Acupuncture and IBS in MK

IBS: Chinese Acupuncture and Herbs are more effective than Drug Therapy

I am not sure if you have recently followed an outstanding BBC programme called “Doctor without Drugs.” I suspect it will cause some controversy but to see how this young Doctor managed to wean patients off drugs and expose how the pharmaceutical industry promotes their drug prescriptions in GP surgeries was a true eye-opener.

I would like to share a new study that compares drugs with acupuncture and herbal treatment for Irritable Bowel Syndrome (IBS).

Researchers compared two groups, one received acupuncture and herbal medicine and the other received drug therapy. The group receiving acupuncture and herbs had superior positive patient outcome rates. Acupuncture and herbs produced clinical outcomes yielding greater improvements in stool consistency and significantly greater reductions of abdominal pain, mucus in the stool, bloating, and bowel urgency.

At the Chongqing Hospital, researchers started with a sample size of 126 human patients with IBS. The patients were randomly divided into the acupuncture plus herbs group and the drug group, with a total of 63 patients in each group. For both groups, there were improvements in abdominal pain and discomfort scores. However, the acupuncture plus herbs group demonstrated significantly greater clinical improvements. In addition, the group receiving acupuncture plus herbs had greater reductions of anxiety levels and behavioural disorders. The data indicates that the acupuncture plus herbs group had significant improvements in general psychological well-being and overall perceived energy levels. 

IBS affects the large intestine and involves cramping, distention, diarrhoea or constipation, and abdominal pain. Often, there is mucus in the stool and the condition is chronic. Exacerbating factors include specific foods, hormonal changes, stress, and secondary illnesses. IBS tends to occur in younger patients and the rate is double for women. IBS, when presenting as a long-standing illness, often involves dietary restrictions and accidental malnourishment caused by an attempt to avoid exacerbating foods. The long-standing nature of the illness may also contribute to mental depression. Two major types of diagnostic criteria define IBS, the Rome criteria and the Manning criteria.

For the Rome criteria, one important parameter is that abdominal pain lasts for a minimum of 3 days per month and involves at least two of the following: decreased pain after defecation, changes in the frequency of defecation, and changes in the consistency of stool. The Manning criteria includes pain relieved by defecation but also takes into account mucus in stool, incomplete bowel movements, and variability of stool consistency. An MD may order a colonoscopy, sigmoidoscopy, lower GI series (liquid barium X-ray), or CT scan to confirm the diagnosis.

All participants and procedures were approved by the Chongqing Nanchuan Hospital medical ethics committee. All participants were volunteers with a diagnosis of IBS. All participants had prerequisite abdominal pain and abnormal defecation frequencies. No participants were admitted to the study groups that had taken medications within three months prior to the investigation. Exclusion criteria involved several other parameters: mental illness, low blood pressure, and history of abdominal surgery.

The sample size involved 67 males and 59 females, with an average age of 55 years. The average duration of IBS per patient was 31 years. After randomization into the two groups, there were no significant differences in terms of age, gender, and course of IBS duration.

The group receiving drug therapy was administered loperamide hydrochloride capsules (1 tablet, 3 times per day), 30 minutes before meals. In addition, they received 9 g of Si Shen Wan, two times per day. Loperamide hydrochloride (trade name IMODIUM) is used to control diarrhoea. Functionally, loperamide hydrochloride slows bowel movements to achieve its effective action. The drug may cause drowsiness, fatigue, or dizziness and is not recommended for breastfeeding mothers because the drug is transferred through the milk. In this acupuncture continuing education study, the group received acupuncture plus herbal medicine.

Dietary modifications for all patients in both groups included the following recommendations:

• No raw, cold, or spicy food
• Regulate consumption of food to moderate levels of intake
• Regular meals consumed at regular intervals, 3 times per day
• Non-oily, light foods that are easily digested are appropriate
• Non-oily, light, and easily digested foods are appropriate

Several important findings were made. The acupuncture plus herbal medicine group had greater positive patient outcomes. In addition, the relapse rate was lower in the acupuncture plus herbs group than in the drug group. The results indicate that acupuncture, herbs, and continuing patient education on dietary modifications is an effective integrative approach to patient care for patients with IBS.

References:
Zhang Yousheng, Zhang Xiaodong, Investigation of the Effect on Treatment of Irritable Bowel Syndrome with Traditional Chinese Medicine and Acupuncture, Chongqing Nanchuan Hospital, 2016.

Sun YZ & Song J. (2014). Therapeutic Observation of Acupuncture at Jiaji (EX-B2) for Irritable Bowel Syndrome. Shanghai Journal of Acupuncture and Moxibustion. 34(9).

Zhongguo Zhen Jiu. 2012 Oct;32(10):957-60. [Meta analysis of acupuncture-moxibustion in treatment of irritable bowel syndrome]. Pei LX, Zhang XC, Sun JH, Geng H, Wu XL. Acupuncture and Rehabilitation Department, Jiangsu Province Hospital of TCM, Nanjing, China.

JAMA. 1998 Nov 11;280(18):1585-9. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Research Unit for Complementary Medicine, University of Western Sydney Macarthur, Campbelltown, New South Wales, Australia.

Liu, Xiao-xia. “Moxibustion on Shenque (CV 8) improves the effect of acupuncture for diarrhea-predominant irritable bowel syndrome.” Journal of Acupuncture and Tuina Science 12, no. 6 (2014): 362-365.