Ask an expert - body - abdomen / gastro intestinal - bloating

2 questions

Q: I've been receiving acupuncture for 15 months for digestive disorders, bloating, sluggish bowels, hemorrhoids, twisted fascia to the pelvic floor and atrial fibrillation related to the stomach. Symptoms mildly get better but return even worse within a week or sometime after treatment. Why? What do I do?

A: There is a behavourial therapy called NLP of which a a favourite premise is that "If you always do what you always did, you'll always get what you always got, so if something you're doing isn't working, do something different." On that basis it would be very tempting to say that you perhaps should change the therapy or the therapist, and sometimes there is a simple truth in this.

However, we have come across many situations where the practitioner is actually doing a good job even though the symptoms remain largely unchanged. Patients can sometimes be held in a pattern which might become far worse if not treated, and we still have a fond memory of an old patient whose lack of progress was depressing us until he said 'do you know, I think I'm getting worse slower.'

That said, bloating and sluggish bowels make for a very uncomfortable life, and we suspect that alongside your acupuncture treatment you may need to be doing something more focused on your nutrition to see the benefits of both treatment. Most of us have a rudimentary knowledge of the kinds of food which a patient should avoid given their state of balance, and in many cases the advice we give does score some good results. Sometimes, however, the advice needs to be more precise, and there are many practitioners who take this Chinese nutritional training at a much higher level, almost akin to herbal medicine. In fact, many digestive disorders, which prove intractable to acupuncture alone, are greatly benefited by Chinese herbal medicine. Most of the members of the RCHM (Register of Chinese Herbal Medicine) are also BAcC members, but you may find that going to a Chinese Herbal Medicine practitioner alongside your acupuncture practitioner might work a treat, especially if your rapport with your current practitioner is one you don't want to lose.

Before taking this step, though, it might well be worth reviewing your diet with your existing practitioner.  There are four or five 'headline' syndromes which describe bloating and sluggishness, and it should be immediately apparent what would be good for you to avoid. Timing of eating is also critical. There is an old English saying 'breakfast like a king, lunch like a lord and dine like a pauper', and we have seen some patients make dramatic improvements simply by moving towards this pattern. There are also certain food types which are just not good for some people. We had a patient whose digestive disorders alone refused to change even though everything else improved. Once he cut out lactose, though, his symptoms almost vanished.

The fact that things don't change may well mean that the treatment is not powerful enough to break the pattern of your digestion, and that something you are eating is having a more potent effect on the system. We suspect that your best move would be to have a kind of 'case conference' with your practitioner and agree a plan to move your case forward, either by adding some other dietary changes or by adding another tier of dietary change to accompany your treatment. We certainly hope this gets you going in a more positive direction.

Q: My sister has been experiencing tummy bloating for the  last two years.  She is interested in having acupuncture.

A: We are assuming in answering your query that your sister has had her symptom checked out thoroughly by conventional medicine. When you say 'tummy bloating' we don't know whether you mean 'all the time' or 'after eating.' Although it would be unlikely there are a number of fairly serious conditions which constant bloating may indicate, and it would be important to check that none of these is present, since delaying conventional treatment may have serious consequences.

 

The most likely outcome, if your sister has seen her GP, is that the problem has been diagnosed as irritable bowel syndrome (IBS), a term which is used to cover a wide range of symptoms of which bloating is one. Within Chinese medicine abdominal bloating is very often tied to the poor functioning of a specific part of the system, the Spleen as understood in Chinese medicine terms, but the issue then is deciding whether this is a primary problem in itself or whether within the complex inter-relationships of the system, this is a problem elsewhere causing the Spleen to malfunction. The art and skill of the practitioner lies in making this kind of determination.

 

There are inevitably going to be many questions which the practitioner will ask about when the bloating occurs and what specific triggers your sister may have noticed, but we suspect that even without knowing more detail that the timing of eating food will be an issue as well as the kinds of food she is eating. This is not quite the same as food intolerance. From a Chinese medicine perspective there are certain types of food which aggravate some of the constitutional imbalances which people have and are best avoided. Many people, for example, are hindered by eating a great deal of cold and damp food, like raw fruit and vegetables, for example, and the irony is that many diets using these as a staple aimed at weight loss often have the opposite effect. However, it would need a proper face to face assessment to make this kind of judgement.

 

We cannot recommend individual practitioners, but if you use the search facility on the front page of the BAcC website and enter your postcode and nearby postcodes we are sure that your sister will find a practitioner who can offer her face to face advice on whether treatment would be of benefit to her.    

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