Acupuncture for symptomatic gastroparesis

Kim, Kun Hyung; Lee, Myeong Soo; Choi, Tae‐Young

doi:10.1002/14651858.cd009676.pub2

Cited by 26 publications

(37 citation statements)

References 64 publications

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“…There is borderline support (78% agreement) for the use of prokinetics as a group, but the panel agreed on the use of 5‐HT 4 receptor agonists as a class 76–89 . There is also no consensus on the use of other neuromodulators, herbal therapies, acupuncture or psychological therapies in gastroparesis 90–93,116–118 . The same is true for invasive therapies such as botulinum toxin injection, GES, pyloric endoscopic myotomy or (partial) gastrectomy 95–113 .…”

Section: Recommendationsmentioning

confidence: 99%

“…A Cochrane systematic review found overall higher symptom improvement rates with acupuncture compared to usual or medical therapy, but due to the heterogeneity and low quality of studies, and the risk of bias, the conclusion is considered uncertain. 118 Several algorithms propose nutritional support in the form of enteral or parenteral nutrition for refractory gastroparesis with weight loss and/or nutritional deficiencies. 44,71,119 While short-term parenteral nutrition may provide rapid weight recovery, its longterm use should be avoided for risk of catheter-related sepsis and hepatotoxicity.…”

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confidence: 99%

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United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

et al. 2021

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Background: Gastroparesis is a condition characterized by epigastric symptoms and delayed gastric emptying (GE) rate in the absence of any mechanical obstruction.The condition is challenging in clinical practice by the lack of guidance concerning diagnosis and management of gastroparesis.Methods: A Delphi consensus was undertaken by 40 experts from 19 European countries who conducted a literature summary and voting process on 89 statements. Quality of evidence was evaluated using grading of recommendations assessment, development, and evaluation criteria. Consensus (defined as ≥80% agreement) was reached for 25 statements. Results:The European consensus defined gastroparesis as the presence of symptoms associated with delayed GE in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms, with often coexisting postprandial distress syndrome symptoms of dyspepsia. The true epidemiology of gastroparesis is not known in detail, but diabetes, gastric surgery, certain neurological and connective tissue diseases, and the use of certain drugs recognized as risk factors. While the panel agreed that severely impaired gastric motor function is present in these patients, there was no consensus on underlying pathophysiology.The panel agreed that an upper endoscopy and a GE test are required for diagnosis.Only dietary therapy, dopamine-2 antagonists and 5-HT 4 receptor agonists were considered appropriate therapies, in addition to nutritional support in case of severe weight loss. No consensus was reached on the use of proton pump inhibitors, other classes of antiemetics or prokinetics, neuromodulators, complimentary, psychological, or more invasive therapies. Finally, there was consensus that gastroparesis adversely impacts on quality of life and healthcare costs and that the long-term prognosis of gastroparesis depends on the cause.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Recommendationsmentioning

confidence: 99%

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confidence: 99%

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

et al. 2021

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“…Gastroparesis is characterized by delayed gastric emptying with associated upper abdominal symptoms and is often a complication of diabetes-induced hyperglycemia or surgery ( 56 ). A systematic review of acupuncture for the treatment of gastroparesis found preliminary qualitative evidence that acupuncture provided short-term improvement in symptoms of gastroparesis, regardless of etiology (i.e., diabetes, surgery) ( 57 ). These findings point to the use of acupuncture to mitigate abdominal pain related to gastroparesis; however, the findings were characterized as low-certainty or very-low certainty evidence and should be interpreted with caution.…”

Section: Evidence Acquisitionmentioning

confidence: 99%

Efficacy of Acupuncture in the Treatment of Chronic Abdominal Pain

Berger¹,

Liu²,

Jin³

et al. 2021

Anesth Pain Med

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Context: Abdominal pain is a widespread complaint and is one of the common reasons leading patients to seek medical care, either in emergency situations or with their primary providers. While acute abdominal pain is a better defined, usually surgical condition, chronic abdominal pain requires longer, typically lifelong, therapy. Chronic abdominal pain may also present with acute flares and complications. Here we review seminal and novel evidence discussing the use of acupuncture in the treatment of abdominal pain, indications, and conditions that may benefit from this approach. Evidence Acquisition: Chronic abdominal pain is a common complaint causing significant morbidity and disability and has a hefty price tag attached. Recent studies show it may be prevalent in as much as 25% of the adult population. It is defined as three episodes of severe abdominal pain over the course of three months. Chronic abdominal pain could be the result of chronicity of acute pain or of chronic pain syndromes, most commonly IBD syndromes and IBS. While a plethora of treatments exists for both conditions, these treatments usually fall short of complete symptom control, and there is a need for complementary measures to curb disability and increase the quality of life in these patients. Acupuncture is a form of integrative medicine that has long been used in Chinese and traditional medicine, based on the rebalancing of the patient’s Qi, or Ying/Yang balance. It has been shown to be effective in treating several other conditions, and novel evidence may expand its use into other fields as well. Clinical trials studying acupuncture in chronic pain conditions have been promising, and recent evidence supports the use of abdominal pain in chronic abdominal pain conditions as well. Though not curative, acupuncture is a complementary approach that helps reduce symptoms and improved quality of life. Conclusions: Chronic abdominal pain is a widespread condition, mostly affected by the IBS and IBD spectrum. Etiologies are still being studied for these conditions, and while novel treatment approaches are absolute game changers for these patients, many continue to experience some level of symptoms and disability. Acupuncture may provide further alleviation of these symptoms in select patients, thus improving quality of life, reducing disability, and saving healthcare dollars. It is a largely safe and inexpensive method that may significantly contribute to the quality of life of selected patients.

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“…25 A systematic review demonstrated that acupuncture is a low-risk treatment that may have short-term benefits for patients with gastroparesis and we can conclude that there is a low level of evidence to fully support this as a mainstay of treatment at this time. 26 Patients with refractory gastroparesis (failed nutritional/ psychological therapy, failure of medication therapy, recurrent hospitalization, nutritional deficiency) should be considered for interventional therapy (endoscopic vs. surgical). These can be further divided into therapies specifically targeting the pylorus as opposed to a more generalized gastric approach.…”

Section: Treatment Optionsmentioning

confidence: 99%

Endoscopic Management of Gastroparesis

Seeras

Docimo

2021

Digestive Disease Interventions

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Gastroparesis is a complex pathology that continues to evolve in its diagnosis and treatment. Throughout the years, we have gained a more thorough understanding of normal and pathologic physiology of the stomach, which has allowed us to garner different approaches to the treatment of gastroparesis. We aim to evaluate the current literature regarding diagnosis and treatment of gastroparesis with a specific focus on the endoscopic management of this pathology.

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Acupuncture for symptomatic gastroparesis

Cited by 26 publications

References 64 publications

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

Efficacy of Acupuncture in the Treatment of Chronic Abdominal Pain

Endoscopic Management of Gastroparesis

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