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It is often difficult to answer questions like yours because there are so many variations on this particular theme. This happens not least because the term IBS has become so elastic that it covers nearly every digestive problem from one end of the digestive tract to the other.

The first thing to say is that if you are experiencing or have experienced any episodes of diarrhoea then we are assuming, and hoping, that your GP is fully aware of this. The management of chronic diarrhoea involves ensuring that a person remains adequately hydrated and also does not develop deficiencies in some of the vital trace elements which are re-absorbed in the lower gut. We are not suggesting that you should be taking preparations like diarolyte, but we think that your doctor should be making suggestions about what it is best to do, along with organising investigations like stool tests and endoscopy to ensure that there is nothing more serious going on.

The second thing we would do, if you were a patient, would be to have one of those discussions which we enjoy (!) about what you are actually describing. Chinese medicine works from an entirely different theoretical basis from conventional medicine, with a complex understanding of the energies of the body. The term 'diarrhoea' is used to cover a wide range of presentations, and the treatment for all in conventional medicine is often the same. From a Chinese medicine perspective there are some crucial variations, which is why we need to establish exactly what is happening. There is a considerable difference between, say, the kind of explosive and often unpleasant bowel movement which often feels like heat leaving the body and the less well-formed stool that needs to be passed urgently and quickly. These point to entirely different pathologies in the system, and that would mean very different kinds of treatment.

The research evidence for the treatment of IBS is not great, as our factsheet shows

but this has a great deal to do with the difficulty of assembling test and control groups with identical presentations and causes of problem. Our clinical practice involves treating many people with IBS, often as a part of a wider pattern of problems, and we usually feel confident about being able to make some progress. The question for us is often how much and how sustainable, rather than does it work, and oddly for a therapy about encouraging movement and flow we are often more able to bring loose movements under control than to deal with constipation which often forms part of a wider pattern of 'stuckness.'

IBS often sits as a part of a wider pattern of imbalance, and the strength of Chinese medicine is that in treating the person, not simply the named condition, it aims to remove underlying causes as much as addressing the symptoms alone.

The best advice that we can give is that you visit a local BAcC member for an informal chat about whether acupuncture may be appropriate for you. Most of our colleagues are willing to do this without charge so that they can give an informed view before a patient commits to treatment.

You may well find that acupuncture treatment is effective for you not simply because of the treatment for eczema itself but also for the treatment of the stress which seems to make it worse. As our two factsheets show

there is research on both which is mildly encouraging, and even more research into anxiety

'Stress is such a wide catch-all that unless you really start to unravel what stress means to someone it is very difficult to line up their definition with the kind of data you have to hand.

If we deal in conventional medical disease labels for skin problems we often find that the research to hand is not as good as we might hope. In our clinical practice, however, we usually find that it is rare for someone simply to have a skin condition without there being some other accompanying clinical features, and because we treat the person, not the disease, we almost always find that the wider context enables us to work with the root cause of the problem, not simply its manifestation. This may sound a bit pompous, but it really is the most effective way to work in our view, by understanding what the patient experiences within the context of their overall health picture.

The one factor which we invariably mention with treating skin conditions is that the received wisdom inside the profession is that Chinese herbal medicine treatment used in conjunction with acupuncture is often seen as the most potent combination for addressing chronic skin complaints. Most members of the Register of Chinese Herbal Medicine are also on the BAcC register, and it might well be worth your while to see if someone near to you is able to offer this combination of treatments. If not we are are sure that acupuncture alone may be able to offer some real progress, especially with the management of stress.

In all skin conditions, though, the real challenge is measuring progress, and we would always urge someone to try to establish a measurable outcome to assess whether treatment is really working. It can take a while for skin conditions to relent, and it is very valuable to have some sort of marker for improvement to judge whether treatment is starting to take root.  

We are very pleased to hear that you managed to stop smoking with the help of acupuncture. However, weight loss is a slightly more problematic area. We used to be asked about this a great deal, and a typical answer (probably an answer within an answer as we read it) which we gave was:

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 on weight 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 problem and 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 someone lose 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 give someone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncture treatment 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 by someone 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 very likely 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.

This rather doom laden response was written at a time when there had been a proliferation of shops offering rapid weight loss, and we felt a strong need to rebut what we regarded as unsustainable claims. That said, it would substantially remain the same advice we would give now. The main benefit of acupuncture, we suspect, is to support people with the drive and determination to keep on track, as well as helping their systems to adjust to the positive changes which weight loss brings.

The one very solid piece of evidence in your favour is that fact that you managed to stop smoking with treatment. This is a very good sign, and encourages us to believe that you are likely to be someone who can benefit for weight loss. Results will not be impactful as the finite end of a habit, but as long as there is consistent progress and the treatment is geared to long term change (i.e. not weekly treatment indefinitely) we think that you may well find that acupuncture can help you.

It will probably come as no great surprise to you that there hasn't been a great deal of research into this problem, and none that we can find about the use of acupuncture treatment. Searching the internet does generate one or two personal stories where the effect of Chinese medicine in the form of acupuncture and Chinese medicine has been tremendous, and two or three very detailed differential diagnoses by Chinese practitioners of what lichen planus may represent in TCM terms. However, evidence like this, while encouraging, is far from proof, and wouldn't in itself be the basis for a recommendation.

This is where we believe that Chinese medicine is very well placed to respond to conditions which for the most part have very few effective treatments in conventional medicine save for the almost universal use of steroids. The symptoms remains the same whichever system of medicine one uses, but the diagnostic categories of Chinese medicine have different ways of interpreting them which are often more literal and sound rather strange to the western ear - invasions of heat and damp, fire poisons and the like. However, most patients find that these sorts of labels often describe their experience of the problem to a tee.

The key thing about this kind of description and Chinese medicine categories is that it is quite rare to see a single symptom that isn't accompanied by other systemic changes which a patient may not regard as pathological, and treating the person as a whole can often mean removing a deeper layer of imbalance of which the symptom is just visible evidence. In fact, in the oldest traditional systems symptoms were almost disregarded on the simple basis that if the body as a whole was in balance then symptoms would disappear naturally.

The best advice that we can give is that you visit a local BAcC member to see what they make of the overall picture which you present. They may well see patterns which are treatable, and as such may be able to offer a good idea of how effective treatment may be. The consensus on websites suggests that a mixture of acupuncture and herbal medicine might be a good idea, and looking at the Register of Chinese Herbal Medicine list will almost certainly generate a hit of someone who belongs to both bodies. However, any BAcC member will be able to give you an idea of what may be possible.

This is a very good question. It is the received wisdom inside the profession that treatment should be started as soon as possible after a stroke, and that the potential for change and improvement diminishes over time. This is driven in part by the fact that in China it is not at all unusual for someone to start having treatment on the day of a stroke, the logic being that the energy of the body has been disturbed and the sooner that it is corrected, the less likely the disturbance is to be 'set' in the system. 

We have some sympathy with this view. There have been several books published in the last couple of decades which have explored the possibility that once an energetic pattern has become established it is no longer seen as a pathological factor but becomes the essence of the person. This means that someone can in a rather peculiar way become invested in the post-illness state as their reality, with the attendant difficulty in getting things to change. If you talk to people who teach the Alexander Technique you find the same model; once the body has  a set pattern it takes a long time to re-train it.

However, our clinical experience with post-stroke patients is rather more mixed than this. Whilst we have always warned patients who come in many months or years after the initial stroke that progress may be slow or in some cases non-existent, we have found that some people do have a marked and immediate response to treatment, often in direct proportion to their underlying constitutional health. A person who was strong and energetically in good shape before the CVA often has a greater power to recover.

There has been a mountain of research into this area, as you can see from the rather long review paper which we have on our website

but which may be a little technical for many readers. It has long been our hope that the evidence will reach a critical mass where we can argue a case for early intervention within the NHS with acupuncture treatment, if for no other reason than the fact that increasing the speed of recovery would save the NHS millions of pounds in rehabilitation costs. We have some hope that familiarity with the Chinese system will encourage some trials in the UK.

As far as your brother is concerned, however, it is rather difficult to say what might be possible without a face to face assessment. What you and he will find, however, is that most of our members are very happy to give up a little time without charge to prospective patients to see whether acupuncture treatment would be a good option. Most of us are very frank about someone's chances because the disappointment of achieving nothing or very little is just as palpable by the practitioner as the patient. We get it wrong - some people we think we can't help recover amazingly and we think we can help don't. In the main, however, we tend to recognise those people for whom acupuncture is well worth a try.

The crucial thing is to try to set measurable outcomes so that improvements are not just a matter of feeling better in oneself, good as this is, but visible through verifiable markers - better range of movement, greater endurance in in walking, and so on. This avoids the problem of running up a large bill without really getting anything back. If it isn't working after five to ten sessions it is better to draw a line unless there are secondary improvements which render the treatment worthwhile.

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