constipation

Acupuncture and Chronic Constipation: An Integrative Approach in Traditional Chinese Medicine

Chronic constipation is a common gastrointestinal disorder characterized by infrequent bowel movements, straining, and a sensation of incomplete evacuation. Affecting millions worldwide, it often leads to discomfort, psychological stress, and reduced quality of life. While conventional treatments include dietary modifications, over-the-counter laxatives, and medications, many individuals are seeking alternative modalities. One such modality, acupuncture, has gained attention in both clinical and research settings for its potential efficacy in promoting bowel health.

Treatment Strategy

In traditional Chinese medicine, chronic constipation is often attributed to imbalances in the body’s “Qi” (vital energy) and the function of key organs such as the spleen, lungs, kidneys, and large intestine. Several patterns of disharmony may be identified, including:

1. Qi Deficiency: Weakness in the body’s energy can lead to reduced motility.

2. Yang Deficiency: Insufficient warmth in the body may cause sluggish bowel movement.

3. Spleen Qi Deficiency: The spleen’s inability to transform and transport food leads to stagnation.

Acupuncture aims to restore balance by stimulating specific points on the body to enhance Qi flow, improve organ function, and alleviate symptoms. In the context of chronic constipation, acupuncturists may select points that correspond to the large intestine, spleen, and kidney meridians. Some commonly used acupuncture points for constipation include:

- Stomach 36 (ST36): Known for its ability to strengthen the digestive system.

- Large Intestine 4 (LI4): Widely used for pain relief and bowel regulation.

- Spleen 6 (SP6): Important for digestive health and regulating menstruation.

Evidence Based

Recent studies have explored the effectiveness of acupuncture as an intervention for chronic constipation, yielding promising results.

1. Randomized Controlled Trials (RCTs)

A systematic review published in the journal Neurogastroenterology & Motility (2020) conducted a meta-analysis of RCTs evaluating the effectiveness of acupuncture in treating chronic constipation. The study concluded that acupuncture significantly improved bowel movement frequency and patient-reported outcomes compared to control groups receiving no treatment. These findings support the integration of acupuncture into chronic constipation management.

2. Acupuncture vs. Conventional Therapy

Another study in the American Journal of Gastroenterology (2019) compared the efficacy of acupuncture with standard laxative therapy in patients with chronic constipation. The study found that patients receiving acupuncture experienced greater improvements in stool consistency and frequency, as well as reduced reliance on medication.

3. Mechanistic Insights

Research in Evidence-Based Complementary and Alternative Medicine (2021) has suggested that acupuncture may influence gastrointestinal motility through neuroendocrine pathways. The stimulation of acupuncture points can enhance the release of neurotransmitters like serotonin, which play a crucial role in gut motility.

4. Quality of Life Improvements

A longitudinal study published in The Journal of Alternative and Complementary Medicine (2022) reported significant improvements in patients' quality of life, anxiety levels, and overall well-being after undergoing a series of acupuncture treatments for chronic constipation. Participants reported not only better bowel function but also reduced stress associated with their condition.

Acupuncture offers a holistic and effective approach to managing chronic constipation, addressing both symptomatic relief and underlying disharmonies within the body. The growing body of clinical evidence supports its application as a complementary treatment modality in enhancing gastrointestinal motility and improving quality of life. As research continues to evolve, integrating acupuncture with conventional therapies may provide a more comprehensive approach to managing chronic constipation, making it a valuable option for patients seeking alternative or adjunctive treatments.

References

- [Neurogastroenterology & Motility](https://onlinelibrary.wiley.com/journal/13652982) (2020), Systematic Review.

- [American Journal of Gastroenterology](https://journals.lww.com/ajg/pages/default.aspx) (2019), Study on Acupuncture vs. Laxative Therapy.

- [Evidence-Based Complementary and Alternative Medicine](http://www.hindawi.com/journals/ecam/) (2021), Mechanistic Insights into Acupuncture and Gastrointestinal Function.

- [The Journal of Alternative and Complementary Medicine](https://www.liebertpub.com/journal/jacm) (2022), Longitudinal Study on Quality of Life Improvements.

Hypertension affects 25% of the adult population worldwide. Pharmacotherapy involves the use of various blockers and is associated with side-effects. Acupuncture was one of the earliest methods of treatment for “hard pulse disease” (now called hypertension) Acupuncture reduces blood pressure through its regulatory effect on the neuroendocrine system, the vascular endothelium, the renin–angiotensin-aldosterone system (RAS), and oxidative stress, thereby enhancing pharmacotherapy synergystically. Acupuncture has also been found to be renoproctive, reducing pathological structural changes to the kidneys caused by anti-hypertensive drugs. It has been found that acupuncture intervenes the process of RIF (renal interstitial fibrosis) by reducing synthesis of kidney type I, III collagen and restraining expression of TGF-beta1. . With regular acupuncture, along with exercise and a healthy lifestyle, patients may explore the possiblity of reducing medication dosage with their PCP, reducing the side-effects of medications.

PMID: 33613809, 24298778

HYPERTENSION

CASE STUDY: CHRONIC HYPERTENSION

• Background: 60 yo, female presented with chronic constipation since young adulthood. She was prescribed laxatives which she used for more than 10 years, until it stopped working. Patient then sought the help of a naturopath for a more holistic approach. She was recommended multiple supplements which helped, however multiple supplementation proved to be overwhelming, compromising compliance. Patient had to take supplements to stimulate a bowel movement, much like pharmaceuticals. Patient's goal is to reduce supplement intake and have them as support only when needed.

• Treatment Plan: Acupuncture treatment twice a week for 2 months; then reduced treatment frequency to once a week on the third month onwards. Treatment alternated between traditional and electroacupuncture.

• How Patient Attributes Success: (1) No headache, no redness in ears and face since starting acupuncture treatments. (2) Most BP readings range from (2) Though not his chief complaint, patient noticed his bowel movements became regular. Prior to acupuncture, patient was on the constipated side, with bowel movement every 2-3 days. Around the 3rd month, patient started to hear and feel movement in her intestines. She was pleasantly surprised by the peristaltic movement as this was something she had never felt before. Patient also shared that she had gradually reduced the dosage and frequency of her supplement intake. Patient also missed a few weeks of treatment and reported that her bowel movements continued to be regular, well-formed, once a day, or every other day; sometimes twice a day. More recently, she shared she now has to take her supplements as needed. Patient is on month 5 of treatment plan and continues to come in for maintenance treatment every other week.

Ovulatory dysfunction is the leading cause of infertility. Acupuncture has been found to reguate the hypothalamic-pituitary-ovary (HPO) axis, which is essential in controlling female reproduction and the key to timely ovulation. Infertility is often the result of a dysregulation of the HPO axis, such as “high GnRH” and “high LH.” Acupuncture increases blood flow to the uterus, improving the chances of ovum implantation onto the uterine wall while reducing the ovary's immune-inflammatory response by decreasing the expression of nerve growth factor (NGF), corticotropin-releasing factor (CRF), and endothelin-1 (ET-1) found in PCOS.

The Both the World Health Organization (WHO) and the National Institutes of Health (NIH) recognizes the use of acupuncture for fertility and female reproductive support such as Polycystic Ovarian Symdrome (PCOS), Premenstrual Syndrome, Dysmenorrhea, Fertility and IVF support.

PMID: 35832528

FERTILITY/IVF SUPPORT

CASE STUDY: OVARIAN CYSTS

• Background: 34 yo, female presented with pain in left lower quadrant (LLQ) due to ovarian cysts in her left ovary. The cysts measure 1.5 cm and 3 cm, respectively. Ultrasound imaging also revealed multiple follicles in the right ovary, which almost met the diagnostic criteria for PCOS. Pain in LLQ is a constant ache, with occasional stabbing pain, especially before and during her period. Patient also suffers from mid-cycle bleeding, with bleeding lasting for 25 days. She also flu-like symptoms (congestion, muscle aches) prior to her period.

• Treatment Plan: Acupuncture treatment twice a week for 1 month. Because of her specific case, patient was switched to a custom herbal treatment plan.

• How Patient Attributes Success: (1) Pain relief during acupuncture and herbal therapy. (2) PMS symptoms also improved. (3) Reduced stress, which is a driving factor for most fertility issues. (4) Significant improvement in most recent ultrasound results: multiple follicles on the right ovary completely gone; with only 1 remaining cyst was found on the left ovary measuring 2 cm. (5) Patient was pain free since starting acupuncture and herbal medicine, allowing her to avoid surgery (6) PCP is supportive of her herbal treatment.

• These results were corroborated by significant improvement in her tongue, a diagnostic pillar in Chinese Medicine, after 3 months of herbal treatment. Patient conitnues to be on the herbal plan until remaining cyst resolves.

Ovulatory dysfunction is the leading cause of infertility. Acupuncture has been found to reguate the hypothalamic-pituitary-ovary (HPO) axis, which is essential in controlling female reproduction and the key to timely ovulation. Infertility is often the result of a dysregulation of the HPO axis, such as “high GnRH” and “high LH.” Acupuncture increases blood flow to the uterus, improving the chances of ovum implantation onto the uterine wall while reducing the ovary's immune-inflammatory response by decreasing the expression of nerve growth factor (NGF), corticotropin-releasing factor (CRF), and endothelin-1 (ET-1) found in PCOS.

The Both the World Health Organization (WHO) and the National Institutes of Health (NIH) recognizes the use of acupuncture for fertility and female reproductive support such as Polycystic Ovarian Symdrome (PCOS), Premenstrual Syndrome, Dysmenorrhea, Fertility and IVF support.

PMID: 35832528

FERTILITY/IVF SUPPORT

CASE STUDY: IVF SUPPORT

• Background: 34 yo, female presented with pain in left lower quadrant (LLQ) due to ovarian cysts in her left ovary. The cysts measure 1.5 cm and 3 cm, respectively. Ultrasound imaging also revealed multiple follicles in the right ovary, which almost met the diagnostic criteria for PCOS. Pain in LLQ is a constant ache, with occasional stabbing pain, especially before and during her period. Patient also suffers from mid-cycle bleeding, with bleeding lasting for 25 days. She also flu-like symptoms (congestion, muscle aches) prior to her period.

• Treatment Plan: Acupuncture treatment twice a week for 1 month. Because of her specific case, patient was switched to a custom herbal treatment plan.

• How Patient Attributes Success: Patient immediately felt relief from acupuncture treatments. Pain in LLQ decreased, PMS symptoms also improved. Acupuncture significantly helped with stress, which is a driving factor for most fertility issues. Symptoms continue to improve while being on the custom herbal plan. After 3 months of being on the herbal plan, significant changes in the patient's tongue was seen. This was further confirmed by her most recent ultrasound results: multiple follicles on the right ovary completely gone; only 1 remaining cyst was found on the left ovary measuring 2 cm. Patient conitnues to be on the herbal plan until remaining cyst resolves. Patient was able to avoid surgery. PCP is supportive of her herbal treatment.

The Both the World Health Organization (WHO) and the National Institutes of Health (NIH) recognizes the use of acupuncture for gastrointestinal conditions including, but not limited to: nausea, indigestion, acid reflux, bloating, diarrhea, constipation, abdominal pain, ulcers, colitis.

Acupuncture is a drug-free therapy that offers digestive relief without the unwanted side effects of pharmaceuticals. Acupuncture does this mainly by regulating the spleen and stomach systems.

BONE SPUR

CASE STUDY

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

Lateral epicondylitis (LE), known as “tennis elbow”, is the most common cause of lateral elbow pain due to the overuse of the common extensor tendon (CET), which has a prevalence of 1–3% in the general population (1-5) The thickness in unilateral LE patients revealed a significantly higher value in affected CET (5.31±0.49 mm) than in healthy CET (3.95±0.37 mm) (P<0.05) Lee et al. (13) measured the thickness of CET in patients with LE and found it was significantly thicker than that of healthy control subjects, which is consistent with our results. This phenomenon may be ascribed to the swelling caused by pathological changes of CET in LE, which leads to an increase in thickness. However, many dense collagen fibers contributing to increasing the thickness of normal CET probably results in stiffer elasticity (32). LE, reflecting an overuse injury primarily due to repetitive strain from tasks and activities, is a degenerative process and is characterized of angiofibroblastic hyperplasia, micro-rupture, an abundance of fibroblasts, vascular hyperplasia, and notably, a lack of traditional inflammatory cells within the tissue (15,30,33). These changes have been shown to play the most critical pathophysiological role in the production of LE and make the tendon softer. CET is softer in a diseased elbow when measured with SWE.

Researchers randomly assigned 41 patients into acupuncture and control groups. Conventional treatment (rest, NSAIDS, bracing, stretching/exercise) were applied to both groups. Pain scale and the Duruoz Hand Index (DHI) for functioning of the affected limb, pressure pain threshold, and common extensor tendon (CET) thickness were assessed before and after treatment for both groups. Ten treatments roughly 2 or 3 times a week for 4 weeks were provided to the patients. Both pain and DHI scores in both groups decreased, however the pressure pain threshold and CET thickness only demonstrated improvement in the acupuncture group. (This is significant in that physicians would be impressed with structural changes due to acupuncture treatment…)

PMID: 28590765, PMID: 31956543

CASE STUDY

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

CASE STUDY: BONE SPUR

TENNIS ELBOW

The Both the World Health Organization (WHO) and the National Institutes of Health (NIH) recognizes the use of acupuncture for gastrointestinal conditions including, but not limited to: nausea, indigestion, acid reflux, bloating, diarrhea, constipation, abdominal pain, ulcers, colitis.

Acupuncture is a drug-free therapy that offers digestive relief without the unwanted side effects of pharmaceuticals. Acupuncture does this mainly by regulating the spleen and stomach systems.

CASE STUDY

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

SCIATICA

Researchers randomly assigned 41 patients into acupuncture and control groups. Conventional treatment (rest, NSAIDS, bracing, stretching/exercise) were applied to both groups. Pain scale and the Duruoz Hand Index (DHI) for functioning of the affected limb, pressure pain threshold, and common extensor tendon (CET) thickness were assessed before and after treatment for both groups. Ten treatments roughly 2 or 3 times a week for 4 weeks were provided to the patients. Both pain and DHI scores in both groups decreased, however the pressure pain threshold and CET thickness only demonstrated improvement in the acupuncture group. (This is significant in that physicians would be impressed with structural changes due to acupuncture treatment…)

CASE STUDY

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

CASE STUDY: BONE SPUR

MIGRAINE - NEUROLOGICAL

The Both the World Health Organization (WHO) and the National Institutes of Health (NIH) recognizes the use of acupuncture for gastrointestinal conditions including, but not limited to: nausea, indigestion, acid reflux, bloating, diarrhea, constipation, abdominal pain, ulcers, colitis.

Acupuncture is a drug-free therapy that offers digestive relief without the unwanted side effects of pharmaceuticals. Acupuncture does this mainly by regulating the spleen and stomach systems.

CASE STUDY

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

NEUROPATHY

The Both the World Health Organization (WHO) and the National Institutes of Health (NIH) recognizes the use of acupuncture for gastrointestinal conditions including, but not limited to: nausea, indigestion, acid reflux, bloating, diarrhea, constipation, abdominal pain, ulcers, colitis.

Acupuncture is a drug-free therapy that offers digestive relief without the unwanted side effects of pharmaceuticals. Acupuncture does this mainly by regulating the spleen and stomach systems.

CASE STUDY

• Texas Licensed Acupuncturist credentialed via the Texas Medical Board

• National Board-Certified Diplomate of Oriental Medicine (NCCAOM)

• National Board-Certified Herbalist (NCCAOM)

• Doctoral Canditate, Doctor of Acupuncture with a Chinese Herbal Medicine Specialization (DAcCHM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texas

• Master of Acupuncture and Oriental Medicine (MAOM) from the American College of Acupuncture & Oriental Medicine (ACAOM), Houston, Texa

CHEMO SUPPORT