Electroacupuncture outperforms transcutaneous electrical stimulation in severe constipation

22 Dec 2021
Electroacupuncture outperforms transcutaneous electrical stimulation in severe constipation

Administering acupuncture with a zap to patients with severe chronic constipation produces better outcomes than transcutaneous electrical stimulation (TES), increasing the frequency of complete spontaneous bowel movements (CSBMs) and improving quality of life, as shown in a study.

In the study, 70 patients were randomized to undergo electroacupuncture (EA) or TES, with the acupoints in both groups being bilateral. Each patient received 24 sessions of EA or TES over 8 weeks and were followed for 24 weeks after treatment.

Researchers compared the proportion of participants achieving an increase of 1 CSBMs at week 8 as well as changes in the number of CSBMs and spontaneous bowel movements, stool character, difficulty in defecation, Patient Assessment of Constipation Quality of Life (PAC-QOL). They also evaluated the proportion of patients who used rescue medication and adverse reactions.

A total of 60 patients completed the trial: 32 participants (91.43 percent) in the EA group and 28 (80.00 percent) in the TES group. Significantly more patients in the EA group than in the TES group achieved the primary endpoint of an increase in CSBMs from baseline at week 20 (68.75 percent vs 35.71 percent; p=0.019) and week 32 (59.38 percent vs 32.14 percent; p=0.042).

At the same time, the proportions of patients having 3 CSBMs per week were higher in the EA group at both week 20 (56.25 percent vs 21.43 percent; p=0.008) and week 32 (46.88 percent vs 17.86 percent; p=0.027).

PAC-QOL score after 8 weeks of treatment was also markedly better in the EA group than in the TES group (mean, 19.06 vs 12.48; p=0.031).

There were no significant between-group differences in defecation difficulty, stool character, and the use of rescue medication.

The findings show that EA may be the better mode of treatment for severe chronic constipation, although the noninvasive TES could be a more suitable choice for patients who are afraid of acupuncture. More trials with larger sample sizes are needed to validate the present data.

J Clin Gastroenterol 2021;doi:10.1097/MCG.0000000000001645