Acupuncture may relieve symptoms of postprandial distress syndrome

Last Updated: 2020-05-11

By Lisa Rapaport

(Reuters Health) - Acupuncture may help improve or eliminate symptoms of postprandial distress syndrome such as uncomfortable sensations of fullness or bloating, a randomized trial suggests.

The trial included 278 Chinese patients aged 18 to 65 years who met the Rome IV criteria for postprandial distress syndrome (PDS). Participants were randomized to 12 sessions of acupuncture or sham acupuncture over 4 weeks and followed for a total of 16 weeks. A total of 228 participants completed outcome measurements at week 16.

Mean age at baseline in the intent to treat population was 41.6 years in the acupuncture group and 41.2 years in the control group. Both groups had similar mean symptom scores on an 8-item questionnaire at baseline of 7.9 and 7.8, respectively; they also had similar baseline mean Nepean Dyspepsia Index scores of 57.1 and 55.5, respectively.

After 4 weeks of the intervention, 27.8% of patients in the acupuncture group and 17.3% of patients in the sham acupuncture group reported elimination of all three cardinal symptoms of PDS: postprandial fullness, upper abdominal bloating, and early satiation. Results were similar at 16 weeks, researchers report in the Annals of Internal Medicine.

"Prokinetic drugs are the first-line treatment for postprandial discomfort syndrome, however, this treatment is limited by its unsatisfactory efficacy and adverse event profile," said lead study author Dr. Jing-Wen Yang of Beijing University of Chinese Medicine.

"Acupuncture is a safe treatment with fewer adverse events," Dr. Yang said by email. "Therefore, those who are dissatisfied with the efficacy of the drug, cannot tolerate the side effects of drugs, and are able to afford the time of treatment and transportation are more suitable to choose acupuncture."

In the study, the estimated response rate was also higher with acupuncture, at 83% at week 4 compared with 31.4% for the sham acupuncture group.

At week 4, mean scores on the 8-symptom questionnaire declined by 5.4 points for the acupuncture group and 3.8 points with sham acupuncture. By week 16, the difference was more pronounced, with mean score declines of 5.2 points and 3.1 points, respectively.

In addition, mean Nepean Dyspepsia Index scores declined by 15.4 points in the acupuncture group and by 8.1 points in the sham acupuncture group at week 4. The difference was similar at week 16.

One limitation of the study is that self-reported symptoms are subjective, the study team notes. The 18% dropout rate may have also compromised the results of the study, researchers point out.

While patients were blinded, the acupuncturists were not, and it's possible that this impacted the outcomes in some way, said Dr. Peter Lio of Northwestern University Feinberg School of Medicine in Chicago.

Still, some previous studies suggest that acupuncture may indeed help ease discomfort in the GI tract, Dr. Lio, who wasn't involved in the study, said by email. Patients should still see a doctor to confirm that diagnosis, and rule out other causes of indigestion such as reflux disease, a stomach ulcer, or a gall bladder problem, Dr. Lio advised.

"If it does appear to truly be in this functional category, however, then it is certainly reasonable to talk to your doctor about acupuncture as an evidence-based option, especially when it seems that most of the treatments discussed for this condition are not heavily evidence-based," Dr. Lio said. "Ideally, a licensed acupuncturist would then be the one to carry out those treatments and could hopefully follow the basic approach outlined in the study with the 9 points indicated, treating 3 times per week for 4 weeks."

SOURCE: https://bit.ly/2zwMXRX Annals of Internal Medicine, online May 11, 2020.