Manual therapy for GI diseases

Acupuncture; Acupuncture has been used for treating FD, IBS, constipation and diarrhea (Chang et al., 2001; Wang, 2004; Takahashi 2006; Tillisch, 2006). The dysfunction of GI motility and visceral hypersensitivity are especially considered as important factors of functional GI disorders. Acupuncture has been shown to improve GI dysmotility and reduce visceral pain. Thus, acupuncture is effective in patients with functional GI disorders (Takahashi 2011).

Acupuncture alters various stress-induced physiological responses. Delayed Unknowngastric emptying and accelerated colonic transit induced by acute restraint stress were restored by electro-acupuncture (EA) in rats (Iwa 2006). EA at legs stimulates parasympathetic activity and inhibits sympathetic activity under the stressful conditions, resulting in the restoration of impaired gastric motility (Imai 2009) and dogs (Taniguchi et al., 2012).

Accelerated colonic transit induced by chronic stress is also mediated via central CRF1 receptors in rats (Yoshimoto 2012).

EA increased the number of OXT-immunopositive cells and decreased CRF-immunopositive cells at the PVN following chronic stress (Yoshimoto et al. 2012). These suggest that EA may act on OXT neurons at the hypothalamus, resulting in reduced CRF expression and restoration of GI dysmotility following chronic stress.

TENS; In contrast to acupuncture, transcutaneous electrical nerve stimulation (TENS) is a non-invasive Unknownprocedure in which electrodes are placed on the skin and stimulated by electricity. A recent study demonstrated that TENS applied to the acupuncture points at the hands and lower legs improves GI symptoms in patients with FD (Liu et al. 2008).

TENS is a possible alternative candidate therapy for the treatment of patients suffering from stress-related diseases. TENS is side effect-free and cost-effective. TENS can be effectively done at home, is portable, requires little time commitment, is easy to learn. TENS is a promising treatment for anxiety and/or GI disorders in any population of patients (Sallam et al. 2007).

Further clinical and basic studies are needed whether no needle insertion procedure (TENS) has similar effects on the somoatosensory pathway, compared to the needle insertion procedure (acupuncture).