Acupuncture has a Placebo Effect on Rectal Perception but not on Distensibility and Spatial Summation: A Study in Health and IBS

Rohrböck, Reingard B.K.; Hammer, Johann; Vogelsang, Harald; Talley, Nicholas J.; Hammer, Heinz F.
October 2004
American Journal of Gastroenterology;Oct2004, Vol. 99 Issue 10, p1990
Academic Journal
BACKGROUND: Recent data suggest that acupuncture has effects on gut physiology and perception. Spatial summation is a central mechanism of perception and describes the phenomenon that thresholds for perception are lower if more receptors are stimulated.OBJECTIVES: We assessed perception thresholds for rectal distension and cutaneous referral of symptoms, while inflating one or two rectal balloons and the effect of both electro-acupuncture and placebo-acupuncture on rectal distensibility, perception, and spatial summation.METHODS: A tube with two barostat balloons was placed in the rectum of 12 healthy subjects and nine irritable bowel syndrome (IBS) patients with rectal symptoms. Volume-controlled stepwise distension of the distal balloon only or both balloons was performed first as a control, and thereafter with simultaneous placebo- or electro-acupuncture in dermatomes S3 and S4. A symptom questionnaire and anatomic questionnaire was completed during each distension.RESULTS: Rectal elastance increased from 42.0± 19.6 log mmHg/ml during one-balloon distension to 59.6± 33.1 log mmHg/ml during two-balloon distension (p<0.05) in healthy subjects, and from 48.8± 14.4 log mmHg/ml (one balloon) to 77.6± 24.2 log mmHg/ml (p<0.001) in patients with IBS. Electro-acupuncture had no effect on rectal sensation, elastance, and cutaneous referral when compared to placebo-acupuncture. However, acupuncture (both electro- and placebo-) increased volume thresholds for sensation compared to control experiments, while objective parameters like rectal tone and elastance were unaltered.CONCLUSION: Acupuncture has a placebo effect on rectal perception but has no effect on rectal distensibility and visceral referral. Spatial summation affected both rectum distensibility and perception, but was also not altered by acupuncture.(Am J Gastroenterol 2004;99:1-8)


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