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Ask an expert - body - abdomen / gastro intestinal

38 questions

Gastroparesis has been the subject of some limited research, and there are encouraging reports that acupuncture may be a useful as part of the treatment strategy. One 2010 case study is reported:

 

 

http://aim.bmj.com/content/28/2/101.1.extract

 

and in 2004, a slightly more complex study

http://www.ncbi.nlm.nih.gov/pubmed/15510787

 

suggested that acupuncture might be helpful. However, the whole body of evidence is a long way short of what health commissioners in the West would regard as sufficiently conclusive to make any definite claims.

 

Chinese medicine, however, uses an entirely different conceptual structure to understand the body and mind in good health and in disease, and the diagnostic systems are often able to make sense of symptoms in terms of functional weakness in a way that is alien to western medicine. Since each person has a unique pattern of energy it is impossible to say for under-researched areas of illness that acupuncture would be of definite benefit. However some of the symptoms which are regularly associated with the condition fall very neatly into diagnostic patterns and syndromes in Chinese medicine for which an estbablished range of treatments do exist. It would be worthwhile talking to a BAcC member local to you to establish whether, in their view, acupuncture may be able to help.

 

Even if there is not a direct equivalence, it is worth bearing in mind that some of the systems of Chinese medicine work in a very different way, aiming to re-balance the body's energies, without specific regard to symptoms, in the belief that a system in balance will not create the alarm bells which symptoms represent. This can be as powerful as direct treatment of the symptom.

Q. I have had Crohn's disease for 23 years. I have managed this without drugs for the last 14 years (diet, exercise, healthy lifestyle) however the Doctors convinced me to start an immunosupressant drug about 6 months ago as they said the disease activity was very severe (even though I experience few, and only mild, symptoms). The drug does not seem to have worked and the doctors are suggesting I add another immunosupressant drug to this. I am really keen to prevent this so am looking for alternative treatments. I am aware that there is a body of research supporting the effectiveness of acupuncture in the treatment of Crohn's and was hoping you would be able to recommend somebody who has a knowledge/experience of this?

 

A. The use of acupuncture and moxibustion for the treatment of Crohn's Disease and related conditions such as ulcerative colitis has a long history in China. There are many studies which seek to establish what treatments are more effective, but most presume that acupuncture already works and are not accepted in the west because of methodological weakness. You will find individual studies which show some positive outcomes, such as

 

 

http://www.ncbi.nlm.nih.gov/pubmed/15114043

 

and a much quoted systematic review which is highly encouraging

 

http://www.ncbi.nlm.nih.gov/pubmed/17659687

 

but it would be a bit of a stretch to call this a 'body of evidence.'

 

There is always an element of concern in our advice when someone has a potentially serious condition which is being treated with conventional medication. If the markers for your illness are quite serious, in spite of the relative absence of symptoms, and serious enough for your doctors and consultants to want to try a second immunosuppressive drug, it would be irresponsible of us to recommend that you try to use acupuncture instead of this. Our advice would always be to use acupuncture treatment alongside conventional medicine for cases such as yours, and if and only if the markers reduce, then discuss with your consultant the possibility for reducing the prescribed medicines.

 

As far as our members are concerned, all are equally equipped to use Chinese medicine for the most frequent presentations in clinic; indeed, the generalist physician was honoured in ancient China above the specialist physician who was seen to be limited. There are one or two areas where members focus their work on specific groups of patients, like children or pregnant women, and they often take on board some additional conventional medical material to help them to work better with their patients. The entry level acupuncture skills are the same for all members, however, and experience usually means learning how to use the basic knowledge better, not learning more new knowledge. Any BAcC member located near you should be able to provide you with safe and competent treatment.

 

Q. My 28year old daughter has been off work for 1 year with debilitating abdominal pain, after the usual investigations it has been found that she has adhesionsin in her abdoman (although the doctors have not confirmed that this is the cause of her pain). With the exasperating out-look of trial & error pain killers for the next indefinate period whould acupucture be of help?

 

A. The doctor's caution in not concluding that the adhesions are causing the pain is justified; although adhesions can cause considerable pain in the lower abdomen they are by no means the only cause of chronic pain. Many people, for example, suffer from forms of irritable bowel syndrome with similar symptoms but without any obvious physical evidence like adhesions to identify as a possible cause.

 

 

The strength of Chinese medicine is that many of its diagnostic systems draw directly on the patient's description of the exact type, nature and location of the pain which they are experiencing, and can make sense of this in relation to the various functions in the lower abdomen and the patterns of flow of energy in the area. This can often provide treatment strategies which aim to relieve the pain by moving energy where it is blocked or in excess.

 

The best course of action would be for your daughter to visit a BAcC member local to where she lives to see whether they think that her problem is one which they consider might be helped by treatment. Chinese medicine treats the person, not the illness or disease, which is why it is always difficult to say 'acupuncture treats x' with absolute certainty; in some cases a practitioner might conclude that there are other more appropriate therapies to deal with a person's specific problem. However, people with ill-defined chronic abdominal pains often turn to acupuncture, and anecdotally there are frequent reports of a lessening of the frequency and severity of the condition. At this point, however, the research evidence is a little thin on the ground, but that is as much to do with the fact that running trials for conditions without precise definition is very difficult.


 

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