Acupuncture for the Treatment of Irritable Bowel Syndrome

In this series of articles I am focusing on acupuncture as a treatment option for a variety of medical conditions. So far I have written about a range of conditions: fertility – a condition commonly associated with acupuncture – and others you may not automatically consider seeking acupuncture treatment for. To read more about these conditions and for more about acupuncture in general, you can read the following articles:

Acupuncture – What Is It and How Does It Work?
Shingles – What Is It and How Can Acupuncture Help?
Acupuncture, a Powerful Treatment for Stress and Insomnia
Acupuncture as a Treatment for Depression
Acupuncture to Prevent Chronic Infections
Fertility in Chinese Medicine Pt 1 – Supporting Kidney Essence
Fertility in Chinese Medicine Pt 2 – Acupuncture for Infertility

This week I am going to write about one of the more common digestive complaints, Irritable Bowel Syndrome (IBS). In western medicine, this diagnosis is given to people who struggle with digestive symptoms in the large intestine. There is usually a combination of constipation, diarrhea (or a mixture of the two), abdominal pain, cramps, gas and bloating. Most people who suffer from IBS struggle with it for years and often learn to manage it with diet and fiber support, stress management, probiotics and, in some cases, anti-depressants.

Chinese medicine (as I have discussed before), is able to go one step further, giving  a much deeper look at your health and taking into account all of your symptoms. This allows us to give a more precise diagnosis and therefore tailor treatment to your specific irritable bowel symptoms.

IBS in Chinese Medicine

In ancient Chinese medicine the body was seen as an Empire where each organ has a specific job to do and is responsible for certain emotions. Each organ is paired to another – one ‘yin’, the other ‘yang’ and the aim is to maintain the right balance of yin and yang energy (or qi) between each pair.

When it comes to IBS, it is the liver (yang, paired with the gallbladder) and the spleen (paired with the stomach) we look to as they both play a major role in regulating our digestive system as well as the lungs which are the yin paired organ of the large intestine (which is yang).

In fact, all of the organs in Chinese medicine are connected, and when there is injury or insult to one there can be a rebound effect on another. The emotional factors of anger, worry and sadness disturb the flow of qi and, as a result, pathologies can show up between the liver, spleen, lungs, and large and small intestines. Let’s look at the role each of these organs plays, the basic patterns of IBS that relate to them and how we use acupuncture to treat them.

The Role of the Liver in IBS

In the empire of the body, the liver is the General. Just as a General commands his army, so the liver commands all the functions in the body. Without a properly functioning liver, chaos occurs. When there is stagnation of the liver qi then other systems in the body back up.

The main emotion associated with the liver is anger and frustration. So, if your IBS is caused by stagnation of the liver qi you may be irritable, short-tempered, frustrated or depressed.  The liver, when it is out of balance can wreak havoc on other organs which, in the case of IBS, means the spleen, lung and the large intestine. These are the patterns involving the liver that can cause IBS:

Liver Qi Stagnation Causing Stagnation in the Large Intestine

Symptoms: Pain and distension in the abdomen – the pain is worse with pressure. In this pattern people have constipation and a feeling of incomplete bowel movements.

Treatment principle: To move the liver qi and unblock its stagnation and move stagnant qi in the intestines.

Acupuncture points:
Liver 3 regulates liver qi, promotes smooth flow of qi and relieves stagnation. This point is a good one for emotional stress and calming the mind. It is located on the top of the foot in the web between the 1^st and 2^nd toe.

Stomach 25 is the front alarm point of the large intestine (an alarm point is one that has a more immediate effect on the associated organ – in this case the large intestine – and can therefore help relieve any acute pain the patient is experiencing at the time of a treatment). This point also regulates the qi and promotes the function of the large intestine relieving constipation, abdominal pain and bloating. It is located on the abdomen, about 2 inches on either side of the belly button.

Liver Over-Acting on the Spleen

Symptoms: This pattern is characterized by an interaction between two separate patterns – liver qi stagnation and spleen qi deficiency (see below) – and symptoms will draw from both patterns depending on the balance between the two. For example, you may have constipation, diarrhea, or both. Or you could experience abdominal pain and bloating with increased anger and short-temper or an overactive mind. You could have abdominal pain that is relieved by applying pressure alongside feeling bloated or puffy.

Treatment principle: To relieve stagnation of qi in the liver and the intestines, to tonify the spleen and harmonize the liver and spleen.

Acupuncture points: In addition to the points for liver qi stagnation or spleen qi deficiency you can add the following:

Liver 13 is the front alarm point of the spleen; it tonifies the spleen and moves liver qi stagnation. You can find it on the abdomen in front of the free end of the 11^th rib (the last rib you can feel on the side of your waist) on both sides of the abdomen.

Liver 14 is the front alarm point of the liver and the crossing point of the spleen and liver meridians. It is located on the chest, 2 ribs directly below the nipple (what is called the ‘mammillary line’).

The Role of the Spleen in IBS

The spleen’s job is to separate the pure from the impure within the body. Basically, the spleen is involved in the transformation and transportation of substances and we rely on this function for the formation of qi, blood and fluids which ensure we get the nutrition we need. Worry is the emotion that harms the spleen so if you are someone who constantly ruminates, turning your thoughts over and over in your mind this has a direct effect on your digestive system – too much worry injures the spleen and impairs its ability to digest food.

Spleen Qi Deficiency

Symptoms: Increased swelling and puffiness anywhere in the body, bloating in the digestive system, loss of appetite, fatigue, diarrhea and loose stools. In this pattern any pain in the abdomen is alleviated by applying pressure.

Treatment principle: To tonify the spleen qi and strengthen the functions of transformation and transportation.

Acupuncture points:
Stomach 36 tonifies the stomach and spleen qi and regulates the intestines. It is located about 4 finger-widths below the knee on the outside of the shin bone. If you feel around there is usually a place your finger easily lands on, this is stomach 36.

Spleen 6 tonifies the spleen, clears dampness, relieves abdominal pain and bloating, and helps with diarrhea. It can be found 3 finger-widths above the ankle on the inside of the leg.

The Role of the Lungs in IBS

The lungs are the master of qi and their job is to control breathing, rule the skin and body hair, and regulates the pathways for the circulation and excretion of water (water passages).

The emotions associated with the lungs, and its paired organ the large intestine, are sadness and grief. These two organs are said to be connected both internally and externally, and therefore what affects the lungs can also show up as a pathology in the large intestine, such as irritable bowel syndrome. This is because, if the lung qi is deficient, it is not able to descend from the lungs to help the function of the large intestine.

Lung Qi Deficiency with Qi Stagnation in the Large Intestine

Symptoms: As with the earlier pattern, “Liver Over-Acting on the Spleen”, this is another mixed pattern influenced by the balance between deficiency and excess. In this case there will be more symptoms of lung qi deficiency, frequent colds, shortness of breath, asthma and fatigue. This pattern is associated with constipation, bloating and abdominal pain that may be relieved or made worse by applying pressure. There also maybe a sensation of incomplete emptying in the large intestine when passing a bowel movement.

Treatment principle: To relieve stagnation of qi in the liver and the intestines, tonify lung qi and promote the descending function of the lung qi.

Acupuncture points:
Lung 7 stimulates the descending function of lung qi which helps with the function of the large intestine. The easiest way to find this point is to lock your two thumbs together and slide the index finger of your left hand on top of your right wrist. It lands directly on top of Lung 7.

Stomach 37 is the lower large intestine point called a He-Se point; it regulates the function of the large intestine, relives intestinal pain, bloating and diarrhea. It is located on the front of the shin, 3 fingers below Stomach 36 (see acupuncture points for Spleen Qi Deficiency above) in the depression between the muscle and the bone.

Closing Thoughts

For many people, irritable bowel syndrome can be a painful and chronic condition and they are frustrated that their doctor does not have a more comprehensive treatment plan for them, or that they only want to throw a drug at them instead of looking for a deeper cause. Acupuncture looks for that deeper cause and is therefore a powerful medicine to help in the treatment and management of IBS. A key element of treatment in both western and Chinese medicine for IBS will always be specific dietary advice based on your diagnosis. As a general rule however, if you have weak, poor digestion then you want to avoid cold, raw damp foods. This means avoiding eating food straight from the refrigerator (take things out of the fridge ahead of time and let them come to room temperature before eating them) and definitely no ice in your beverages. If you are in the Seattle area and would like to schedule an acupuncture treatment with me, my clinic is in Issaquah. I also offer naturopathic appointments in person or on the phone and you can book any of these by using the book online tool above.

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