Dr. Michael Kolotinsky, M.Ac
IBD, which encompasses ulcerative colitis and Crohn’s disease, affects approximately 1.6 million Americans. It can lead to debilitating symptoms that can often leave patients feeling drained, both physically and emotionally. Thanks to the advent of modern medicine, various medications are available to help manage disease activity. However, they have their limitations, and many come with undesirable side effects. Additionally, these therapies primarily focus on immune modulation. This can lead to overlooking the myriad of other factors that can influence IBD disease activity. Such factors include intestinal dysbiosis, increased intestinal permeability, stress, and other psychological influences, and gut motor/sensory dysfunction. It has been estimated that nearly half of all IBD patients utilize complementary and alternative therapies, including acupuncture.
IBD Symptoms
IBD patients commonly experience increased intestinal sensitivity that can lead to diarrhea and abdominal pain, as well as constipation. This triad of symptoms can be attributed to a phenomenon known as gastrointestinal (GI) dysmotility. Acupuncture has been studied for GI dysmotility and has proven effective in improving it through the modulation of autonomic nervous system function, from the esophagus down through the colon.
Abdominal pain occurs in 70% of those with active disease, and 20-50% of those in remission. Approximately 25% of patients use narcotics to help manage this pain, unaware it can potentially worsen disease activity and induce constipation. Extensive studies have demonstrated that acupuncture can alleviate numerous types of painful conditions with various origins. Studies have also reported that acupuncture can decrease opioid use for treating other conditions.
Patients with IBD tend to experience anxiety and depression at a higher rate – 20-30% of patients – than the general population. It has been reported that there is an association between symptoms of anxiety and depression and IBD disease activity. The World Health Organization states that acupuncture is a safe and effective treatment for depression and anxiety. A meta-analysis of 207 clinical trials of acupuncture for the treatment of depression revealed that acupuncture had similar efficacy to antidepressants in improving symptoms and severity of major depression.
Acupuncture Treatment
Several studies have looked at the effects of acupuncture and/or moxibustion on the gut microbiota. Researchers found in a study on rats that moxibustion of specific acupoints increased Bifidobacterium and Lactobacillus levels (“good” bacteria) while decreasing E. coli and Bacteroides fragilis levels (“bad” bacteria). The shift in gut microbiome also resulted in a downregulation of two pro-inflammatory mediators (TNF- α and IL-12). A human obesity trial demonstrated increased Lactobacillus and Bifidobacterium and decreased Bacteroides and Clostridium perfringens (“bad” bacteria) using acupuncture treatment.
Abnormalities in the components that comprise the gastrointestinal epithelial barrier may contribute to the pathogenesis of IBD. Acupuncture has been demonstrated to restore intestinal barrier function in several animal models as well as in patients with IBD. In a rodent model, electroacupuncture at a specific acupoint demonstrated protective effects in decreasing local intestinal inflammation, reducing barrier breakdown, alleviating permeability, and maintaining tight junctions. In a rat model of colitis, moxibustion to 2 specific acupoints inhibited colonic cell death and promoted the repair of the colonic barrier via suppression of inflammatory mediators. A human trial demonstrated that acupuncture combined with moxibustion was superior to mesalamine, a common drug prescribed for IBD, in decreasing intestinal inflammation and improving epithelial barrier function.
In summary, acupuncture can serve as a safe, cost-effective, and noninvasive adjunct to your current therapeutic routine in managing disease activity and reducing symptoms of IBD.
For more information, the Crohn’s and Colitis Foundation has an article which can be viewed here. For a study published by the US National Institutes of Health, please click here.