Acupuncture and the Treatment of Constipation

A Recent Study Shows Acupuncture Effective in the Treatment of Chronic Constipation. It's estimated that 16% of Americans struggle with chronic functional constipation. This type of constipation has no clear structural cause. Because of this, treatments available from western medicine are few, and mainly limited to laxatives. Unfortunately, the symptoms return as soon as the laxative wears off, without creating any long term creative effects. This study from the Annals of Internal Medicine from September of 2016 evaluated the efficacy of acupuncture in the treatment of this type of constipation. Having successfully treated a number of patients with this symptom over the years in my practice I can attest to the efficacy of acupuncture in this case, however the solid data in this study offer a welcomed reminder to try this effective, safe, and underutilized therapy.


The Study:
This was a very good study for a lot of reasons. First, it was published in a reputable, peer reviewed journal, The Annals of Internal Medicine. Secondly, this was a very highly powered study, meaning the way the study was designed and run made it statistically extremely unlikely that the results were from chance. One of the things contributing to its statistical power was the fact that this study consisted of a great number of patients, a total of 1075 in all, spread out over 15 hospitals in China. The study was also very good because besides evaluating the patients during the course of treatment, they also monitored them for 3 months after treatment to see if the benefits continued after the last acupuncture treatment.


Each patient was randomized to receive either acupuncture or "sham" acupuncture, (placing needles at locations of the body that don't contain any commonly known acupuncture points.) This eliminates the chances that the benefits seen are just the result of a placebo. The treatment group had an improvement in bowel regularity and ease, which was double that noted in the sham acupuncture group. When these patients were followed up on over the course of the next 3 months the benefits didn't just remain, they actually continued to improve (going from 1.76 more bowel movements per week on average at the conclusion of treatment, to 1.96 more bowel movements per week 3 months later.)


This study is generating buzz in the medical community because functional constipation is a frustrating condition for doctors. The treatment options available, such as laxative use have only been able to relieve symptoms briefly, and have not had any curative effects.  The use of laxatives can also be accompanied by side effects. And lastly, they can be habit forming, leaving someone unable to have a regular bowel movement at all without their use. 

Acupuncture to treat constipation often uses points located over the abdomen, as well as points on the arms and legs. In some situations, the needles are stimulated with a very mild electrical current, as was done in this study. For the patient it often feels like a subtle buzzing or tingling, and it can increase the effectiveness of the acupuncture. In many cases, electricity is not needed to have an effective and lasting treatment. In fact, I rarely use it in my own practice. 


Acupuncture is often a superior treatment option because unlike other interventions it is entirely free of side effects. It is not habit forming, doesn't introduce unexpected drug adverse effects, and in fact is often quite relaxing and pleasant to receive. 


A typical course of treatment for constipation depends on the patient's individual situation, but often 4-8 treatments are sufficient. 


Read the study abstract here:
http://annals.org/article.aspx?articleid=2552074