Integrative Treatment of Gastroparesis with Traditional Chinese and Western Medicine

Hong-Chun Lin, M.D., Ching-Mao Chang, M.D., Ph.D.

Director/Attending physician (M.D.) of Division of Integrative Medicine, Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

<Cite: https://patient.gastro.org/gastroparesis/>

Overview

Gastroparesis is a digestive disorder characterized by slowed stomach emptying without organic obstruction, leading to symptoms such as loss of appetite, bloating, nausea, vomiting, upper abdominal pain, and belching. Gastroparesis is more common in women than men, and 11%-18% of gastroparesis patients also have diabetes. Obesity and overweight are also high-risk factors for gastroparesis. In addition to diabetes, postoperative gastroparesis is a common cause of discomfort in patients.

Current treatments for gastroparesis focus on improving systemic problems (such as controlling blood sugar in diabetic patients) and symptomatic treatment. Mild symptoms can be improved by adjusting diet and lifestyle, but if the condition is severe, drug therapy, including antiemetics and drugs that promote gastrointestinal motility, may be necessary. In persistent cases, surgery may be considered. Thus, diabetes and surgery are common causes of gastroparesis, and conventional Western medicine treatments mainly focus on symptom relief. The following section will introduce integrative treatments for gastroparesis caused by diabetes and postoperative gastroparesis using traditional Chinese medicine and Western medicine.

Features

Currently, acupuncture is the most common integrative treatment for gastroparesis with traditional Chinese medicine and Western medicine. A meta-analysis study from 2013 on acupuncture treatment for diabetic gastroparesis included and analyzed 14 randomized controlled trials, and found that acupuncture can improve digestion-related symptoms such as nausea, vomiting, and loss of appetite. For acupuncture treatment of diabetic gastroparesis, clinical practitioners often select acupoints along the spleen and stomach meridians, as well as other relevant acupoints that help alleviate symptoms such as nausea and vomiting. A randomized, single-blind clinical study on acupuncture treatment for diabetic gastroparesis showed that after 2 weeks of four acupuncture treatments on patients with type 2 diabetes and gastroparesis symptoms for more than 3 months, acupuncture significantly reduced gastric half-emptying time and improved symptoms. In addition to acupuncture treatment, clinical practitioners may also prescribe traditional Chinese medicine based on the patient's constitution and disease state, in combination with acupuncture treatment (acupoints include Zusanli, Shangjuxu, Xiajuxu, Gongsun, Fenglong, and Neiguan), to effectively improve patient symptoms.

For postoperative gastroparesis, acupuncture is also often used as a treatment. A meta-analysis of 16 randomized controlled trials showed that both acupuncture treatment alone and acupuncture combined with Western medicine treatments can improve postoperative gastroparesis symptoms, with the most commonly used acupoints being Zusanli, Zhongwan, and Neiguan. A study comparing the effects of metoclopramide, a prokinetic drug that promotes gastric emptying and gastrointestinal motility, with acupuncture treatment for postoperative gastroparesis showed that both treatments could improve gastroparesis symptoms, with acupuncture treatment being more effective.

Procedure

Currently, acupuncture treatment for gastroparesis often involves using Zusanli acupoints along the stomach meridian with different acupoints. A study compared the effects of different acupoints on gastroparesis treatment and found that after three treatment sessions, all three groups (Zusanli with Zhongwan, Zusanli with Neiguan, and non-acupuncture acupoints with Zusanli) significantly reduced Gastroparesis Cardinal Symptom Index (GCSI) scores, with the Zusanli and Zhongwan combination showing the best treatment effect.

Notification

Diabetic gastroparesis and postoperative gastroparesis are common causes of gastroparesis. By using integrative treatments with traditional Chinese medicine and Western medicine, such as acupuncture combined with drug therapy, symptoms can be effectively improved and quality of life can be promoted, reducing discomfort for patients.

Estimated cost

1. Acupuncture
2. Herbal medicine
3. Tuina
4. Taichi

Reference

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