Acupuncture for constipation?
A recent editorial in the Annals of Palliative Medicine discusses the results of acupuncture for constipation, and considers why it provides lasting relief. 536 patients participated in the largest study discussed. The average improvement of bowel movements was from 0.4 per week to 2.6. This effect remained at a 12 week follow-up.
The results were controlled against placebo ‘acupuncture’, which only improved regularity to 1.3 movements a week. Most patients with constipation receive laxatives, but 50% of patients are unhappy with these and they can also result in a variety of side-effects. No side-effects were seen with acupuncture.
How does it work?
Studies suggest that acupuncture relieves constipation due to changes it induces in the nervous system. The main reason constipation occurs is a reduction in colonic motility. This happens, essentially, when long-term stress alters the nervous system function.
Our stress response is coordinated by the sympathetic nervous system which sends blood to the skeletal muscles for a fight or flight response. Meanwhile the parasympathetic nervous system is responsible for the ‘rest and digest’ functions and sends blood to the organs and corresponding muscles. Overstimulating the sympathetic nervous system therefore leaves less energy for the organs to do their work, including the colon. Different regions of the brain control these functions.
The researchers found that stimulating certain acupoints can alter the way that the nervous system is firing. This changes what the brain releases. The area of the brain most related to colonic motility is Barrington’s nucleus. Under chronic stress this area’s activity reduces, preventing the parasympathetic nervous system from stimulating the colon. Acupuncture stimulates the parasympathetic nervous system all the way up to Barrington’s nucleus. This results in enhanced bowel movements as well as calming stress. These effects can become normalised over a short course of acupuncture treatments.
From a Chinese medical point of view, I spend time getting to know each individual person’s case before choosing the treatment strategy for any condition. Chinese medicine offers a number of different reasons for reduced gut motility. It can relate to inflammation and stress, which Chinese medicine defines as heat, chronic or acute. Or it can be due to cold, digestive weakness, kidney deficiency or liver qi stagnation. All of these situations would warrant a different set of acupoints and dietary and lifestyle guidelines.
When using acupuncture for constipation, I always use some local points near the site of the symptoms. I also use some distal points that relate more to the underlying cause of the issue.
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