Acupuncture irritable bowel syndrome (IBS) therapy for a more predictable and happier bowel
There is moderate level evidence supporting the use of acupuncture for the relief of symptoms associated with acupuncture irritable bowel syndrome (IBS).
What is irritable bowel syndrome (IBS)?
Irritable bowel syndrome in characterised by unpredictable and often debilitating fluctuations in bowel habits.
Many describe irritable bowel syndrome as alternating bouts of diarrhoea and constipation which may be accompanied by moderate to severe bowel pain.
For some, irritable bowel syndrome is not associated with alternating constipation and diarrhoea. These people may describe their irritable bowel syndrome as being ‘constipation dominant’ or ‘diarrhoea dominant’.
For some, they may move their bowels irregularly (constipation) but when they do they find the stool loose and watery.
Irritable bowel syndrome is often made worse for stress and may also be aggravated by certain food types.
Those living with irritable bowel syndrome, who haven’t consulted with their doctor, are well advised to do so as what is understood to be irritable bowel syndrome may sometimes be something else like Coeliac’s disease (as the signs and symptoms are similar).
What is the history behind acupuncture irritable bowel syndrome therapy?
There is a long history of acupuncture irritable bowel syndrome (IBS).
The concept of a ‘syndrome’ (as discussed below) is a biomedical concept which did not exist in the times when the great acupuncture treatises were being written.
Instead, in Chinese medicine, irritable bowel syndrome is broken down into its constituent parts, being:
- diarrhoea or loose stool
- constipation or hard stool
- alternating diarrhoea or constipation
- other gastro-intestinal upset
Historically, the treatment approach to acupuncture irritable bowel syndrome (IBS) would be guided by the prevailing signs and symptoms.
There is a long tradition of the use of acupuncture in the treatment of IBS, also herbal medicine and appropriate dietary and lifestyle modifications.
From a ‘western’/biomedical perspective, what is irritable bowel syndrome and how is it classified or diagnosed?
In medical terminology, a syndrome is:
- a collection of signs and symptoms, sometimes random and sometimes highly correlated, associated with disease or disorders of the body
- often diagnosed by way of exclusion (which means everything else is eliminated as a cause and what’s left is the syndrome).
The first step towards diagnosis will likely involve a detailed case history. This history may cover:
- presentation of signs and symptoms
- perhaps abdominal palpation
Further diagnostic measures may be taken to eliminate other causes of disease. These may include:
- scans and other radiography of your digestive organs and digestive tract
- blood work to check for markers associated with allergy or inflammation
- stool sample (to check for parasites)
- gastroscopy or colonoscopy
How does the acupuncture and Chinese medicine practitioner approach acupuncture irritable bowel syndrome (IBS) therapy?
The great skill of the Chinese medicine diagnostic model is its heavy reliance on signs and symptoms and developing a line of questioning to help the practitioner uncover the cause of disease.
Chinese medicine trained acupuncturists study the mechanisms of digestion from both a biomedical and Chinese medicine point of view. In Chinese medicine, bowel function is a part of digestion.
When acupuncturists and Chinese medicine practitioners, like Peter Kington Brisbane acupuncture practitioner, diagnose they do so from a Chinese medicine diagnostic framework.
The acupuncture Chinese medicine diagnostic framework will seek to establish a timeline of events and context of the signs and symptoms. The purpose of these questions is to:
- history of your IBS: this will cover when your symptoms started and how you’ve noticed, if at all, they have changed over time
- nature of your IBS: articulate and understand your unique presentation of irritable bowel syndrome by careful notation of your signs and symptoms
- triggers for your IBS: is there something which triggers your IBS? Sometimes certain foods may upset your stomach (especially grains, some fruits or dairy). Another common trigger for IBS is stress. Stress comes in many forms and might be physical stress (working long hours) or emotional stress (this could be sudden or chronic)
- progression of symptoms: do you notice a common pattern to the progression of your signs and symptoms. For example, your IBS may be triggered by stress which is followed by a headache which is followed by explosive diarrhoea. Your acupuncture irritable bowel syndrome (IBS) practitioner will be keen to discuss any such symptomatic patterns.
Acupuncturists will also palpate your abdomen and look for tender spots on your arms and legs (utilising the network of acupuncture channels).
Will the acupuncture and Chinese herbal medicine practitioner only ask questions about my irritable bowel syndrome (IBS)?
Chinese medicine is a holistic model of medicine.
As a holistic model of medicine it firmly places your main complaint which, in this instance is IBS, firmly in the centre of your diagnosis
After asking detailed questions about your irritable bowel, your practitioner will be quietly building a picture in their mind of what might be happening in your body to allow for these signs and symptoms.
Acupuncturists love patterns of signs and symptoms and in these early questionings they will be looking for a pattern of signs and symptoms that is unique to you.
They will then go looking elsewhere in your body for similar patterns of signs and symptoms. This process is called verifying the diagnosis.
Questions may relate to menstrual habits (for women), sleep, headaches, skin conditions or your ability to resist a cold or flu.
The diagnosis, in this instance, is the Chinese medicine diagnosis. The Chinese medicine diagnosis is unique to the practice of acupuncture and Chinese medicine.
What happens once all this information has been gathered (the Chinese medicine diagnosis)?
The Chinese medicine diagnosis is unique to the practice of acupuncture and Chinese medicine.
The Chinese medicine diagnosis is only arrived at, by the practitioner, after the careful analysis of signs and symptoms.
The Chinese medicine diagnosis is unique to the individual. If three people presented with ‘irritable bowel syndrome’, their patterns of symptoms would be all different and so would their Chinese medicine diagnoses.
Because of the uniqueness of the Chinese medicine diagnosis, treatment is customised to the individual – meaning different people, all with IBS, will receive different acupuncture and different herbs or different lifestyle and dietary advice.
The important thing to remember is that the Chinese medicine diagnosis NEVER replaces your medical diagnosis. While the medical diagnosis will be of interest to the acupuncture irritable bowel syndrome (IBS) practitioner, it is not essential.
The purpose of the Chinese medicine diagnosis is to provide an anchor from which a principle of treatment is built and then a treatment plan is created.
What evidence is there to support acupuncture irritable bowel syndrome (IBS) therapy?
Contained within this evidence review are evidence summaries of systematic reviews and other ‘level I’ forms of evidence.
The Acupuncture Evidence Project lists the evidence for the use of acupuncture irritable bowel syndrome (IBS) therapy as potential positive (based on moderate evidence).
Two recent studies paint divergent pictures.
One 2012 systematic 2 concluded the evidence for acupuncture irritable bowel syndrome therapy was of low to moderate quality which made the evidence insufficient.
A more recent follow up randomised controlled trial (2016) 3 concluded acupuncture irritable bowel syndrome (IBS) therapy to be superior to usual care, based on a symptom severity score.
The study tracked participants’ symptoms at six, nine and twelve monthly intervals (after the completion of treatment) – all of which demonstrated a high rate of ongoing symptom relief.
A further check at twenty-four months did not demonstrate this.
A word about the importance of diet and lifestyle modification for those with irritable bowel syndrome (IBS).
Where certain food triggers are associated with irritable bowel syndrome, dietary and lifestyle changes (for example, increasing exercise or managing stress) may be offered as a way of helping support your acupuncture irritable bowel syndrome therapy.
Any changes will be discussed in your initial or subsequent consultation.
I feel as though I need to know a little more about understanding evidence.
For those not familiar with it, interpreting evidence can be daunting and confusing.
There is an extensive discussion around the use of evidence in supporting acupuncture over on this FAQ page.
What if my condition isn’t listed on this page?
All that means is that there hasn’t been enough research to officially say, “yep it helps”. Before deciding whether acupuncture irritable bowel syndrome (IBS) therapy is for you, feel free to give Peter a call to chat about your individual circumstances and his experience or knowledge of your problem
Ready to book your first consultation?
Peter Kington, Brisbane acupuncture practitioner, offers a range of days and appointment times for your first and follow-up consultations. Call (07) 3367 1150 or contact Peter here and he or an associate will call you back, have a quick chat about your needs and find a mutually convenient time for your first appointment.
- MacDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (revised evition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. [accessed 21 February, 2018.
- Manheimer E, Wieland LS, Cheng K, Li SM, Shen X, Berman BM, et al. Acupuncture for irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2012 Jun;107(6):835-47; quiz 48.
- MacPherson H, Tilbrook H, Agbedjro D, Buckley H, Hewitt C, Frost C. Acupuncture for irritable bowel syndrome: 2-year follow-up of a randomised controlled trial. Acupunct Med. 2016 Mar 15