Irritable bowel syndrome (IBS) is functional disorder of digestive system, commonly including abdominal cramps, bloating, diarrhoea and constipation. The condition often begins when a person is between 20-30 years of age. Women are more likely to develop IBS and often suffer more symptoms during their periods. Around 20% of people in the UK are affected by IBS. It is the most common functional digestive condition seen by GPs. Because it is typically a chronic and recurrent disorder the cost in terms of social, economic and health care utilization is substantial.
The cause of IBS is unclear. Approximately 50% people with IBS can relate the start of symptoms to the stressful event. IBS symptoms tend to get worse during time of stress or anxiety. It is believed that hypersensitivity of sensory nerve in gut, infection in gut and intolerance of certain foods play important roles in the IBS. Reducing stress and anxiety, regular exercise, healthy diet and lifestyle tend to relieve IBS symptoms. Medications are necessary for some people with IBS to alleviate the symptoms; however, sometimes treatments are unsatisfactory.
Acupuncture is a modality by stimulating specific acupoints to rebalance the functions of many body systems such as immune system, endocrine systems and many more. It’s one treatment of multiple targets led acupuncture being used to treat various conditions at the same time. Recently acupuncture has been used to treat IBS. The following is the briefing of effect of acupuncture on IBS.
- Acupuncture is an effective therapy for irritable bowel syndrome
Acupuncture is used to treat IBS in many countries including UK and its clinical efficacy of relieving symptoms in IBS was investigated. Macpherson et al., (2012) conducted an open pragmatic randomized controlled clinical trial. Patients with IBS (n=233), with average duration of 13 years were recruited and divided into two groups. 116 patients with IBS were given 10 weekly individualized acupuncture sessions, while 117 patients without acupuncture treatment as control group. The study showed that there was a significant reduction in IBS symptom severity score in patients within acupuncture group compared with control group by the end of treatment. The benefits of acupuncture lasted for further 9 months when the follow up tests were carried out at 6, 9 and 12 months. This study provides strong evidence suggesting acupuncture is very effective in treating IBS.
In their 24-month follow up study (Macpherson et al., 2016), the overall response rate was 61%. The adjusted difference in mean IBS SSS at 24 months was −18.28 (95% CI −40.95 to 4.40) in favour of the acupuncture arm. However, no statistical significant difference of IBS Symptom Severity Scores was found between acupuncture group and usual care group at 24-month. They suggested that this may be, at least in part, linked with the progressive improvement reported within the usual care group.
The follow up study also found a statistically significant difference favouring acupuncture at 12-month, which was only shown a statistical tendency in the previous report. Further, authors suggested that sustainable therapeutic effects between the ends of treatment at 3 months through 24 month indicated that obvious benefits of acupuncture represented more than a simple placebo response.
- Catgut embedding acupuncture significantly improves irritable bowel syndrome
Catgut embedding, a special type of acupuncture technique markedly relived the symptoms of irritable bowel syndrome (IBS), according to a report recently published in the Journal of Research in Medical Sciences.
Catgut is a type of cord that is made from the natural fibres in the wall of goat or sheep intestines. Catgut is embedded on the acupoints for 7-10 days. It exerts continuous stimulation on the acupoint and enhances and prolongs its therapeutic effect. It is believed that catgut embedding acupuncture can improve body immune function, promote metabolism and is used to treat many conditions including body weight loss.
Rafiei et al., (2014) carried out a double blinded randomized clinical study to assess the effect of catgut embedding acupuncture on the patients with IBS. Sixty patients with IBS were recruited for the study and randomly divided into 3 groups. Real acupuncture group, catgut embedded on acupoints UB17, UB23, UB25. DU3, SP9, SP15, ST25, ST36, Ren12, and 4 and Kid15. Sham group, catgut embedded on sham acupoints GB26, SP8, 1 inch ST25, UB22, and Ren5. Medication control group. IBS symptoms such as pain, abdominal bloating, diarrhoea and constipation were assessed prior to and after the treatment. Following 2-week treatment, patients in real catgut embedded acupuncture group reported a significant improvement in all symptoms compared with sham acupuncture and medication group. In addition, patients in real acupuncture group showed an average 2 kg weight loss. The study provided evidence that catgut embedded acupuncture is effective in treating patients with IBS.
- H Macpherson et al., (2012) BMC Gastroenterology. 12:150. http://www.ncbi.nlm.nih.gov/pubmed/23095376
- MacPherson H et al., Acupuncture for irritable bowel syndrome: 2-year follow-up of a randomised controlled trial. Acupunct Med. 2016 Mar 15. pii: acupmed-2015-010854. doi: 10.1136/acupmed-2015-010854. http://aim.bmj.com/content/early/2016/03/15/acupmed-2015-010854.abstract
- Rafiei R et al., A new acupuncture method for management of irritable bowel syndrome: A randomized double blind clinical trial. J Res Med Sci. Oct 2014; 19(10): 913–917. http://www.ncbi.nlm.nih.gov/pubmed/25538771
- Grateful acknowledgements are due to Drs MacPherson H and Rafiei R and colleagues (This paper was based on their articles cited in above Reference section), as well as to Dr. Bai-Yun Zeng for his work in preparing this briefing paper.