Ask an expert - body - abdomen / gastro intestinal - irritable bowel

6 questions

Q:  We are not quite sure what the best advice we can give is. 'Twisted bowel' used in a medical context is a serious problem, and unless there have been extensive investigations which show that the extent of the twisting is not serious, then in most cases surgery would be very likely. The risks of loss of blood supply in or around the bowel are very considerable, and can lead to life threatening infection.

 

We suspect that you are using the term in a more informal way which people often employ when they have irritable bowel syndrome and have visited a number of complementary therapists who use the term in a slightly more loose way. As far as treatment of IBS is concerned, the evidence for the successful use of acupuncture was dismissed as inconclusive many years ago, but the last decade has seen a number of very encouraging studies as our factsheet

 

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/irritable-bowel-syndrome-ibs.html

 

demonstrates. These all point to an enhancement of the bowel function and positive changes in gut motility which may have an impact on what is being described as twisted bowel.

 

There is always a danger of getting too involved with the technicalities of western named conditions and forgetting that in traditional Chinese medicine the main thrust of diagnosis and treatment was and remains setting the whole system in order in the simple but effective belief that a system in balance corrects itself. Although primarily concerned with function rather than structure there is no doubt that in many cases restoring what we consider to be good function can lead to a major improvement in structure, most obviously seen in treating lower back pain. If a system is in balance, then in theory it should regain its natural shape.

 

However, we would need a great deal more detail before being able to offer a guess at a prognosis, and your best option is to visit a BAcC member local to you for a brief face to face assessment of what is going on and what benefit acupuncture treatment may bring. Most BAcC members are happy to give up a little time without charge to discuss whether acupuncture is a sensible treatment option, and this also has the benefit of you being able to meet them and see where they work before committing to treatment.

Q:  My wife had surgery for bowel cancer 3 years ago. Since then she has had a great deal of trouble managing her bowel movements and has had daily panic rushes to the little room! She has found this very difficult and distressing. Can acupuncture help and if so is there somebody with expertise in the area of bowel cancer treatment and its after effects that could help her? We live in Pulborough, West Sussex about 12 miles north of Worthing/south of Horsham.

A:  It is extremely difficult to generalise about the treatment of bowel frequency and urgency after surgery for bowel cancer. So much depends on the amount of tissue removed and exactly where from, and it is not uncommon for it to take a long time to restore normal function. There is evidence for the treatment of urgency, frequency and discomfort within the conglomeration of symptoms under the heading of irritable bowel syndrome
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/irritable-bowel-syndrome-ibs.html
 
but this is not quite the same as surgical resection.
 
There are two possible ways in which acupuncture treatment may be of benefit. Acupuncture is increasingly used to aid normal recovery processes in a great many areas, and although the research of these cases is still broadly in its infancy, there is no doubt in our minds from the anecdotal evidence we have that people do tend to recover more quickly and 'better' from surgery. This expert has on many occasions treated patients pre- and post- cholecystectomy (gall bladder removal) to very good effect. This is not a surprise, however; although a great deal of modern focus is on treating named conditions traditional chinese medicine was primarily concerned with restoring balance and homeostasis. Whe you consider the massive disruption to the whole system caused by surgery, anything aimed at helping to restore natural order is probably going to be of benefit.
 
The other possibility is that there has been disruption to specific parts of the system in such a way as to cause frequency and urgency. From a Chinese medicine perspective knowing the cause of a problem is sometimes less important than recognising how it manifests. If the pattern of signs and symptoms which your wife has approximates to one of the recognised syndromes, then there may well be some help which a practitioner could offer. The only and best way to see if this is the case is to seek an informal face to face assessment from a BAcC member local to you. Most will offer you a little time without charge to assess better than we can here whether treatment may be of benefit.
 
As far as expert practitioners are concerned, we take the view that all of our members are properly trained to be able to offer good Chinese medicine to any patient they see. There may be some value in seeking out someone with a few more years of experience in dealing with patients with serious conditions, but that will not change the basic principles of diagnosis and treatment which we all offer. There are a number of extremely well-qualified and experienced practitioners in your area, including two in Pulborough itself, and we are sure that by using our search function you will be able to locate someone who may be able to help your wife.  

A:   There are no specialists within the BAcC in the treatment of IBS. This is not because we lack expertise; there are hundreds of extremely experienced practitioners, and the standard of graduate entrant is also very high. The issue is that Chinese medicine primarily treats the person, not the condition, so for every twenty people who have the generic label 'IBS sufferer' there may be twenty different diagnoses in Chinese medicine, each requiring a different treatment strategy. To that end, every practitioner is properly equipped to treat every patient whom they see according to Chinese medicine principles.
 
This is, of course, very different from saying that acupuncture can help every named condition. There are many conditions where treatment will only have a marginal effect, say, for example, in the treatment of Type 1 diabetes. However, there are always aspects of someone's health which can be improved, even if only at the level of helping someone to be better able to cope with what they have.
 
IBS is, in fact, one of the more common problems with which people present, and we recently answered a specific question about IBS in which were the paragraphs:
 

Q: Can acupuncture be an effective treatment for serious IBS issues? Medical diagnosis recently has indicated that the lower intestine and bowel are severely inflamed and twisted. The only recommended treatment is a drug which is also used as an anti-psychotic, with serious side effects. I am seeking a treatment regime more sympathatic to the body but do not know if acupuncture could work.
 
A:  We have produced a factsheet on IBS

 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/irritable-bowel-syndrome-ibs.html
 
which summarises the overall position and makes reference to a number of research studies which show that acupuncture treatment may well have a significant benefit for the IBS sufferer.
 
However, in our experience the diagnosis of IBS is usually nowhere near as specific as the one which you have, which seems to indicate visible changes in the bowel and its position within the lower abdomen. The majority of cases are mainly, it often appears, diagnosed on the basis of reported symptom, and are often addressed by changes to diet and various strategies which help to reduce the stress which seems to aggravate the condition...........
 
..............The best course of action is to discuss the situation with a BAcC member local to you. We are confident that they will be able to give you much more specific advice based on a face to face assessment of what is going on from a Chinese medicine perspective.


 

Q: Can acupuncture be an effective treatment for serious IBS issues? Medical diagnosis recently has indicated that the lower intestine and bowel are severely inflamed and twisted. The only recommended treatment is a drug which is also used as an anti-psychotic, with serious side effects. I am seeking a treatment regime more sympathatic to the body but do not know if acupuncture could work.

A:  We have produced a factsheet on IBS
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/irritable-bowel-syndrome-ibs.html
 
which summarises the overall position and makes reference to a number of research studies which show that acupuncture treatment may well have a significant benefit for the IBS sufferer.
 
However, in our experience the diagnosis of IBS is usually nowhere near as specific as the one which you have, which seems to indicate visible changes in the bowel and its position within the lower abdomen. The majority of cases are mainly, it often appears, diagnosed on the basis of reported symptom, and are often addressed by changes to diet and various strategies which help to reduce the stress which seems to aggravate the condition.
 
In your case, however, it sounds as though there is a very clear pathological change in the gut, and we would always advise patients in your situation to follow western medical advice about medication in the short term to bring the problem under control. Contrary to what many people believe, though, acupuncture and conventinal treatment are not an either/or. That is the true virtue of being a complementary therapy; it can work alongside conventional medicine. That is not to say that we do not believe that conventional medicine does not put a strain on the system, and just as the medication usually has a long list of side effects which appear in the factsheets which come with them, so from a Chinese medicine perspective there are going to be parts of the system which suffer slightly from processing the drugs. However, everything has to be seen in its wider context. The positive effects of the medication reduce pressures on other areas, and good acupuncture treatment will support both the reduction in symptoms and the pressure on the parts of the system coping with the medication.
 
We usually recommend that people have acupuncture treatment alongside the conventional treatment because the first priority is to bring the problem under control. We are sure that your GP will not want to carry on prescribing medications any longer than is necessary, and if the symptoms do subside, you can discuss with the GP how to reduce the dose and eventually stop taking them. We are certain from the evidence available that regular acupuncture treatment after that will help to control any recurrence of symptoms.
 
We are sometimes asked why we simply don't recommend acupuncture as an alternative to medication, but our view is that each person is unique and different, and to make such a recommendation sight unseen could have serious consequences. If, however, the symptoms are stable and bearable and your GP is happy to delay the start of the course of drugs for a month or six weeks, you could probably have enough treatment over that period to see what benefits acupuncture treatment may offer. If there was a reduction in symptoms, then you could maintain a watching brief with the GP over the next three months.
 
However, we offer this advice with some caution, because we cannot judge from your brief description of your case just how serious the problem is, and we would not want to have encouraged you to delay conventional treatment if your GP and your consultant are anxious that your start as soon as possible.
 
The best course of action is to discuss the situation with a BAcC member local to you. We are confident that they will be able to give you much more specific advice based on a face to face assessment of what is going on from a Chines medicine perspective.

Q:  I have been diagnosed with an irritable bladder. Can acupuncture alleviate my symptoms, which is an urgent need to urinate.

 

A: As our factsheet shows  there is some evidence to suggest that urgency of urination can be helped by acupuncture, although there is not yet anywhere near enough evidence to make substantive claims here. If you search the internet there are a number of studies such as this one
 
http://www.ncbi.nlm.nih.gov/pubmed/15994629  which offer some hope.
 
However, we have to remind ourselves sometimes that Chinese medicine has been dealing with problems like this for over 2000 years, and has a very sophisticated process for understanding patients' symptoms against a backdrop of an entirely different conceptual framework. The understanding of the body as a system of energy, 'qi', in flow and the concepts of yin and yang to describe its flow and inter-relationships is very alien to the western ear. However, the rather wider understanding of organs as functional units with effects on body mind and spitit, and the underlying premise that symptoms are alarm bells, not the problem itself, can sometimes offer possibilities for understanding a problem in a far wider context. This will often be corroborated by other problems which a patient suffers and by diagnostic signs which the practitioner sees, and can often lead to a situation where a practitioner can tell the patient about symptoms that they haven't yet mentioned. If the problem is a part of a recognised syndrome or pattern of symptoms a practitioner will be able to give a clear idea of prognosis. Even if it doesn't the attempt to re-establish balance in the system can also have an effect on individual symptoms.
 
We recommend that you talk to a BAcC member local to you an ask for their advice in a brief face to face consultation whether they think that they can help you. We trust that they will give you an honest assessment, and refer you on to other modalities of treatment if they felt that these offered a better prospect of success.
 
 

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