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    Acupuncture Trial Shows Interest and Belief in Alternative Medicine

    Does acupuncture help alleviate the symptoms of irritable bowel syndrome?

    Possibly, according to a study by Canadian researchers at Queens University in Kingston, Ontario, who presented the results at the Digestive Disease Week conference in San Diego.

    "We could not show a beneficial response that was directly related to acupuncture treatment," said Dr. Catherine Lowe, a gastroenterologist and lead investigator, "but some individuals in the study had dramatic responses and were convinced that the acupuncture made a big difference. Like most studies that involve patients with IBS, there is a very significant placebo response. Just participating in a clinical trial can positively influence the patient."

    Lowe decided to explore the possibility that acupuncture could be beneficial for those with IBS after conversing with a physiotherapist who used acupuncture to treat musculoskeletal problems.

    "We postulated that since acupuncture had analgesic properties, it may be helpful in patients with IBS who are troubled by chronic pain," she explained. "After reading the literature, I discovered that there were many reasons why theoretically acupuncture may help."

    Some of those reasons, according to Lowe:
    ~ Numerous animal studies show that acupuncture has an effect on gastrointestinal motility, and abnormalities in motility are thought to play a role in IBS.
    ~ A few studies have shown that acupuncture improves sleep quality and that IBS symptoms worsen when sufferers' sleep patterns are disturbed.
    ~ Patients with IBS have abnormal sensation within the rectum and colon. Acupuncture releases endorphins and may therefore modulate the abnormal pain pathways and lessen symptoms.

    Lowe also found only one other study on acupuncture and IBS a small, uncontrolled one showing that acupuncture has a beneficial effect on people with IBS.

    The Canadians' randomized, double-blind study (neither doctors nor patients knew who received what) recruited 50 volunteers with IBS (80 percent female), ages 18 to 73 years old. Twenty-eight of the subjects received acupuncture; 22 received a technique that mimicked acupuncture. The testers confirmed that the "placebo patients" thought they had received acupuncture.

    The treatments were given with needles at nine points for 20 minutes twice a week for four weeks. Participants were evaluated before receiving the acupuncture, at the four-week mark and three months after the first treatment. The investigators used a quality-of-life survey with 33 questions which they developed. Some sample questions:

    ~ Did you have to rush to the bathroom today?
    ~ Did you avoid any foods because of your bowel symptoms today?
    ~ Did you avoid any activities with family, friends or at work because of your bowel symptoms today?

    Individual patients in both groups showed significant improvement by the end of the study, partly due to the placebo effect, researchers said. And there was no difference in improvement experienced by the patients who received active treatment and those who received the placebo. To claim that acupuncture is beneficial, those in the acupuncture group would have to show a 90 percent improvement. Lowe said, but their improvement was not that high.

    Still, what Lowe and her associates learned is that people with IBS are more interested in alternative therapies than patients with other types of gastrointestinal illnesses like Crohn's disease.

    "I don't know why this is true, but it may be due to the chronic nature of IBS and the lack of effective standard medical treatment," she said.

    What advice does Lowe have for those considering acupuncture as a treatment for IBS?

    "I would caution that currently we don't have any evidence that acupuncture helps," she advised. "However, some individuals may derive benefit from it and feel this is something they wish to pursue. It is expensive, so they should not continue with it if they don't see a benefit in the first weeks of treatment."


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