Electroacupuncture may be an effective treatment for chronic severe functional constipation

1. Patients treated with electroacupuncture (EA) had a greater increase in complete spontaneous bowel movements (CSBM) compared to the control group (sham EA).

2. Acupuncture-related adverse events during treatment were infrequent, as well as mild or transient, in both groups, suggesting EA is a safe treatment for chronic severe functional constipation (CSFC).

Evidence Rating Level: 1 (Excellent)

Study Rundown: Chronic constipation is a significant health problem, affecting approximately 16% of the world’s population. While laxatives are traditionally used to relieve this condition, constipation is known to reoccur following discontinuation of treatment. As such, many patients are dissatisfied with traditional therapy. Recent studies have suggested that EA may serve as an alternative treatment for chronic constipation; however, there is currently little evidence to support its therapeutic benefits. The authors of this study, therefore, aimed to determine the efficacy of EA for treatment of CSFC through a randomized, sham-controlled trial. They found that an 8-week treatment of EA increased CSBMs to a greater extent than sham EA. Additionally, they observed few adverse effects with EA, providing evidence to support the safety of this procedure. This study was limited with respect to its trial length, as longer-term follow up was not assessed. Furthermore, the study lacked a thorough blinding assessment and did not control for patients’ and acupuncturists’ expectations of effectiveness. Overall, the study suggests that EA may form a safe and effective alternative treatment for CSFC.

Click to read the study, published today in Annals of Internal Medicine

Relevant Reading: Efficacy of electroacupuncture in the treatment of functional constipation: A randomized controlled pilot trial.

In-Depth [randomized controlled trial]: In this study, participants were allocated to the EA or sham EA group and underwent an 8-week treatment program. Each participant was required to complete a stool diary for a total of 20 weeks, in addition to a Patient Assessment of Constipation Quality of Life questionnaire. The study found that patients in the EA group had increased CSBMs from baseline. Specifically, the increase was 1.76 (95%CI 1.61 to 1.89) in the EA group and only 0.87 (95%CI 0.73 to 0.97) in the sham EA group. The difference between groups was 0.90 (95%CI 0.74 to 1.10, p < 0.001). A similar trend was observed during weeks 9 to 20. In addition, the proportion of patients having 3 or more weekly CSBMs in the EA group was 31.3% over the treatment and 37.7% during follow-up. This is in contrast to the control group, where only 12.1% experienced CSBMs during treatment and 14.1% during follow up (p < 0.001).

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