Irritable Bowel Syndrome

New research concludes that acupuncture is effective for the treatment of IBS, irritable bowel syndrome. IBS is characterized by chronic episodes of abdominal cramping and pain with diarrhea and/or constipation. The meta-analysis concludes, “Acupuncture exhibits clinically and statistically significant control of IBS symptoms.”

Published in the World Journal of Gastroenterology, the study investigated all types of IBS: diarrhea predominant, constipation predominant and alternating. A total of 64 research papers were found on acupuncture for the treatment of IBS. The researchers used strict controls and study designs and sorted for “randomization, concealment of allocation, double blinding, and dropouts.” A total of 6 studies met the methodological quality required for trial inclusion. The researchers noted “our meta-analysis of six randomized controlled trials suggests that acupuncture improves the symptoms of IBS, including abdominal pain and distension, sensation of incomplete defecation, times of defecation per day, and state of stool.”

The researchers concluded that acupuncture is both safe and effective. They noted, “No serious adverse events associated with acupuncture were reported in the articles.” Additionally, the researchers investigated the mechanisms by which acupuncture produces positive clinical outcomes for patients with IBS. One study “showed that improvement in pain in IBS was positively associated with increased parasympathetic tone in the acupuncture group.”

One of the studies reviewed in the meta-analysis was conducted at the University of York and published in BMC Gastroenterology. This two-arm randomized controlled trial consisted of 233 patients that had been suffering from IBS for an average duration of 13 years. A total of 116 patients received acupuncture and conventional care and 117 patients received only conventional medical care. The acupuncture group received 10 weekly acupuncture treatments.

The group receiving acupuncture combined with conventional medicine had an increase of 18% in positive clinical outcomes. This benefit was confirmed at this percentage at 6, 9 and 12 months. The researchers concluded, “Acupuncture for irritable bowel syndrome provided an additional benefit over usual care alone. The magnitude of the effect was sustained over the longer term. Acupuncture should be considered as a treatment option to be offered in primary care alongside other evidenced based treatments.”

The researchers uncovered an important clinical trend. They found that patients showing improvements from acupuncture for IBS at 3 months were likely to have sustained improvement at 12 months. They concluded, “In a rigorously conducted pragmatic randomised controlled trial, we have evaluated the effectiveness of acupuncture as a treatment for irritable bowel syndrome when offered as an adjunct to usual treatment in primary care. Acupuncture was found to significantly improve outcomes at three months, with the number needed to treat being six. We found some evidence of a sustained benefit over the longer term. Acupuncture should be considered as a potential treatment option in primary care alongside other evidence-based treatments.”

Chao, Guan-Qun, and Shuo Zhang. “Effectiveness of acupuncture to treat irritable bowel syndrome: A meta-analysis.” World J Gastroenterol 20, no. 7 (2014): 1871-1877.

MacPherson H, Tilbrook H, Bland JM, Bloor K, Brabyn S, Cox H, Kang’ombe AR, Man MS, Stuardi T, Torgerson D, Watt I, Whorwell P. Acupuncture for irritable bowel syndrome: primary care based pragmatic randomised controlled trial. BMC Gastroenterol 2012; 12: 150 [PMID: 23095376 DOI: 10.1186/1471-230X-12-150].