Constipation? Try the alternative treatment

March 3, 2015

By Cheng Wang, MD(China), PhD, L.Ac, LOM

Constipation, also known as dyschezia or costiveness, is one of those topics few like to talk about for it can be both painful and frustrating. Constipation happens when the bowel movements become difficult or less frequent [1]. Almost everyone gets constipation at some time during his or her life. In the United State, it is the most common digestive complaint [2] affecting about 2% to 20% of the population [3]. Women, the elderly and children are more likely to obtain this annoying symptom.

Generally, the diagnosis of constipation is established if you have two or more of the following symptoms for at least 3 months: [4-6]
(1) infrequent bowel movements (typically three times or fewer per week)
(2) difficulty during defecation (straining during a bowel movement more than 25% of the time or hard stools more than 25% of the time)
(3) incomplete bowel evacuation more than 25% of the time

There are many reasons that can lead to constipation, and they are often divided into functional and structural factors. The functional factors may include inadequate water or fiber in the diet, disrupted diet, lack of activity or exercise, stress, depression and medicines. While the structural factors involve with Colon disease, ulcerative colitis, intestinal tumors, intestinal tuberculosis, intestinal obstruction, etc. Usually, constipation is induced by a disorder of bowel function rather than an organic problem [7].

Constipation is more of a symptom than a disease, therefore it is usually easier to prevent than to treat. By keeping a well-balanced diet with plenty of fiber, taking in sufficient water or fluids, and exercising regularly, your symptoms may be well improved [3]. And for those serious cases that do not respond to the lifestyle adjustment, a very mild stool softener or laxative is recommended. But these drugs can only temporally relieve your symptoms and may give rise to other adverse reactions for long-term use.

As a result, complementary or alternative therapies, such as acupuncture, are attractive to both patients and practitioners. Acupuncture, with its long history in China, has been used for managing gastrointestinal symptoms, including abdominal pain, diarrhea, constipation and gastroenteritis [8]. Many clinic randomized controlled trials have demonstrated that acupuncture is an effective treatment for functional constipation [9-11].

According to Traditional Chinese Medicine, constipation is a manifestation of the dysfunction of large intestinal conduction, which is caused by various factors including gastrointestinal heat or cold, stagnant of Qi, and deficiency of Qi or Blood. Depending on different etiology and pathogenesis, constipation can be categorized as four types: the hot constipation, the cold constipation, the Qi-stasis constipation, and the deficient constipation.

During the acupuncture treatment, different acupuncture points (acupoints) will be selected based on the above classification. The insertion of sterile needles at specific acupoints is supposed to smooth the meridians and restore the proper flow of Qi. When De-qi occurs, acupuncture can activate all physical processes in the body, especially the circulation of body fluids. Meanwhile, different acupuncture manipulations will be applied to dispel the pathologic factors of heat or cold and correct the deficiency of Qi or Blood. Taking these functions, acupuncture can effectively cure constipation.

In addition, modern researches [9-11] have found that acupuncture therapy can accelerate intestinal peristalsis, stimulate the secretion of intestinal mucus, increase the frequency of defecation and promote the discharge of faeces.

1. Chatoor D, Emmnauel A (2009). "Constipation and evacuation disorders". Best Pract Res Clin Gastroenterol 23 (4): 517–30.
2. Sonnenberg, A; Koch, TR (1989). "Epidemiology of constipation in the United States". Dis Colon Rectum 32 (1): 1–8.
3. Locke GR, Pemberton JH, Phillips SF (December 2000). "American Gastroenterological Association Medical Position Statement: guidelines on constipation". Gastroenterology 119 (6): 1761–6.
4. Walia, R.; Mahajan, L.; Steffen, R. (October 2009). "Recent advances in chronic constipation". Curr Opin Pediatr 21 (5): 661–6.
5. McCallum, I. J. D.; Ong, S.; Mercer-Jones, M. (2009). "Chronic constipation in adults". BMJ 338: b831.
6. Emmanuel, A. V.; Tack, J.; Quigley, E. M.; Talley, N. J. (December 2009). "Pharmacological management of constipation".Neurogastroenterol Motil 21: 41–54.
7. Leung FW (February 2007). "Etiologic factors of chronic constipation: review of the scientific evidence". Dig. Dis. Sci. 52(2): 313–6.
8. Ouyang H, Chen JD: Review article: therapeutic roles of acupuncture in functional gastrointestinal disorders. Aliment Pharmacol Ther 2004, 20:831-841.
9. Wang LJ, Wang LL: Randomized controlled study on chronic functional constipation treated with grain-shaped moxibustion and acupuncture [Article in Chinese]. Zhongguo Zhen Jiu 2011, 31:320-324.
10. Jin X, Ding YJ, Wang LL, Ding SQ, Shu L, Jiang YW, Huo WY: Clinical study on acupuncture for treatment of chronic functional constipation [Article in Chinese]. Zhongguo Zhen Jiu 2010, 30:97-101.
11. Wang CW, Li N, He HB, Lu JQ, Liu ZS: Effect of electroacupuncture of Tianshu (ST 25) on the rational symptoms of functional constipation patients and evaluation on its efficacy satisfaction: a single-center, prospective, practical and randomized control trial [Article in Chinese]. Zhen Ci Yan Jiu 2010, 35:375-379.

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