Ask an expert - body - abdomen / gastro intestinal - nausea and vomiting

4 questions

Our factsheet on nausea and vomiting

https://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/nausea-and-vomiting.html
talks a great deal about the evidence for acupuncture treatment helping with this distressing side effect of chemotherapy. This quotes a study by Ezzo which is now over a decade old but which points clearly to a level of efficacy. It is in the form of a systematic review, a consolidated account of all available trials of suitable quality, and very much loved by research statisticians for giving a far clearer idea than single trials of whether something really works.We always undertake a review of literature and studies which may have been published more recently and have found several overviews for the use of acupuncture treatment with cancer treatment as a whole. One rather useful one ishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577953/which looks at all aspects of the management of cancer and its treatment. It's a little technical, as many of these studies are, but not beyond most people to be able to find some useful material. This studyhttps://www.ncbi.nlm.nih.gov/pubmed/24815460also provides useful background.The key thing we have to be clear about with all cancer patients is the limit within which we work. As you have no doubt read we always claim to treat people, not diseases, but if we are not careful this is extended to 'treating people with diseases' and then truncated to 'treating diseases'. When someone has cancer this is a message they would like to hear, but there is no evidence that acupuncture treatment can treat cancer per se. Where it can be really effective is in reducing the side effects of the conventional treatments for cancer which are often debilitating and distressing. We also believe that treating the person, not simply the problem which they have, also mobilises the body's own healing responses to address many aspects of the strain under which conventional treatment places the body and the mind.The best advice we can give is that you visit a local BAcC to discuss with them what may be possible for you. Most are willing to give up a little time to prospective patients without charge to see at first hand what they might be able to offer. This also gives you a chance to meet them and see where they work before committing to treatment.

Q:  My daughter (aged 20) has been diagnosed with cyclical vomiting syndrome. She has had 8 episodes in 2 years and has been admitted to hospital 3 times for stays of over 1 week each time to try to stop  the vomiting and rehydrate her. The doctors cannot find any cause for this and we are just experimenting with different medications when an episode begins. I had acupuncture during my pregnancy for severe morning sickness and wondered if it might help my daughter. Can you offer any advice? 

A:  As a rather broad generalisation the use of acupuncture for stopping nausea and vomiting is well documented and researched. Our newly updated fact sheet

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/nausea-and-vomiting.html

provides a wealth of evidence of the various manifestations of nausea and vomiting and its treatment. As you can see from the detail the research evidence on the treatment of morning sickness is not as positive as the post operative nausea treatment, but our clinical experience is that more often than not we can reduce the severity of the episodes even if they persist. The only caution, as your daughter knows all too well, is that someone can become severely dehydrated very quickly, and we always advise colleagues not to let the patient's current conventional treatment schedules lapse while they follow someone's urge to find an alternative solution.

Of course, the major concern that we have is that the research protocols often run completely counter to the way we actually work in treating people rather than named conditions. The formula treatment often applied, while it may work well with a number of patients, will be nowhere near as good as treatment which sets this symptom in its overall context. This can often generate better results, but can also reveal underlying issues which might make a rapid fix of the problem unlikely. An honest practitioner will let you know this rather than let you pin your faith on studies which may not apply, and we trust out colleagues to work in this way.

The best advice, advice which we tend to give routinely, is for your daughter to visit a BAcC member local to her for a brief chat and informal face to face assessment of what may be possible. Most members are happy to give up some time without charge for a prospective patient to discuss what is happening, and this also gives the patient a chance to meet the practitioner and see where they work. In my personal experience, this is a very sensible and reassuring way to work, and patients appreciate the fact that they are not being railroaded into treatment about which they are uncertain.

I hope that acupuncture treatment is able to help your daughter with what I know to be a very debilitating problem.

Q: I had my middle and lower right lobe removed from my lung 7 weeks ago. I have recently had an infection around the lung and been on IV anti biotics in hospital for 1 week and now home on oral antibiotics . During this time I have had severe nausea and intermittent sickness. I take anti sickness tablet cyclzine but it appears to make no difference. I also still have pain and take paracetamol . What I would like to know is could accupuncture help or cure the nausea or even help with the pain as the traditional treatment doesn't seem to be .

A: We are very sorry to hear of what you have been through

It's very heartening to be able to point to some very good quality research for the treatment of bot post-operative pain and post-operative nausea, as our fact sheets demonstrate:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/nausea-and-vomiting.html

and

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/post-operative-pain.html

We aren't able to offer this as conclusive evidence, at least not to the standards which the ASA

require us to demonstrate for claims of efficacy, but there has always been a decent consensus amongst both traditional and medical acupuncturists that nausea in particular is treatable. Indeed as the factsheet shows, there is one acupuncture point on the arm which is cited in nearly every trial as one that 'does what is says on the tin.' This is the same point which is used in the various seas sickness bands which are found on sale in most chemists.

Any practitioner taking you on will need to be a little more cautious than usual, because there is no doubt that from both an eastern and western perspective your immune system will have taken a serious knock, but as long as someone works carefully within our Code of Safe Practice or equivalent all should be well.

The best advice, which you will see repeated in most of our answers, is to contact a BAcC member local to you and seek a brief face to face assessment of whether they think acupuncture treatment may be of benefit. You may find that home visits are more appropriate at this stage, and many members are happy to do this.

Q:  I have had chronic nausea for two years. Many investigations have not found a cause.   I am on antidepressants at the moment. Can accupuncture help me?

A: As our factsheet on nausea shows
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/nausea-and-vomiting.html
 
acupuncture treatment has been used with some success in treating a number of specific types of nausea, mainly those ones where there is a clearly defined cause which enables an acceptable research protoco, to be drawn up.
 
In Chinese medicine itself there are a number of well-recognised protocols which have been developed over the last two months for understanding not simply the symptom but its possible cause in Chinese medicine terms. There are a number of disturbances of functions of the Organs (always capitalised when we talk about Organs because the Chinese concept is far wider than the physical organ of coventional medicine) which can lead to nausea, and the art and skill of the practitioner is in determining which of these patterns or syndromes need to be addressed.
 
Although we would feel optimistic, based on our clinical experience, that acupuncture treatment may be of benefit, each case is unique and different, and it would be important to set measurable outcomes and set review periods if you did decide to have treatment.
 
However, you mention that you are on anti-depressants, and this raises two issues. Firstly, in conventional medical terms, the nausea may simply be a side effect of the drugs you are taking. Although most people who experience a reaction to a medication find that the effect is almost immediate, there are some for whom this kind of reaction develops over time. It may be worthwile exploring with your doctor whether there is another tablet from the same group which you might try to see if this reduces the nausea.
 
The other issue is that from a Chinese medicine perspective medications are dealt with by Organs, primarily the Liver and Kidney, which can be put under a constant low grade strain by having to process the chemicals. There are a number of Liver syndromes for which nausea is one of the presenting symptoms, and it may be that while you are taking medication this may always be a concomitant factor. A skilled practitioner should be able to support these functions and reduce the side effects.
 
It is important, though, that if you find not only that the nausea reduces but also your overall mood lifts through having treatment, as is sometimes the case, that you keep your GP in the loop about any changes to your medications. We occasionally have patients whose improvements encourage them to stop taking their anti-depressants, and sudden stopping of the tablets can cause a rebound effect which makes the condition recur, only more severely. Most GPs are happy to discuss planned reductions in medication. 

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