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Q: I'm contacting you on my wife's behalf. She has suffered from extreme indigestion/heartburn for a long time. She has had endoscopies and ultrasound tests that have all come back clear. She has one last PH test. We really need to look for alternative therapy. Can acupuncture help?
A: There is surprisingly little research on the use of acupuncture for the treatment of acid reflux even though it is a very common presenting condition in our clinics. There are one or two studies like this http://www.ncbi.nlm.nih.gov/pubmed/20697939 http://www.ncbi.nlm.nih.gov/pubmed/17875198
and occasional articles like this one http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080874/
which suggest other possibilities for the appearance of heartburn symptoms, but not the solid body of evidence one might expect based on the usually quite effective treatment of this problem.
Obviously there are physical problems such as hiatus hernia where there has been a physical change in structure of the oesophageal tract which can cause heartburn. If this is the case, then it will seriously limit the possibilities for treatment in any system of medicine. If investigations show that this is not the case, however, then there may be some value in using acupuncture treatment.
From a Chinese medicine perspective the classic presentation of reflux or heartburn is described as Stomach Fire or Rebellious Stomach Qi where the energy of the Stomach does not follow its normal pattern of causing food to descend but lets it stay in the Stomach or reverse its flow to create the classic symptoms with which people suffer. Knowing the immediate precipitating cause, however, does not mean that one goes straight to this for treatment. The flow of energy in the body, called 'qi' in Chinese, is a complex interweaving of channels connecting Organs whose functions are also inter-related. The art and skill of the practitioner lies in determining whatthe primary underlying imbalances are, in the belief that treating here will cause the symptom to go and stay gone rather than be treated simply as a symptom.
This is one of the primary differences between Chinese and conventional medicine. From the Chinese medicine perspective the symptom is an alarm bell telling the practitioner that the system is out of balance. Thus twenty patients with the same symptom could have twenty different underlying causes and therefore twenty different treatments, in contrast to the standard western procedures which have two or three main strategies for a problem. In Chinese medicine the balance of the system is unique in every patient, and this means that each treatment plan is also unique.
It follows that this does limit what we can say about individual cases and why we invariably advise people to visit a local BAcC member for an informal assessment of what is going on and whether treatment would be of benefit. Most practitioners can get an idea in a very short time of what is going on and as a consequence give a good informed view of what might be possible. This would invariably take into account other changes in the way that everything functions which are perhaps not significant enough to concern anyone but from our perspective enrich the picture which we have. Reflux and heatburn are often accompanied by changes in bowel habit, and secondary information can refine the diagnosis a great deal. A practitioner can take all sorts of other factors into account, including mental and emotional ones, tooffer you a much more precise assessment of what may be possible.
Q: If you go to the practitioner search function on the BAcC home page you will see under the postcode search an option to search by other criteria. If you click on this link you will find a location search, and by entering 'Spain' in the 'country' box you will see a list of ten names of our members in Spain.
These are spread out across the country so it is probable that only one or two are within reach. However, there are often informal networks of practitioners within a country, especially expatriates, and the nearest to where you are likely to be may well know the names of other practitioners who are not necessarily BAcC Overseas members who are working in Spain.
We tried to cut and paste the results but the way the site is constructed means that we could not get all ten names and their relevant addresses on the same screen all at once!
Q: Has there been any success in the treatment of ME/CFS? Principally dizziness and fatigue but many other symptoms.
A: ME/CFS is finally being accepted by conventional medical practice as a legitimate problem, not as a fashionable label for feeling a little below par. We have always felt that this is on a par with the relationship between headaches and migraines. The latter are not simply a slightly difficult version of the former, but a real debilitation conditionwhich is indescribable unless you've actually experienced it. In the same way the fatigue and mental fog associated with ME/CFS is not just a flu which goes on, and we have seen many patients whose lives have been radically changed for good.
Our factsheet http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/chronic-fatigue-syndrome.html
takes a rather apocalyptic line with its gloomy predictions of a 5% recovery rate. Our experience is that this is taking a very specific view of recovery, and a great many more people manage to get back to a high level of previous functioning as long as they manage the condition well.
It is always necessary to be careful, though, with ascribing every symptom to ME. Because the condition affects the whole system there will often be secondary problems which are not simply a direct consequence of the condition but a consequence of the effect of the condition on the overall energetic balance of the person. This might mean, for example, that the dizziness could be treated effectively by helping to reduce the effects of the ME on the pre-existing balance of the body. We are all more or less out ofbalance from birth, not pathologically but because the variations in individual balance from the centre are what make us the individuals we are. The ancient Chinese doctors used this understanding of the person to help them to treat in advance of the changes of the season to protect patients against climates which could push their constitutions out of kilter enough to generate symptoms. This preventative approach was central to Chinese medicine.
This is a rather long-winded way of saying that each symptom has to be seen in the context of the whole. We find that many patients with a disease label see every problem through that lens, and so it is ' the Parkinsons' or 'the MS' or 'the ME', when in fact some of the problems are entirely contingent. The best advice that we can give is to visit a BAcC member local to you for advice on the specific manifestations of the problems you have. They will be able to see first hand what is going on, and be more thanhappy to give you some time without charge to assess whether they believe they can help.
What we can say is that it may be a long process. Our experience is that it can take months to get on top of the problem, and that there are often setbacks. The management programme for ME run in the NHS actually places severe restrictions on what people are allowed to do even when they begin to feel better because experience has taught them that positive changes are often fragile, and the sufferer's first reaction when they feel better, to go out and enjoy themselves, can often undermine their progress. The key thing, if you decide to have acupuncture treatment after talking to a practitioner, is to review progress on a regular basis. The fact that change may take a long time can sometimes mean that treatment can go on and on when there is no real change, and a wise practitioner will try to find some means of objectively assessing whether there actually is progress.
We find that many conditions like this are like an interlinked spiral of problems, and that if we can change one aspect of the presentation it often helps a sufferer to believe that things can change, which in turn fuels progress in other areas.
A: As you can imagine, this is a topic which pops up relatively frequently, and a typical answer we have given in the past is:
Weight loss was the subject of some critical scrutiny a decade ago, and the conclusion drawn at the time was that acupuncture did not have any significant effect onweight loss. However, trying to test whether acupuncture can help someone to reduce their weight is likely to be a difficult matter; there are dozens of reasons in Chinese medicine why someone's weight may be increasing. Trying to group together a sufficiently large number of patients whose western problemand eastern diagnosis are the same is extremely difficult.
In one or two cases there is a very direct correlation between someone's weight and their underlying imbalances from a Chinese medicine perspective. Correcting these may have an immediate impact on, say, the amount of fluid someone is carrying, and that could create a 3-5kg loss very quickly.
However, all of the best dietary programmes say that after the initial and often quite dramatic week or two most good weight loss programmes at best will see someonelose only a pound or two every month, and in fact, there is discouragement from trying to do more in order for the body's system to keep pace with the change.Acupuncture may well have been used successfully alongside some fairly strict dietary rules, and from a patient's perspective it would be very difficult to say whether the acupuncture treatment added value to what someone was doing already.
The bottom line is that there are are no 'magic' points which reduce someone's weight without effort, and the effect of acupuncture may be no more than to givesomeone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncturetreatment that itself would be a very positive outcome.
There is nothing that we would add to this advice other than to beware of anyone making promises they cannot keep about what acupuncture treatment can deliver. Some of the less reputable high street shops still appear to be making claims of a fairly speculative nature without any evidence which supports what they claim.
This is probably the best advice that we can give. Our clinical experience is that their are often subtle emotional and spiritual issues underpinning the loss of control which people have of their weight, and some of these are amenable to acupuncture treatment. We have answered many questions on anxiety and depression, and we find quite often that a response to depression is to comfort eat. Helping with the depression may well reduce the desire to use food in this way.
One has to be realistic, however. Some of the psychological issues are not best suited by long term acupuncture treatment and really do need to be addressed directly bysomeone skilled in this area. There are also many occasions when the 'habit energy' to eat is so well entrenched that a direct intervention like hypnotherapy or cognitive behavioural therapy is appropriate because it goes straight to the point. We also have to tell some patients, sensitively we hope, that oaks breed oaks and willows breed willows. If a family are all size 18, then the chances are that trying to be a size 8 is not going to be likely.
The best advice we can give is that visiting a BAcC member local to you will be able to provide you with advice based on a brief face to face assessment. This is verylikely to offer you the best range of options for you. All of our members are concerned to ensure that a patient gets the help they need, which is not always what they have to offer. We often refer to other colleagues if we feel something would work better. Each patient is unique, and finding what works for each individual case is the best guarantee of success.
Q: I had acupuncture this morning which has left me with a headache like pressure basically like I had before. Can I take pain killers?
A: The answer about pain killers is, of course - do! Although we are often seen as very anti-western medicine, this is not the case. The only concern that we have about painkillers is that from our perspective more often than not the symptom which someone has is not the same as the problem, but more likely to be a kind of alarm bell alerting the person to the fact that whole system is out of balance. Taking painkillers for a long time is rather like switching off a fire alarm because it is too noisy. As a short term fix, therefore, they are fine, but as a long term solution less so.
It is possible that your headache is not simply a result of treatment but also a sign that the pattern as a whole is shifting. It is not unknown with headaches and migraines for a patient to have a very rapid and unpleasant return of the symptom which is worse than usual. This is often seen in Chinese medicine as a sign that the body is expelling a pattern which is causing the problem.
However, it is also possible that the headache is a transient adverse effect of the treatment. Some people, very few it has to be said, get a number of short term symptoms which soon pass. If they happen after every treatment session the responsible practitioner will be reducing the power of the treatments - fewer needles, less action on the needle - to ensure that the adverse effects are lessened. A very small number of people just have very strong reactions to treatment, and for this unlucky few it's a straightforward judgement call about whether the longer term gains outweigh the short term discomfort.
It is always worth talking to your practitioner about this as your first port of call. There may be something of great value in the report you make which will inform your treatment. It may also be that the after-care advice wasn't quite as clear as it could have been. Alcohol, strong exercise and spicy foods can all cause a treatment to havesecondary effects because the system's balance has been affected at the time of treatment and can be disturbed more easily.
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