Acupuncture: a good choice to patients with intractable slow-transit constipation

Background. The roles of the sympathetic and parasympathetic systems in mediating the effect of electroacupuncture (EA) at ST37 on jejunal motility have yet to be demonstrated. Aim. We used rats and mice to investigate the effect and mechanism of action of EA at ST37 on jejunal motility. Methods. Jejunal motility was recorded by a balloon placed in the jejunum and connected to a biological signal collection system through a transducer. The effects of EA (3 mA) at ST37 were evaluated in Sprague-Dawley rats without drugs and with the administration of clenbuterol, propranolol, acetylcholine, and atropine. Further, the efficacy of EA at different intensities (1/2/4/6/8 mA) was measured in wild-type mice and β 1 β 2 −/− mice and M2M3 −/− mice. Results. In Sprague-Dawley rats, the excitatory effect of EA at ST37 on jejunal motility disappeared in the presence of the muscarinic receptor antagonist atropine. EA at ST37 was less effective in M2M3 −/− mice than in wild-type mice. Furthermore, to a certain extent, there existed “intensity-response” relationship between jejunal motility and EA. Conclusions. EA at ST37 can enhance jejunal motility in rats and mice mainly via excitation of the parasympathetic pathway. There is an “intensity-response” relationship between EA and effect on jejunal motility.

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“…Acupuncture possesses credible therapeutic efficacy on gastrointestinal dysfunction [7, 8], but the underlying mechanism remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Electroacupuncture at ST37 Enhances Jejunal Motility via Excitation of the Parasympathetic System in Rats and Mice

Yuan

Wang

et al. 2016

Evidence-Based Complementary and Alternative Medicine

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“…One study did not specify the duration of constipation . Constipation was described as severe in three studies, refractory in six, and intractable in three studies …”

Section: Resultsmentioning

confidence: 99%

“…The duration of constipation prior to inclusion ranged from 6 months to at least 1 year . Other studies used the Rome II or Rome III criteria for functional constipation, implying minimum duration of 12 and 6 months, respectively. Still, other studies used terms like “several years” .…”

Section: Resultsmentioning

confidence: 99%

“…All studies described a failure of medical therapy such as laxatives, dietary modification, or biofeedback . Only two studies required patients to have failed a 4‐week run‐in period of medical therapy such as fiber, laxatives, enemas, and suppositories.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies evaluated non‐medical, non‐surgical therapies, three of which evaluated only patients with slow transit constipation using abnormal colonic transit test, excluding pelvic floor dysfunction using anorectal manometry and defecography . A study on spinal magnetic stimulation included patients with slow transit constipation, pelvic floor dysfunction, or both, assessed with colonic transit time and defecography .…”

Section: Resultsmentioning

confidence: 99%

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Searching for a definition for pharmacologically refractory constipation: A systematic review

Soh

Kang

Siah

et al. 2018

J of Gastro and Hepatol

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Functional Disorders: Slow-Transit Constipation

Tillou

Poylin

2016

Clinics in Colon and Rectal Surgery

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Constipation is a very common complaint, with slow-transit constipation (STC) accounting for a significant proportion of cases. Old age, female gender, psychiatric illness, and history of sexual abuse are all associated with STC. The exact cause of STC remains elusive; however, multiple immune and cellular changes have been demonstrated. Diagnosis requires evidence of slowed colonic transit which may be achieved via numerous modalities. While a variety of medical therapies exist, these are often met with limited success and a minority of patients ultimately require operative intervention. When evaluating a patient with STC, it is important to determine the presence of concomitant obstructed defecation or other forms of enteric dysmotility, as this may affect treatment decisions. Although a variety of surgical procedures have been reported, subtotal colectomy with ileorectal anastomosis is the most commonly performed and well-studied procedure, with the best track record of success.

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Acupuncture: a good choice to patients with intractable slow-transit constipation

Cited by 4 publications

References 3 publications

Electroacupuncture at ST37 Enhances Jejunal Motility via Excitation of the Parasympathetic System in Rats and Mice

Electroacupuncture at ST37 Enhances Jejunal Motility via Excitation of the Parasympathetic System in Rats and Mice

Searching for a definition for pharmacologically refractory constipation: A systematic review

Functional Disorders: Slow-Transit Constipation

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