Acupuncture for Irritable Bowel Syndrome: 2-Year Follow-Up of a Randomised Controlled Trial

Abstract

BackgroundA recent randomised controlled trial (RCT) of acupuncture as a treatment for irritable bowel syndrome (IBS) demonstrated sustained benefits over a period of 12 months post-randomisation.AimTo extend the trial follow-up to evaluate the effects of acupuncture at 24 months post-randomisation.MethodsPatients in primary care with ongoing IBS were recruited to a two-arm pragmatic RCT of acupuncture for IBS. Participants were randomised to the offer of up to 10 weekly sessions of acupuncture plus usual care (n=116 patients) or to continue with usual care alone (n=117). The primary outcome was the self-reported IBS symptom severity score (IBS SSS) measured at 24 months post-randomisation. Analysis was by intention-to-treat using an unstructured multivariate linear model incorporating all repeated measures.ResultsThe overall response rate was 61%. The adjusted difference in mean IBS SSS at 24 months was −18.28 (95% CI −40.95 to 4.40) in favour of the acupuncture arm. Differences at earlier time points estimated from the multivariate model were: −27.27 (−47.69 to −6.86) at 3 months; −23.69 (−45.17 to −2.21) at 6 months; −24.09 (−45.59 to −2.59) at 9 months; and −23.06 (−44.52 to −1.59) at 12 months.ConclusionsThere were no statistically significant differences between the acupuncture and usual care groups in IBS SSS at 24 months post-randomisation, and the point estimate for the mean difference was approximately 80% of the size of the statistically significant results seen at 6, 9 and 12 months.Trial registration numberISRCTN08827905.

Review article: an analysis of safety profiles of treatments for diarrhoea‐predominant irritable bowel syndrome

“…Overall, 11 patients with IBS‐D or functional diarrhoea reported 11 AEs: insomnia (n = 4), fainting (n = 3), abdominal pain (n = 1), cold limbs (n = 1), and weakness (n = 1) with electroacupuncture; and hot flush (n = 1) with loperamide . However, one study found that improvements in IBS symptoms observed with acupuncture at 3 months were sustained for up to 2 years, although there was no difference between acupuncture and usual care; follow‐up data were available for 61% of study participants at 2 years . Number needed to treat and number needed to harm values for acupuncture as an IBS treatment modality have not been reported.…”

“…96 However, one study found that improvements in IBS symptoms observed with acupuncture at 3 months were sustained for up to 2 years, although there was no difference between acupuncture and usual care; followup data were available for 61% of study participants at 2 years. 99 Number needed to treat and number needed to harm values for acupuncture as an IBS treatment modality have not been reported.…”

Electro‐acupuncture at ST37 and ST25 induce different effects on colonic motility via the enteric nervous system by affecting excitatory and inhibitory neurons

“…The currently used medical treatments can improve intestinal motility and thereby improve the patient's quality of life, but they do not improve the contraction and relaxation of intestinal muscles, and are also associated with adverse side effects . In clinical practice, acupuncture is accepted as an alternative potentially effective therapy for constipation, irritable bowel syndrome and other diseases . It is believed that specific acupoints are associated with certain regional effects .…”

“…4 In clinical practice, acupuncture is accepted as an alternative potentially effective therapy for constipation, irritable bowel syndrome and other diseases. [5][6][7] It is believed that specific acupoints are associated with certain regional effects. 8 In the case of gastrointestinal dysfunction, ST 25 (tianshu) and ST 37 (shangjuxu) are the most commonly used acupoints for treatment.…”

Electroacupuncture Inhibits Visceral Nociception via Somatovisceral Interaction at Subnucleus Reticularis Dorsalis Neurons in the Rat Medulla

“…Many behavioral studies have confirmed that EA stimulation exerts good effects on rats with acute or chronic visceral hyperalgesia ( Qi and Li, 2012 ; Wang et al, 2012 ). In addition, EA therapy has been proven to be effective in treating visceral pain in long–term follow–up clinical trials ( MacPherson et al, 2017 ). It is generally accepted that EA analgesia is an integrative process of afferent impulses between pain regions and acupoints at convergence neurons and this process involves different levels of central structures, such as spinal dorsal horn ( Rong et al, 2005 ), nucleus tractus solitarius ( Liu et al, 2014 ) and periaqueductal gray ( Wang et al, 2014 ).…”