Epigastric pain is a common symptom in diseases of the stomach, including peptic ulcer, acute and chronic gastritis, and gastric spasm. Acupuncture provides satisfactory relief of epigastric pain-significantly better than injections of anisodamine or morphine plus atropine, as shown in randomized controlled trials (128, 129). For gastrointestinal spasm, acupuncture is also superior to injections of atropine (130), and for gastrokinetic disturbances, the effectiveness of acupuncture is comparable with that of conventional medicine (domperidone) (131).
Another common symptom of digestive disorders is nausea and vomiting. This can be due to a disordered function of the stomach, but it is more often a symptom or sign of generalized disorders. Morning sickness, postoperative vomiting, and nausea and vomiting related to chemotherapy are frequently encountered clinically. In all these conditions, acupuncture at point nèigu?n (PC6) seems to have a specific antiemetic effect. A recent systematic review of trials using acupuncture for antiemesis showed that 11 of 12 randomized placebo-controlled trials, involving nearly 2000 patients, supported this effect. The reviewed papers showed consistent results across different investigators, different groups of patients, and different forms of acupuncture stimulation (132).
Irritable colon syndrome and chronic ulcerative colitis are often difficult to treat with conventional medication. For these diseases, acupuncture may serve as a complementary or alternative therapeutic measure (133, 134).
Because of its analgesic effect, acupuncture can be used in endoscopic examinations, e.g. in colonoscopy. It has been reported that the effect of acupuncture to relieve pain and discomfort during the examination is comparable with that of scopolamine or pethidine with fewer side-effects (135, 136).
There has been extensive research on the effect of acupuncture on the digestive system, with extensive data showing its influence on the physiology of the gastrointestinal tract, including acid secretion, motility, neurohormonal changes and changes in sensory thresholds. Many of the neuroanatomic pathways of these effects have been identified in animal models (137).
Acupuncture shows good analgesic and antispasmodic effects on the biliary tract and, as indicated previously, can be recommended for treatment of biliary colic (62-64). It also has a cholagogic action, which has been demonstrated in experimental studies. In the treatment of biliary colic due to gallstones, acupuncture is not only effective for relieving the colicky pain, but is also useful for expelling the stones. Satisfactory results were reported when electric acupuncture was used in combination with oral administration of magnesium sulfate (138). Acupuncture treatment is also worth trying for chronic cholecystitis, even if there is acute exacerbation (139).