Current Evidence Regarding Conventional Drug Therapy and Acupuncture for the Management of IBS
Current drug therapy has been shown to be of limited benefit and to carry potential risks.[9, 10] In addition, a low level of patient satisfaction with care received from primary care physicians has been found among IBS patients. Consequently, almost 50% of IBS patients turn to acupuncture and other complementary and alternative medicine (CAM) therapies.
Acupuncture has traditionally been utilized for the treatment of a variety of digestive complaints. Research studies have suggested that acupuncture may be effective for certain cases of nausea, vomiting, gastroesophageal reflux disease, functional dyspepsia, bloating, abdominal pain, diarrhea, and constipation.[13, 14] Digestive symptoms could improve after acupuncture treatment partly because acupuncture affects the motility and perception of the digestive organs. Laboratory research using rats[15-19] and dogs demonstrated that acupuncture stimulation significantly impacted gastrointestinal motility and visceral perception, both of which are closely associated with the development of IBS symptoms. Laboratory studies on rats also indicated that acupuncture stimulation on lower limbs (e.g., on the ST36 point) elicits gastric motility via vagal efferents, while acupuncture stimulation on the abdomen (e.g., on the ST25 point) inhibits gastric motility via sympathetic efferents.[18, 19, 21]
Clinical trials on IBS patients, however, have shown mixed results. The 2006 Cochrane Collaboration Systematic Review concluded that current evidence regarding the effectiveness of acupuncture for treating IBS is inconclusive. Further rigorous clinical studies using adequate experimental design are certainly needed. However, compromised standardized acupuncture protocols that involve simply inserting needles into preselected points (often employed by previous clinical trials on acupuncture) are less likely to provide measurable benefits for the majority of IBS patients.
IBS is considered by gastroenterologists to be a “difficult” condition with significant psychological components. Carefully designed, individualized, and comprehensive acupuncture programs will likely be needed to provide profound clinical benefits for many IBS patients.
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