in this area.
PMID: 16441466 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16441466&query_hl=9&itool=pubmed_docsum
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Expert Rev Neurother. 2006 May;6(5):661-7.
Mechanisms of acupuncture analgesia for clinical and experimental pain.
Staud R, Price DD.
University of Florida, Department of Medicine College of Medicine, Gainesville, FL 32610-0221, USA. staudr@ufl.edu
There is convincing evidence that acupuncture (AP) is effective for the treatment of postoperative and chemotherapy-induced nausea/vomiting, as well as postoperative dental pain. Less convincing data support AP's efficacy for chronic pain conditions, including headache, fibromyalgia and low back pain. There is no evidence that AP is effective in treating addiction, insomnia, obesity, asthma or stroke deficits. AP seems to be efficacious for alleviating experimental pain by increasing pain thresholds in human subjects and it appears to activate analgesic brain mechanisms through the release of neurohumoral factors, some of which can be inhibited by the opioid antagonist naloxone. In contrast to placebo analgesia, AP-related pain relief takes some time to develop and to resolve. Furthermore, repetitive use of AP analgesia can result in tolerance that demonstrates cross-tolerance with morphine. However, it appears that not all forms of AP are equally effective for providing analgesia. In particular, electro-AP seems to best deliver stimuli that activate powerful opioid and nonopioid analgesic mechanisms. Thus, future carefully controlled clinical trials using adequate electro-AP may be able to provide the necessary evidence for relevant analgesia in chronic pain conditions, such as headache, fibromyalgia, irritable bowel syndrome and low back pain.
PMID: 16734514 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16734514&query_hl=1&itool=pubmed_docsum
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Zhongguo Zhen Jiu. 2006 Oct;26(10):717-8.
[Acupuncture combined with massage for treatment of irritable bowel syndrome][Article in Chinese]
Huang ZD, Liang LA, Zhang WX.
Department of Acupuncture and Massage, Affiliated Ruikang Hospital of Guangxi TCM College, Nanning 530011, China.
OBJECTIVE: To observe the therapeutic effect of acupuncture combined with massage on irritable bowel syndrome.
METHODS: Ninety-three cases of irritable bowel syndrome were randomly divided into three groups: group of acupuncture combined with massage (group A), simple acupuncture control group (group B), simple massage control group (group C), 31 cases in each group. Their therapeutic effects were compared.
RESULTS: The cured rate and the effective rate in the group A were significantly higher than those in both group B and group C (P < 0.05). CONCLUSION: Acupuncture combined with massage therapy shows a better therapeutic effect on irritable bowel syndrome, and they should be jointly used in clinical treatment.
PMID: 17117571 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17117571&query_hl=1&itool=pubmed_docsum
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Effects of music on gastric myoelectrical activity in healthy humans
Authors: Lin, H-H; Chang, W-K; Chu, H-C; Huang, T-Y; Chao, Y-C; Hsieh, T-Y
Source: International Journal of Clinical Practice, Volume 61, Number 7, July 2007 , pp. 1126-1130(5)
Publisher: Blackwell Publishing
Abstract:
Summary
The aim was to study the effects of listening to music on gastric myoelectrical activity in healthy humans. Gastric myoelectrical activity was recorded using surface electrogastrography from 17 healthy volunteers before and for 30min after they listened to music.
All subjects listened to the same music. Ten perceived the music as enjoyable and seven did not. The percentages of normal slow wave, dominant frequency and dominant power did not differ significantly between baseline and during music intervention.
An analysis of covariance model that included the subjects' feelings about the music and dominant power showed significantly higher dominant power during music intervention in subjects who enjoyed the music. In the individuals who enjoyed the music, dominant power was significantly higher during music intervention than at baseline.
In the subjects who did not enjoy the music, dominant power was significantly lower during music intervention than at baseline. Listening to enjoyable music increases the amplitude of gastric myoelectrical activity in healthy humans.
Music therapy may improve gastric motility and may be used to stimulate gastric emptying.
Document Type: Research article
DOI: 10.1111/j.1742-1241.2006.01090.x
http://www.ingentaconnect.com/content/bsc/ijcp/2007/00000061/00000007/art00014
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WEDNESDAY, July 2 (HealthDay News) -- Researchers say they've taken a significant stride forward in understanding how relaxation techniques such as meditation, prayer and yoga improve health: by changing patterns of gene activity that affect how the body responds to stress.
The changes were seen both in long-term practitioners and in newer recruits, the scientists said.
"It's not all in your head," said Dr. Herbert Benson, president emeritus of the Benson-Henry Institute for Mind/Body Medicine at Massachusetts General Hospital and an associate professor of medicine at Harvard Medical School. "What we have found is that when you evoke the relaxation response, the very genes that are turned on or off by stress are turned the other way. The mind can actively turn on and turn off genes. The mind is not separated from the body."
One outside expert agreed.
"It's sort of like reverse thinking: If you can wreak havoc on yourself with lifestyle choices, for example, [in a way that] causes expression of latent genetic manifestations in the negative, then the reverse should hold true," said Dr. Gerry Leisman, director of the F.R. Carrick Institute for Clinical Ergonomics, Rehabilitation and Applied Neuroscience at Leeds Metropolitan University in the U.K.
"Biology is not entirely our destiny, so while there are things that give us risk factors, there's a lot of 'wiggle' in this," added Leisman, who is also a professor at the University of Haifa in Israel. "This paper is pointing that there is a technique that allows us to play with the wiggle."
Benson, a pioneer in the field of mind-body medicine, is co-senior author of the new study, which is published in the journal PLoS One.
Benson first described the relaxation response 35 years ago. Mind-body approaches that elicit the response include meditation, repetitive prayer, yoga, tai chi, breathing exercises, progressive muscle relaxation, biofeedback, guided imagery and Qi Gong.
"Previously, we had noted that there were scores of diseases that could be treated by eliciting the relaxation response -- everything from different kinds of pain, infertility, rheumatoid arthritis, insomnia," Benson said.
He believes that this study is the first comprehensive look at how mind states can affect gene expression. It also focuses on gene activity in healthy individuals.
Benson and his colleagues compared gene-expression patterns in 19 long-term practitioners, 19 healthy controls and 20 newcomers who underwent eight weeks of relaxation-response training.
More than 2,200 genes were activated differently in the long-time practitioners relative to the controls and 1,561 genes in the short-timers compared to the long-time practitioners. Some 433 of the differently activated genes were shared among short-term and long-term practitioners.
Further genetic analysis revealed changes in cellular metabolism, response to oxidative stress and other processes in both short- and long-term practitioners. All of these processes may contribute to cellular damage stemming from chronic stress.
Another expert had a mixed response to the findings.
Robert Schwartz, director of the Texas A&M Health Science Center's Institute of Biosciences and Technology in Houston, noted that the study was relatively small. He also wished that there had been more data on the levels of stress hormones within the control group, for comparison purposes.
However, Schwartz called the study "unique and very exciting. It demonstrates that all these techniques of relaxation response have a biofeedback mechanism that alters gene expression."
He pointed out that the researchers looked at blood cells, which consist largely of immune cells. "You're getting the response most probably in the immune cell population," Schwartz said.
"We all are under stress and have many manifestations of that stress," Benson added. "To adequately protect ourselves against stress, we should use an approach and a technique that we believe evokes the relaxation response 20 minutes, once a day."
http://www.everydayhealth.com/publicsite/news/view.aspx?id=617094&cen=&pd=2008/07/02
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BMC Complement Altern Med. 2008 Jul 24;8(1):46.
Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO.
van Tilburg MA, Palsson OS, Levy RL, Feld AD, Turner M, Drossman DA, Whitehead WE.
ABSTRACT: BACKGROUND: Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain.
METHODS: 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims.
RESULTS: CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription mediation were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice.
CONCLUSIONS: CAM is used by one-third of FBG patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.
PMID: 18652682 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/18652682?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
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Exercise may help people with irritable bowel
Reuters
NEW YORK (Reuters Health) - Regular exercise may relieve constipation in people who suffer from irritable bowel syndrome, according to a study in the International Journal of Sports Medicine.
Irritable bowel syndrome, or IBS, is a common disorder affecting up to 30 percent of the population by some estimates. Symptoms may include chronic abdominal pain, bloating, diarrhea, and constipation.
Studies involving healthy adults have shown that regular exercise can relieve constipation and feelings of bloating. Therefore, it seems "intuitively appealing" to encourage IBS sufferers to exercise regularly to find relief from these symptoms, the study team notes.
Regular exercise may relieve constipation in people who suffer from irritable bowel syndrome, according to a study
****To check out the notion, Dr. Amanda J. Daley of the University of Birmingham in the UK and colleagues recruited 56 adults (mostly women) with doctor-diagnosed IBS for a study lasting 12 weeks.
The participants were randomly assigned to usual care (i.e., a "control" group) or to an exercise program, consisting of two 40-minute one-on-one exercise consultations designed to provide exercise skills, knowledge, confidence and motivation -- the goal being 30 minutes of moderate intensity exercise 5 days a week.
The researchers chose this type of intervention, they say, because it has been found to boost exercise in other patient groups, and because it could be more easily integrated into current healthcare practice than supervised programs.
After 12 weeks, the exercise group chalked up significantly more weekly exercise than the control group and they reported significantly greater declines in symptoms of constipation.
The fact that this brief, pragmatic exercise intervention led to a significant increase in the amount of exercise IBS patients engaged in is "encouraging," Daley and her colleagues say, especially considering that people with IBS may avoid participating in exercise because of their abdominal symptoms.
This study, they conclude, highlights the possibility that exercise may be an effective way for people to manage their IBS symptoms, particularly constipation.
SOURCE: International Journal of Sports Medicine, September 2008.
© Reuters 2008
http://www.canada.com/topics/bodyandhealth/story.html?id=ca9e159f-f1a3-4016-98b3-9d110393acfb
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Yoga's stress reduction helps alleviate IBS
By SARAH AVERY
McClatchy Newspapers
The ancient practice of yoga is increasingly finding a new following — among doctors and medical researchers who are working to prove its benefits for a variety of illnesses.
Researchers at University of North Carolina Hospitals are studying yoga's benefits for people with irritable bowel syndrome. Doctors at Duke University in Durham, N.C., recently completed a study showing that yoga provided significant help for postmenopausal women with early breast cancer.
And in eastern North Carolina, an oncologist sees improvement in his patients who take yoga classes. He has written a book about the importance of mindfulness.
"There's been an explosion of data using yoga as a treatment option," said Shelley Wroth, an obstetrician at Duke Integrative Medicine and a yoga teacher. She said studies have found that yoga helps people suffering diseases such as hypertension, anxiety, arthritis, chronic back pain, carpal tunnel syndrome, fibromyalgia, stress, depression, diabetes and epilepsy — among others.
"It shows so much promise," Wroth said.
A recent study at Duke involved breast cancer patients who were experiencing severe hot flashes and other menopause symptoms. Because of their illness, they were prohibited from taking hormone replacement therapy, so yoga was proposed as an alternative. The study found significant improvement among the women in the study who took yoga classes, compared to another group of women who did not.
"There's a lot of reactions to stress that exacerbate the menopausal symptoms," said Laura Porter, co-author of the Duke study. "Yoga — the physical poses and the more cognitive aspects of it — dampens the stress reactivity."
But even as the science establishes yoga's benefits, less is known about why it is helpful. Porter and others postulate that the practice reduces stress through stretching poses, practiced breathing and meditation. For people battling illness, stress reduction may pack extra potency.
"A lot of our diseases have some sort of origins in stress and the stress reaction," said William Frey, who is leading a yoga class at Rex Healthcare in Raleigh, N.C., as part of a UNC-Chapel Hill study among patients with irritable bowel syndrome. "By taking care of stress, you're starting to eliminate some of the diseases that are caused by it."
Frey said he began offering yoga eight years ago through his university's Integrative Medicine program.
"There was some concern we might be bringing spiritual elements into a very clinical setting," Frey said. "Getting the word out was difficult — so much else was going on that was scientifically based, this was pushed off. But as people have seen its staying power, and see the results and research, there's beginning to be more respectability."
Yoga's legitimacy has increased with interest by the National Institutes of Health, which now funds studies on yoga and its effect on diseases. But some skepticism remains — in the medical profession and among patients.
Gioia O'Connell, a 54-year-old breast cancer survivor from Apex, N.C., said she wasn't sure that yoga would help her. Her main hesitation was that yoga stemmed from Eastern roots, and she worried it was incompatible with her Christian faith. Still, she signed up this summer as part of the study at Duke.
"I have to tell you, it was energizing," O'Connell said. After being diagnosed with cancer in 1994 and undergoing a lumpectomy, chemotherapy, radiation and rounds of daily drugs, she felt wrung out. "It helped with stiffness, aches and pains. And the breathing really did help my energy level. That's what I deal with, being a cancer survivor, the fatigue."
Sources: PubMed; Duke University
(Broken link removed)
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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
Edited by lctuscher (09/26/14 03:13 PM)
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BMC Complement Altern Med. 2008 Dec 19;8:65.
Treatments for irritable bowel syndrome: patients' attitudes and acceptability.
Harris LR, Roberts L.
Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
BACKGROUND: Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable.
METHODS: Six hundred and forty-five participants identified from an earlier IBS-prevalence study received a postal questionnaire to evaluate preferences and acceptability of nine forms of treatment. Proportions accepting each form of treatment were calculated and thematic analysis of qualitative data undertaken.
RESULTS: A total of 256 (39.7%) of 645 potential respondents completed the questionnaire (mean age 55.9 years, 73% female). Tablets were most acceptable (84%), followed by lifestyle changes (diet (82%), yoga (77%)). Acupuncture (59%) and suppositories (57%) were less acceptable. When explaining lack of acceptability, patient views fell into four broad categories: dislike treatment modality, do not perceive benefit, general barriers and insufficient knowledge. Scepticism, lack of scientific rationale and fear of CAM were mentioned, although others expressed a dislike of conventional medical treatments. Past experiences, age and health concerns, and need for proof of efficacy were reported.
CONCLUSION: Most patients were willing to accept various forms of treatment. However, the reservations expressed by this patient-population must be recognised with particular focus directed towards allaying fears and misconceptions, seeking further evidence base for certain therapies and incorporating physician support and advice.
PMID: 19099570 [PubMed - indexed for MEDLINE]
PMCID: PMC2633319
http://www.ncbi.nlm.nih.gov/pubmed/19099570?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
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