Digestive difficulties can vary, but they are never pleasant. Gas, indigestion, and loose stool, to name a few, can all be uncomfortable and challenging to live with. Constipation is another digestive irregularity that many people face on a regular basis and will try almost any treatment with hopes of relief. Good news: we can use acupuncture for constipation relief! Read on to learn about how we use acupuncture for constipation, including etiology, manifestations, diagnosis, treatment, and preventative measures. DISCLAIMER: this blog post is intended for informational purposes only. Do not perform any treatments included in the post yourself. This includes, but is not limited to, acupuncture, herbal medicine, and Chinese nutritional therapy. They should only be performed by educated and licensed acupuncture practitioners.
Constipation is a common patient complaint and can be accompanied with various other symptoms. People experiencing constipation can report pain and difficulty when trying to make a bowel movement, as well as a feeling of an incomplete bowel movement along with other symptoms. According to Western Medicine, constipation can be caused by a variety of factors. These factors include inadequate hydration, poor diet, a lack of dietary fiber, medication side effects, and physical inactivity, among other causes; a complication with the smooth muscle of the colon can result in the inability of the body to move and excrete waste products.
According to Chinese Medicine theory, constipation is an issue of the Large Intestine organ, like that of Western Medicine. While poor dietary habits are also seen as an etiological mechanism in CM, there is also the consideration of poor eating habits, such as hurried eating, distracted eating, working while eating, and eating standing up; essentially any behavior/activity performed while eating that distracts the person from eating. In addition to poor dietary habits, there is an emotional component to constipation in CM. Unexpressed emotions such as resentment, frustration, and anger can lead to qi stagnation, which will affect the Large Intestine and can lead to constipation. With this understanding, we can begin to plan an acupuncture treatment for constipation.
The colon, in Western Medicine, performs several functions including the final absorption of nutrients following the digestive process, as well as the production of stool and waste matter (as a result of nutrient absorption). These processes are done through reactions between neurotransmitters and muscular reactions/movements to produce and move the stool down the digestive tract for excretion. Researcher Rao notes that:
Constipation may result from structural, mechanical, metabolic, or functional disorders that affect the colon… either directly or indirectly. Because there is significant interaction between the brain and the gut… where defecation could be postponed for several days, it is worth emphasizing that neurological dysfunction may have profound effects on colonic function.
In summary of this concept, there are a variety of factors that can influence the pathophysiology of constipation (physical, mental, chemical, and structural), all of which can lead to the colon being unable or have difficulty producing and/or moving stool.
According to Chinese Medicine, constipation is most often caused by qi stagnation, a stoppage or blockage of the proper movement of qi energy which ensure the body’s proper function. As a result of dietary, lifestyle, and emotional complications that do not fully nourish or support proper qi movement, qi begins to stagnate in the LI resulting in constipation. Maciocia notes that Liver qi stagnation is often a precursor to LI qi stagnation. LR qi stagnation also shares etiology based in unexpressed emotions or emotional strain. As the LR is responsible for the smooth flow of qi, once the LR qi begins to stagnate, it is going to cause qi stagnation in other areas of the body. It is also possible that LR qi stagnation can develop as a result from LI qi stagnation; LI qi stagnation can also lead to the formation of dampness, resulting from the lack of movement of qi.
Constipation can manifest with symptoms of constipation itself, which can include difficulty making a bowel movement, significant straining while trying to have a bowel movement, firm/hard stools, the sensation of incomplete bowel evacuation, a feeling of blockage, and too few bowel movements in a given week. Along with these symptoms, Chinese Medicine recognizes that constipation can present with abdominal distension and pain, passing small stools, irritability, and the aggravation of the condition in accordance with one’s mood shifts. The tongue may appear as normal or may appear slightly red on the sides; the pulse may be wiry on both rear positions.
Constipation can be diagnosed via a physical examination. Both Western and Chinese Medicine principles note that the abdomen can be examined/palpated for distension and pain, as well as for the presence of stool. Rao notes that it may be relevant to test for colon cancer in some cases, which can be done via assessing blood count, glucose levels, and thyroid function, among other tests. Maciocia notes that “abdominal distension and pain with bitty stools are enough to diagnose qi stagnation of the Large Intestine.” With a diagnosis, we can begin to design an acupuncture for constipation treatment.
The primary Western treatment for constipation is with laxatives, both over the counter and prescription. Chinese Medicine would advise the use of herbal medicine as well as acupuncture for constipation, with the treatment principle of moving qi in the Large Intestine. The following points can be used: CV3, CV6, GB34, SP6, SP15, ST25, and BL25. All points will receive reducing/sedating needle action. Moxa may be used in subsequent treatments to help support the qi movement and to nourish the LI, and possibly LR, organ(s).
Researchers Zheng et al. performed a study on the treatment of constipation with acupuncture in which they assigned participants into one of four groups. Three groups involved acupuncture treatment and the fourth was a control group; the control group received oral administration of mosapride. The following points were used for each group: 1) ST25 and BL25, 2) LI11 and ST37, 3) ST25, BL25, LI11, and ST37. Treatment was carried out for sixteen sessions over four weeks, with each treatment lasting thirty minutes; points were stimulated with a 15Hz current. At four weeks the researchers did not find significant difference between the four groups, but at eight weeks they did find that the rates of spontaneous bowel movements were lower in the control group than the three acupuncture groups. After analyzing the results, Zheng et al. found that both acupuncture and mosapride increased stool frequency and stool consistency after four weeks, and that the style of acupuncture had little relevance on the treatment outcome.
In addition to the use of laxatives, Western Medicine would recommend dietary and lifestyle changes to prevent the occurrence of further constipation. Increased hydration and dietary fiber intake are two likely recommendations that would be made to help the colon function properly. Engaging in more regular exercise and generally being less sedentary are also advised. Along with acupuncture for constipation, Chinese Medicine would also encourage dietary changes and increased hydration. Kastner suggests the following foods to support the Large Intestine: food neutron and cool in nature, foods of the sour taste, and foods eaten raw, steamed, or balanced. He includes the following foods in his suggestion: oranges, plums, grapefruit, cucumbers, spinach, black tea, plum juice, tofu, yogurt, and wheat, among other things. CM would also emphasize the importance of not eating while standing, eating while working, or eating in a hurry; taking time to focus only on the meal you are eating and to fully savor the experience is important for supporting the proper, smooth flow of qi.
By using acupuncture for constipation relief, we can alleviate pain and discomfort as well as support digestive health and regularity. By incorporating nutrition and lifestyle changes into an acupuncture treatment, we can work to reduce the frequency and severity of constipation episodes. Contact me to learn more about acupuncture for constipation as well as other symptoms.
References
Kastner, J. (2009). Chinese nutrition therapy: dietetics in traditional chinese medicine (tcm)(2nd ed.). Stuttgart, Germany: Thieme.
Maciocia, G. (2015). The foundations of chinese medicine: a comprehensive text (3rd ed.). St. Louis, MO: Elsevier Health Sciences.
Rao, S. (2003). Constipation: evaluation and treatment. Gastroenterology Clinics of North America, 32, 659-683. doi:10.1016/S0889-8553(03)00026-8
Zheng, H., Liu, Z., Zhang, W., Chen, M., Zhong, F., Jing, X., … Rong, P. (2018). Acupuncture for patients with chronic functional constipation: a randomized controlled trial. Neurogastroenterology & Motility, 30(7), 1-9. Retrieved from https://doi.org/10.1111/nmo.13307
DISCLAIMER: this blog post is intended for informational purposes only. Do not perform any treatments included in the post yourself. This includes, but is not limited to, acupuncture, herbal medicine, and Chinese nutritional therapy. They should only be performed by educated and licensed acupuncture practitioners.
National Institutes of Health (NIH) studies have shown that acupuncture is an effective treatment alone or in combination with conventional therapies to treat the following:
Nausea caused by surgical anesthesia and cancer chemotherapy
Dental pain after surgery
Addiction
Headaches
Menstrual cramps
Tennis elbow
Fibromyalgia
Myofascial pain
Osteoarthritis
Low back pain
Carpal tunnel syndrome
Asthma
It may also help with stroke rehabilitation.
If you are curious about the benefits of acupuncture, scheudule an appointment for a personal consultation, and evaluation.
