This blog is to share the latest research and development of acupuncture and raise the awareness of alternative treatments for your conditions, and is for information only.

Thursday 10 January 2019

Electroacupuncture helped improve bowel and bladder function in patients with transverse myelitis

Electroacupuncture was used to treat patients with transverse myelitis to help improve bowel and bladder functions. Results of the clinical study were published in the journal of Acupuncture in Medicine.

Transverse myelitis is a condition in which a section of the spinal cord becomes inflamed. This neurological disorder often damages the insulating material myelin, the covering for nerve cell fibers, disrupting the messages that the spinal cord nerves send throughout the body. As a result, communications between nerve cells in the spinal cord and the rest of the body can be interrupted. The exact reason for transverse myelitis is not know. There are many conditions that appear to initiate the disorder, including infection, multiple sclerosis etc. Symptoms of transverse myelitis range from back pain to more serious problems, such as paralysis or loss of bowel control and bladder dysfunction. There is no cure for transverse myelitis. The treatments to prevent or minimize the permanent dysfunction include corticosteroid, antiviral and other immunosuppressive medications. Alternative medications such as acupuncture have been used to enhance patient’s recovery.

Recently, a small clinical study was conducted to explore the effect of electroacupuncture on bowel and bladder function of patients with transverse myelitis. Sixteen participants were recruited. Electroacupuncture was applied at acupoints bilateral BL32, BL33, and BL35 for 30 min, once a day, five times a week for the first 4 weeks; and once every other day, three times a week for the following 4 weeks. Patients were then followed up for 6 months. Bladder and bowel function were assessed at baseline, 8-week after acupuncture and 6-month follow respectively.

Data showed that at baseline, all 16 patients had abnormal voiding and needed assisted measures >50% of the time to empty the bladders. Following 8-week treatment, five patients (31%) resumed normal voiding; six patients (38%) achieved partially normal voiding assisted by pressing the abdomen to empty the bladder without catheterization, and five patients (31%) didn’t show significant improvement. The residual urine volume (RUV) markedly decreased by 100 mL (IQR 53–393 mL) in nine patients with bladder voiding dysfunction. The number of weekly urinary incontinence episodes, 24-hour urinary episodes, and nocturia episodes per night statistical significantly diminished by 14 (95% CI 5 to 22), 5 (95% CI 1 to 9), and 4 (95% CI 0 to 7) episodes, respectively in 11 patients with urinary incontinence. Following 8-week acupuncture treatment to eight patients with faecal retention, four (50%) resumed normal bowel movements, three (38%) regained partially normal bowel movements, and one (13%) didn’t have any change.

It has been suggested that electroacupuncture stimulation at BL32 and BL33 might directly or indirectly involved in the S2–3 nerve roots, which are the parasympathetic centre of the spinal cord, innervate the muscles in the pelvic area, such as the pelvic floor, urethral sphincters, bladder and anal sphincter muscles. It is plausible that acupuncture stimulation at S2–S3 might enhance recovery of the muscle function.

The preliminary study showed that electroacupuncture might be a promising alternative for the management of bladder and bowel dysfunction in patients with transverse myelitis. Further studies with larger sample and randomized controlled trials are needed to validate the present results.
Reference

Wu J et al., Effects of electroacupuncture on bladder and bowel function in patients with transverse myelitis: a prospective observational study. Acupunct Med. 2018 Aug;36(4):261-266   https://www.ncbi.nlm.nih.gov/pubmed/29909400