A recently published clinical trial showed acupuncture out-performed conventional treatments for IBS. Related fMRI research looking at acupuncture's effects on patients' brains with IBS reveal how and why acupuncture works.
The first clinical study we are looking at is titled: "Effect of acupuncture in patients with irritable bowel syndrome: a randomized controlled trial" and published in Mayo Clinic Proceedings in 2020.
The authors note that many patients stop taking the medications they're prescribed for IBS due to dissatisfaction with lack of benefit and/or complaints of the side effects. Acupuncture, compared to conventional treatments (PEG 4000, or Pinaverium Bromide), had better outcomes and long-lasting effect (up to the 12 week follow-up). Not only did the primary outcome measure show acupuncture was more effective, they also noted:
"We found that acupuncture could lower the severity of abdominal pain and distention. Moreover, participants in the acupuncture group were more satisfied with their bowel habits and found that IBS had less interference with daily life after a 6-week treatment period."
This effect has also recently been looked at from a functional imaging perspective using fMRI. In another recent study titled, "Brain Functional Interaction of Acupuncture Effects in Diarrhea-Dominant Irritable Bowel Syndrome", published in Frontiers in Neuroscience, 2020.
The authors explain what led them to continue this research:
"Recent studies have shown that acupuncture could modulate hypothalamus-limbic systems resulting in higher efficiency and stronger small-world properties in brain function of normal controls (Hennig and Lacour, 2000; Pei et al., 2014). As a specific type of IBS, diarrhea-dominant IBS (IBS-D) has the symptoms of abdominal pain and intestinal discomfort (Whitehead et al., 1980; Mayer, 2008) and brings great trouble to people's daily life. The relevant research showed that the gastrointestinal dysfunction caused by IBS might be associated with the disorders of hypothalamus-limbic nervous systems (Aenck, 2006; Qin et al., 2017). Therefore, we think that acupuncture stimulation could be utilized to relieve pain and modulate related nervous systems to improve the gastrointestinal dysfunction of IBS-D patients. However, few studies tried to explore the brain function mechanisms related to gastrointestinal dysfunction caused by IBS-D and those modulated by acupuncture stimulation combining brain functional interaction and segregation."
Seeing how the brain regions are affected in real-time by acupuncture stimulation and comparing it with IBS assessment scores, helps fill the gaps in understanding the physiological mechanism behind the effectiveness of acupuncture in treating the IBS.
For a more detailed explanation, read the authors' characterization of the effects of the acupuncture:
"We speculated that the acupuncture stimulation cured these abnormal functional connections. We found that these cured functional connections were related to the IBS Symptom Severity Score. The functional connections of IBSbs between the right hippocampus and left middle occipital gyrus and between the right cerebelum9 and vermis6 were increased after acupuncture stimulation. The increased functional connections were negatively correlated to the changed IBS-SSS (r = −0.54, p = 0.0065, r = −0.419, p = 0.041). The functional connections of IBSbs between the left middle occipital gyrus and the right superior occipital gyrus were decreased after acupuncture stimulation. The decreased functional connections were positively correlated to the changed IBS-SSS (r = 0.425, p = 0.038). These results further demonstrated that acupuncture stimulation cured the abnormal functional connections between the right hippocampus and left middle occipital gyrus, between the left middle occipital gyrus and right superior occipital gyrus, and between the right cerebelum9 and vermis6.
We also found that the acupuncture stimulation improved the IBS symptom severity and anxiety of IBS-D patients by activating the related functional connections. The acupuncture stimulation negatively activated the functional connections between the left superior frontal gyrus orbital part and right lingual gyrus and between the right superior temporal gyrus (Song et al., 2006) and right cerebelum8, which were decreased compared with those of IBSbs. The decreased functional connections between the left superior frontal gyrus orbital part and the right lingual gyrus were positively related to the changed IBS Symptom Severity Score (r = 0.417, p = 0.0423). The decreased functional connections between the right superior temporal gyrus and the right cerebelum8 were positively related to the changed Hamilton Anxiety Scale (r = 0.512, p = 0.01)."
This kind of integrative research helps expand our understanding of how and why acupuncture affects the nervous system and can resolve dis-regulation that results in other systems going our of healthy function. We hope you enjoy the research.
Ma, K., Liu, Y., Shao, W., Sun, J., Li, J., Fang, X., ... & Zhang, D. (2020). Brain Functional Interaction of Acupuncture Effects in Diarrhea-Dominant Irritable Bowel Syndrome. Frontiers in Neuroscience, 14, 1261.
Pei, L., Geng, H., Guo, J., Yang, G., Wang, L., Shen, R., ... & Sun, J. (2020, August). Effect of acupuncture in patients with irritable bowel syndrome: a randomized controlled trial. In Mayo Clinic Proceedings (Vol. 95, No. 8, pp. 1671-1683). Elsevier.