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EFFECTS OF ACUPUNCTURE ON ESOPHAGEAL MOTILITY
Felipe M. Vieira1, Fernando A. M. Herbella*1, Daniel H. Habib2, Marco G. Patti3
1Department of Surgery, Federal University of Sao Paulo, Sao Paulo - SP, Sao Paulo, Brazil; 2Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil; 3Department of Surgery, University of North Carolina, Chapel Hill, NC
Background: Chinese medicine is widely used in the East with good results for the treatment of many diseases. Acupuncture, the Chinese medicine procedure most used in the West, has been increasingly used and recognized as a complementary medical treatment. Some studies on gastrointestinal motility are available; however, acupuncture real effect on esophageal motility is still elusive due to the lack of studies with adequate methodology. Aims: This study aims to evaluate acupuncture effect on esophageal motility.
Methods: We reviewed preliminary results of 10 (60% females, mean age 26 years) volunteers (to a goal of n=25). No individual underwent acupuncture sessions before to minimize placebo effect based on previous experience. All individuals underwent high resolution manometry. The test was performed in 3 parts: basal measurements, 20 minutes after acupuncture stimulation of the gastrointestinal point (ST36) and 20 minutes after acupuncture stimulation of a sham point (5 cm medial to ST36) (crossover). ST36 or sham points were alternated in order based on randomization. Lower esophageal sphincter (LES) resting and residual pressure; distal latency and distal contractility integral were recorded. All tests were reviewed by 2 experienced investigators blinded to the acupuncture point.
Results: LES resting pressure was significantly reduced after acupuncture (p=0.005) (Wilcoxon signed-rank test). LES residual pressure and esophageal body motility remained unaltered (table 1).
Conclusion: Our results showed that acupuncture decreases LES basal pressure but not esophageal motility. Acupuncture may be an alternative treatment to spastic disorders of the LES.
Manometric parameters before and after acupuncture
| | Basal | Gastrointestinal point | Sham point | p | | LES resting pressure (mmHg) | 31±12 | 15±8 | 27±13 | Basal x GI = 0.005
Basal x Sham = 0.1
Sham x GI = 0.01
| | LES residual pressure (mmHg) | 8±5 | 10±11 | 11±12 | Basal x GI = 0.9
Basal x Sham = 0.9
Sham x GI = 0.8
| | Distal latency (s) | 5±2 | 7±2 | 7±1 | Basal x GI =0.1
Basal x Sham = 0.06
Sham x GI = 0.7
| | Distal contractile integral (mmHg*cm*s) | 1282±849 | 1435±1026 | 1508±1089 | Basal x GI = 0.9
Basal x Sham = 0.8
Sham x GI = 0.9
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LES: lower esophageal sphincter
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