GI response to acupuncture may be placebo effect

NEW YORK (Reuters Health) - As a treatment for irritable bowel syndrome, acupuncture is associated with improvements in quality of life. However, the improvement reported by patients who underwent a fake or "sham" procedure suggest that a placebo effect is largely responsible for the benefits, new research shows.

The findings, which appear in the medical journal Gut, support previous reports, which have failed to establish acupuncture as an effective treatment for irritable bowel syndrome.

"Based on the small differences found between acupuncture and sham acupuncture, a study using individual traditional Chinese medicine patterns with 566 patients would be necessary to prove efficacy," Dr. Antonius Schneider, from the University of Heidelberg in Germany, and colleagues state. "The question is whether such a difference would be clinically relevant."

While the present study is the largest clinical trial to evaluate acupuncture for irritable bowel syndrome, it had just 43 patients. Acupuncture was applied using standard methods, whereas sham acupuncture was performed with a special needle that simulates puncture, but does not actually penetrate the skin.

Real and sham acupuncture lead to significant and comparable improvements in quality of life, the authors note. The benefit from both declined after a few months.

A comparison of responders and nonresponders in each group further supported a placebo effect as the primary cause of symptom improvement, the report indicates. Coping and other psychological variables may determine whether a particular irritable bowel syndrome patient will have placebo response, the authors note.

In future studies, it might be possible to predict individuals with placebo responsiveness, they add.

SOURCE: Gut, May 2006.