Tag Archives: Dyspepsia

Heartburn, Indigestion Condition Resources

Also known by its medical name of Dyspepsia, or commonly as indigestion or heartburn.

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

Research and Resources on Dyspepsia and Acupuncture:

A scholarly search of the available research papers on the terms “acupuncture” + “dyspepsia” yields over 8,600 papers, and narrowing this to “RCT” to identify Randomised Controlled Trials, gives over 970 results; of which 42% have been carried out since 2017 (Google Scholar). This suggests that acupuncture is being used traditionally and currently in this area, leading to a body of research being carried out, the pace of which has increased in recent years, indicating increased recognition that it is worthy of scientific appraisal regarding its potential role.

Interpreting the research:

When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms.  The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment).  In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.

The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control).  Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.

The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.

The Research:

The British Acupuncture Council has a Research digest where they have looked at some more recent studies including on Dyspepsia, including a 2-arm trial where the refractory functional dyspepsia patients were seen to experience improvement in symptoms for up to two months, with no adverse side effects (RCT; n=200) (Zheng et al, 2018).   An RCT in Korea (n=76) looked at functional dyspepsia as well as other quality of life related measures, finding a significant improvement in FD symptoms for up to 8 weeks in the acupuncture group (Ko et al, 2016).  

A meta-analysis of 16 RCTs (n=1436 total) found positive results both for symptoms and quality of life, albeit that the quality of the research was low in many cases in the trails they examined, but further high quality RCT studies are needed to corroborate the trends (Pang et al, 2016). Recently, Zhang at al, (2020) reached a similar conclusion on examining 35 studies (n=3301), specifically recommending multi-centre trials and high quality RCT’s to supplement the current research body. Currently, we await with interest the results of Kwon et al’s (2021) paper after “acupuncture as add-on treatment for functional dyspepsia protocol for systematic review”.

Regarding Your Individual Condition and Symptoms:

Whilst the scientific studies are of great interest to researchers and acupuncturists in terms of comparing protocols, for the patient not versed in research they are less accessible, which is why when we asked “can acupuncture work for my (condition or symptom) we are not able to give a simple yes or no response.  We are able to tell you what experience we have had in our decades of experience in practise, of the types of outcomes we have seen in similar cases, and give you an idea of our level of experience and knowledge in that area, and how this could relate to your own individual situation.  For this, we recommend booking a free telephone consultation where we can answer any questions you have and give a realistic appraisal of what acupuncture may be able to provide.

Resources:

British Acupuncture Council evidence based factsheet about Gastrointestinal Issues including specific research, trials and mechanisms of action for acupuncture in this condition.

British Acupuncture Council Research Digest – Dyspepsia (just over halfway down the document)

References:

Ko, S.J., Kuo, B., Kim, S.K., Lee, H., Kim, J., Han, G., Kim, J., Kim, S.Y., Jang, S., Son, J. and Kim, M., 2016. Individualized acupuncture for symptom relief in functional dyspepsia: a randomized controlled trial. The Journal of Alternative and Complementary Medicine22(12), pp.997-1006.

Kwon, C.Y., Ko, S.J., Lee, B., Cha, J.M. and Park, J.W., 2021. Acupuncture as add-on treatment for functional dyspepsia: A protocol for systematic review. Medicine100(7).

Pang, B., Jiang, T., Du, Y.H., Li, J., Li, B., Hu, Y.C. and Cai, Q.H., 2016. Acupuncture for functional dyspepsia: what strength does it have? A systematic review and meta-analysis of randomized controlled trials. Evidence-based Complementary and Alternative Medicine2016.

Zhang, J., Liu, Y., Huang, X., Chen, Y., Hu, L., Lan, K. and Yu, H., 2020. Efficacy Comparison of Different Acupuncture Treatments for Functional Dyspepsia: A Systematic Review with Network Meta-Analysis. Evidence-Based Complementary and Alternative Medicine2020.

Zheng, H., Xu, J., Sun, X., Zeng, F., Li, Y., Wu, X., Li, J., Zhao, L., Chang, X.R., Liu, M. and Gong, B., 2018. Electroacupuncture for patients with refractory functional dyspepsia: a randomized controlled trial. Neurogastroenterology & Motility30(7), p.e13316.

Helen
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