ACUPUNCTURE AND IBS

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                                  Acupuncture for IBS
             A presentation by Beth Bennett and Anna McGhee, 28 April 2009
                 Student Practitioners, College of Traditional Acupuncture
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What is IBS?                                      What can acupuncture do for IBS?

IBS is a disorder which interferes with the       Acupuncture is holistic in nature, meaning
normal functioning of the bowel. There are        that the whole person is treated in sickness
several theories as to its cause, including       and in health. Health is considered to be a
hypersensitivity of the nerves or muscles of      state of harmony and balance, while disease
the intestinal wall, food intolerance, and        occurs when that energetic flow is disturbed
infection and bacteria in the gut.                or blocked. Because we treat each person
                                                  as an individual, the treatment that we give is
IBS affects up to 1:5 of the population, is       specific to that person, not just to their
more common in women than men, and                illness.
most often begins in young people aged
between 20-30 years old. It may come and go       In Five Element acupuncture, we consider
throughout life and is frequently triggered by    that person has a major imbalance within
major life changes, difficult or stressful        them that corresponds to one of the Five
situations. About half of all sufferers relate    Elements and is called our "Causative
the start of their symptoms to a particularly     Factor”. We concentrate on finding this
stressful event in their lives.                   fundamental imbalance, and treating it
                                                  directly to get to the root of any disorders.
Main symptoms include: abdominal pain;
diarrhoea, constipation (possibly alternating);   Because of this, patients with similar
bloated feeling; urgent need to empty the         symptoms may be treated on very different
bowel. Other symptoms may include:                points according to their Causative Factor.
headache, tiredness, nausea, heartburn,           These could be on the arms, legs, body or
urinary symptoms, anxiety and depression.         face, using very fine needles. Most patients
                                                  report feeling relaxed after treatment.
IBS must always be diagnosed by a doctor in
order to rule out other illnesses such as         Acupuncture’s great strength is that it works
inflammatory bowel disease or bowel cancer.       on addressing the energy imbalances which
                                                  cause our symptoms and gets them moving
At present there is no cure, but symptoms         again. This can have great benefits for our
can be eased for some with treatment              bodies but also our minds and spirits. This
including: diet and lifestyle changes, anti-      can result in an overall improvement in
spasmodics and anti-diarrhoeal medicines;         physical and emotional well-being and a
laxatives;    probiotics;    anti-depressants;    reduction in IBS symptoms.
relaxation techniques or cognitive behaviour
therapy.
What does the research say?                        Acupuncture ‘in the real world’

If you have ever looked into the research on       The practitioners we have surveyed have all
acupuncture for IBS, you may well have been        told us that they seldom see patients coming
confused. In the past decade or so, there          to them with IBS as their main complaint. It
have been a number of research trials, but         seems that it is a condition that many people
unfortunately the majority of them do not          ‘live with’, so it is usually reported as a
bear up to close scrutiny, and are not all         secondary symptom.
conclusive (Lim et al 2006, Schneider at al
2007b)                                             We are told that in the vast majority of
                                                   cases, patients have responded positively to
Trials have tended to have a small number of       treatment – either a reduction in the severity
participants – from as few as 7 (Chan 1997),       of symptoms, or the clearing up of symptoms
to around 40 to 60 (Schneider et al 2006,          altogether. Some of the success stories are:
Fireman et al 2001), so it would be difficult to
generalise the results.                            ‘M’ came in the early stages of pregnancy, had always had
                                                   some degree of IBS, but after the birth of her child it had
                                                   become loads worse. She was having to avoid anything
In others, the treatment given was not the         fried or creamy and couldn’t eat runny eggs. After
sort of individualised acupuncture treatment       treatment, the difference was dramatic. She could eat
you would receive in real life. For instance,      runny eggs and even came back to say that she’d had
one trial treated 25 people using only a single    cheese cake and extra cream with no side effects.
acupuncture point (Fireman et al 2001).
                                                   ‘B’ had been passing stools only every fortnight for as long
                                                   as she could remember. After three treatments she was
There is the additional confusion of the           going 2-3 times a week. She was over the moon.
placebo effect. Trials can show improvements
to both those treated with ‘real’                  ‘A’ came to have acupuncture for arthritis in her hands.
acupuncture, and those treated by the              She also had IBS which she controlled with a strict diet.
                                                   The acupuncture sorted her arthritis, but it also enabled
insertion of needles into non-acupuncture          her to eat anything (particularly wheat) without getting any
points, or by retractable needles that do not      symptoms.
puncture the skin. (Fireman et al 2001,
Forbes et al 2005, Schneider at al 2006).          ‘N’ is a 14 year old boy, whose IBS and depression was
Further research into this has suggested that      triggered by bullying at school. Acupuncture helped abate
                                                   his symptoms and allow him to continue his studies, build
the placebo effect can be mainly attributed to     new friendships, and eat a greater variety of foods.
the patient-practitioner relationship, which is
of great importance in acupuncture                 ‘S’ presented with such severe bowel dysfunction that she
treatment (Kaptchuk et al 2008). On a              had to take a bucket with her in the car (since a car
physical level, a study has shown that ‘real’      accident several years before). After four treatments, no
                                                   more bucket.
acupuncture produces a measurable effect on
the autonomic nervous system, while ‘false’
acupuncture does not (Schneider at al              How can I find an acupuncturist?
2007a).
                                                   Contact the British Acupuncture Council:
However, there has been a more recent              63 Jeddo Road, London W12 9HQ
small-scale exploratory trial which takes a        tel: 020 8735 0400
more ‘real life’ approach and has compared         www.acupuncture.org.uk
acupuncture treatment for IBS to usual GP
care. In this case, acupuncture has produced
significantly better results in improving          If you would like to know any more
symptoms (Reynolds et al 2008). These              about acupuncture and IBS, please feel
results will hopefully be confirmed by a           free to call us on 07713 604095 (Beth)
future full-scale trial.                           or 07941 045295 (Anna)
Useful general reading on acupuncture

Hicks A (2005) The Acupuncture Handbook London: Piatkus
Mole P (1997) Acupuncture: energy balancing for body, mind and spirit Shaftesbury: Element Books
Trevelyan J (2004) Understanding Acupuncture Lydney: First Stone Publishing


                                                   REFERENCES
IBS information

BBC Health (no date) Irritable Bowel Syndrome available at www.bbc.co.uk/1/hi/health/ medicalnotes/5306656.stm
(accessed 06/02/09)

British Acupuncture Council (2008), Online Patient Survey 2008, available at
http://www.acupuncture.org.uk/student/articles/survey.asp (accessed 28/02/09)

The Gut Trust (no date) Irritable Bowel Syndrome available at http://www.theguttrust.org/education
(accessed 20/01/09)

NICE clinical guidelines (2008) Irritable Bowel Syndrome available at http://www.nice.org.uk/
nicemedia/pdf/CG61IBSUNGv3.pdf (accessed 20/01/09)

Patient.co.uk (no date) Irritable Bowel Syndrome available at http://www.patient.co.uk/ showdoc/23068776/ (accessed
04/02/09)

Research Papers

Chan J, Carr I, Mayberry J (1997) The role of acupuncture in the treatment of irritable bowel syndrome: a pilot study
Hepatogastroenterology 44(17) 1328-30

Fireman Z, Segal A, Kopelman Y, Sternberg A, Carasso R (2001) Acupuncture treatment for irritable bowel syndrome.
A double-blind controlled study Digestion 64(2) 100-3

Forbes A, Jackson S, Walter C, Quraishi S, Jacyna M and Pitcher M (2005) Acupuncture for irritable bowel syndrome:
A blinded placebo-controlled trial World Journal of Gastroenterology 11 (26): 4040-4

Harris L and Roberts L (2008) Treatments for irritable bowel syndrome: patients’ attitudes and acceptability BMC
Complementary and Alternative Medicine 8:65

Kaptchuk T, Kelley J, Conboy L, Davis R, Kerr C, Jacobson E, Kirsch I, Schyner R, Nam B, Nguyen L, Park M, Rivers A,
McManus C, Kokkotou E, Drossman D, Goldman P and Lembo A (2008) Components of placebo effect: randomised
controlled trial in patients with irritable bowel syndrome BMJ 336: 999-1003

Lim B, Manheimer E, Lao L, Ziea E, Wisniewski J, Liu J, Berman B (2006) Acupuncture for treatment of irritable bowel
syndrome Cochrane Database Systematic Review Oct 18 (4)

Reynolds J, Bland J, MacPherson H (2008) Acupuncture for irritable bowel syndrome – an exploratory randomised
controlled trial Acupuncture in Medicine 26 (1): 8-16

Schneider A, Enck P, Streitberger K, Weiland C, Bagheri S, Witte S, Friederich H C, Herzog W, Zipfel S (2006)
Acupuncture treatment in irritable bowel syndrome Gut 55 (5): 649-654 [abstract]

Schneider A, Weiland C, Enck P, Joos S, Streitberger K, Maser-Gluth C, Zipfel S, Bagheri S, Herzog W, Friederich H C
(2007a) Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome
Complementary Therapies in Medicine 15: 255-263

Schneider A, Streitberger K, Joos S (2007b) Acupuncture treatment in gastrointestinal diseases: a systematic review
World Journal of Gastroenterology 13 (25): 3417-24

Thompson W et al (2000) Irritable bowel syndrome in general practice: prevalence, characteristics, referral Gut 46:78-
82 (cited in Harris and Roberts 2008)