Everyone at some point of their life will experience abdominal pain. Abdominal pain is one of the most complicated symptoms which can be caused by many factors. Most of the causes are not serious and the pain can be diagnosed and treated with good prognosis. However abdominal pain can be a sign of very serious illness. If the abdominal pain is severe or recurrent and there are some other symptoms associated with such as fever, inability to keep food down, signs of dehydration, bloody stools, inability to pass stool and there is persistent nausea and vomiting, painful or unusually frequent urination, severe tenderness when you touch the abdomen, swelling of the abdomen, skin appears yellow, weight loss, pain is caused by injury to the abdomen etc, it is important to recognise the symptoms that are serious and see doctors to get it diagnosed. Be careful if you want to take over the counter pain killer. Pain killers sometimes can mask the severity of the illness. Acupuncture is not recommended for severe acute abdominal pain.
Fortunately in most of cases the abdominal pain is not caused by serious illness, but it can be depressing if the abdomen is always painful. Acupuncture can help relieve chronic abdominal pain and bloating.
Smooth muscle is located in the walls of hollow internal organs, such as the arteries, intestines, bladder in the abdomen. When they contract, the organ is squeezed. Most of the abdominal pain is visceral pain which is pain arising from the internal organs. Visceral pain is triggered by smooth muscle distension or contraction, stretching of the capsule surrounding an organ, ischaemia and necrosis, or irritation by chemicals produced during inflammatory processes. If stomach or intestine wall becomes spasm, this may result in pain. So do kidneys, gallbladders. When the uterine smooth muscle becomes spasm, menstrual cramps occur. It is often deep, dull or dragging and is typically diffuse and poorly localised. It can be associated with nauseas, vomiting, and changes in heart rate or blood pressure. It can also evoke strong emotional responses. There can be a referred pain which is pain experienced at a site distant from source of the pain. It is due to the convergence of different afferents on to the same dorsal horn neurones in the spinal cord.
Skeletal muscles are attached to the bones. When the muscle contracts, the related body part moves. As a result, we can move around without problems. The abdominal wall muscles are skeletal muscles which extend from the superior border of the pelvis to the inferior border of the ribcage. There are four pairs of muscles: transverse and rectus abdominis and the internal and external obliques.
The rectus abdominis muscles and abdominal pain
The rectus abdominis muscles are a pair of long flat muscles lie vertically along the middle line of abdomen. Each muscle is divided by narrow bands of tendon into four muscular bodies. It originates from the edge of the pubis bone and thepubic symphysis in the pelvis and ends at the inferior edges of the costal cartilages of the fifth through seventh ribs and at the xiphoid process of the sternum. The rectus sheath is a covering connective tissue surrounding the rectus abdominis muscles where the internal and external oblique muscles attach. The linea alba a thick mass of white fibrous connective tissue is in the mid line of the abdomen and joins the two rectus abdominis together. The important function of rectus abdominis muscles is to flex the spine when they contract. Contraction of the abdomen results in increased pressure within the abdominopelvic cavity and is useful to push substances out of the body during exhalation, defecation, and urination. It helps delivering a baby. If there are trigger points present in these muscles, you could feel the pain at the abdomen, lower and mid back region. The symptoms include pain at the low abdomen, period pain, stomach cramping, heart burn chest pain, indigestion, nauseas, vomiting bloating, genital pain, bladder problem, low and mid back pain etc.
Transverse abdominis muscle and abdominal pain
Transverse abdominis muscle is the deepest muscle on the front and side abdominal wall. It lies between the rib cage and pelvic bone. It starts from the back thoracolumbar fascia, from the top inner surface of the lower six ribs, from the bottom front of the iliac crest and inguinal ligament and it ends at the front abdominal midline called linea alba. It is a very important core muscle in compressing the abdomen, providing thoracic and pelvic stability and supporting abdominal visera. It maintains good posture and help to deliver a baby for pregnant women. Trigger points in transverse abdominis could contribute to the abdominal pain and low back pain.
External and internal oblique muscles
The external abdominal oblique muscles are a pair of muscles that lie on the lateral and anterior sides of the abdominal wall. They are broad, thin and on the top layer of the abdominal muscles. They start from ribs 5-12 and end at the midline of the abdomen, pubis and iliac crest of the hip bones. Contraction of this muscle makes lateral bend and rotation of the spine, flexes the spine and also pulls the chest downwards and compress the abdominal cavity.
The internal abdominal oblique muscles lie on the lateral and anterior sides of the abdominal wall just underneath the external abdominal oblique muscles and above the transverse abdominal muscle. It bends the spine forward and bring the shoulder of the side forward and it also bend the spine sideway and rotates it. It compresses abdominal contents and assists digestive process and breathing. If trigger points are present in these muscles, the pain can be felt in following area, in the side, the waist area, the groin area, the low abdomen, across the upper back below shoulder blades, across the low back just above hips, stomach pain, testicle pain, pelvis pain bladder pain.
Chronic abdominal pain may be present for weeks to months, or even years. Acupuncture can help with some chronic abdominal pain such as indigestion, inflammatory bowel diseases or muscular pain, benign ovarian cysts, pain with frequent urination, muscular pain from the abdominal muscles.
Bloating is a common symptom accompanied with abdominal pain. Most people have experienced this symptom, when the abdomen is stretched, puffy and uncomfortable. The common cause is constipation which is caused by too little fluids and fibers and lack of exercises. Food allergy and intolerance can be caused excess wind production causing bloating. Inflammation in abdomen such as irritable bowel syndrome can lead to bloating. Pain conditions such as low back pain, hip pain, abdominal pain can accompany bloating because of alteration of the nerve activities.
Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic or recurrent abdominal pain or discomfort. The symptoms include chronic abdominal pain, which is often associated with diarrhoea, constipation or bloating. Bowel habit is changed often with increased passing stool frequency and passage of mucus. IBS affects about 20% adult population globally and their quality of life is affected.
IBS is caused by multiple factors, including intestinal motility and intestinal smooth muscle functional disturbance, visceral paresthesia, alterations in the brain-gut axis, psychological factors, gastrointestinal hormones, and intestinal infection. Some evidences suggested that neurohormonal and immune responses to physiological stimulation or psychological stress etc are possible risk factors.
There is no universally accepted satisfactory treatment for this condition. No drug is effective in treating all the symptoms of IBS. Very recently, a study has analysed existing data and suggested that acupuncture improves the symptoms of IBS, including abdominal pain and distension, sensation of incomplete defecation, times of defecation per day, and state of stool. No serious adverse events associated with acupuncture. Acupuncture might modulate pain in IBS by two actions: (1) modulation of serotonin pathway at insula; and (2) modulation of mood and affection in the higher cortical center via the ascending pathway at the pulvinar and medial nucleus of the thalamus (3) Improvement in pain in IBS was positively associated with increased parasympathetic tone in the acupuncture group. They suggested that acupuncture exhibits clinically and statistically significant control of IBS symptoms.
There was lack of standardization of acupuncture treatments for patients with IBS. A study on 113 patients with IBS has shown that 126 acupuncture points used, a distinct core and supporting group of points was associated with each primary pattern and each practitioner also utilized a distinct core and supporting group of points that reflected his/her preferences.
Recently a clinical trial was performed to study the effect of acupuncture on patients with IBS. In this study, 12 weeks of acupuncture was offered on weekly basis. The result has shown that there was a statistically significant difference between groups at three months favouring acupuncture with a reduction in IBS Symptom Severity Score. The number needed to treat for successful treatment was six, based on 49% success in the acupuncture group vs. 31% in the control group, a difference between groups of 18%. This benefit largely persisted at 6, 9 and 12 months.
There was a case study about acupuncture treatment on IBS published in Chinese acupuncture journal. The researchers compared trimebutine maleate, a commonly used drug for IBS. Two acupuncture points ST25 and BL25 were used for daily acupuncture treatment. The symptoms including duration and frequency of abdominal pain, morbidity of abnormal stool, defecation abnormality, stool mucus and score of bloating were assessed. The result showed that there was significant change for both groups which suggested that both acupuncture and the drug are effective on IBS. The effective rate for acupuncture group is higher than for the drug group which indicates that acupuncture was more effective compared to the drug.
Li H et al compared the effect of acupuncture with medicine for diarrhea-predominant IBS. 70 patients with IBS were allocated into two groups acupuncture group and medicine group. In acupuncture group, patients received acupuncture 3-4 treatment per week for 4 weeks. The points selected were Tianshu (ST 25), Zusanli (ST36), Shangjuxu (ST37), Sanyinjiao (SP6), Taichong (LR3) etc. The electric stimulation was added at bilateral ST25. Pinaverium (Dicetel) was given in medicine group. The clinical symptom score and IBS syndrome quality of life (IBS-QOL) score were assessed before and after treatment. The efficacy and the recurrence rate were assessed. Result showed that the symptom score and IBS-QOL score were all improved significantly after treatment in both groups. The efficacy in acupuncture group was greater. 3 month follow up showed that recurrence rate in acupuncture group was lower than medicine group.
Lu YH and Tang XD also showed that acupuncture is effective in 21 patients with IBS diarrhea. The patients received acupuncture 2-3 times a week. 8 treatments made up for one course. Symptoms after acupuncture treatment significantly reduced compared with that before the treatment. The total effective rate was 52.4% after first course and 90.5% after second course.
Sun JH et al also showed effectiveness of acupuncture in 63 patients with diarrhea predominant IBS. They showed acupuncture treatment reduced the severity and frequency of symptoms including abdominal pain, diarrhea, abdominal distension etc. They also showed that the quicker initiation of effect, the more evident clinical improvement in symptoms along the increase in treatment duration as well as the more significant elevation of QOL.
Chao and Zhang analised data from 1966 to 2013 to study the effect of acupuncture on IBS. There were 5 out of 6 high quality studies found. They found acupuncture was beneficial for patients with IBS though further studies are needed to confirm the conclusion because there were only a few studies met the criteria.
Chao and Zhang World J Gastroenterol (2014) 20:1871-1877
Shi ZM et al Zhongguo Zhen Jiu (2011) 31:607-9
Li H Zhongguo Zhen Jiu (2012) 32:679-82
Lu YH and Tang XD Zhongguo Zhen Jiu (2011) 31:975-7
Sun JH et al Chin J Integr Med (2011) 17:780-5
Stuardi T and MacPherson H J Altern Complment Med (2012) 18:1021-7
MacPherson H et al BMC Gastroenterol (2012) 12:150
Welcome to my blog
Acupuncture specialist for Fertility, Facial rejuvenation, Pain relief, Fatigue.
Based at Harley Street and Kensington Central London.Qualified as a medical doctor in Western medicine in China with a Medical degree from Beijing, China and a PhD degree from the UK. Over 25 year research and clinical experiences
Doctor who is passionate about acupuncture
I love what I do, I am good at it and I am always there for my patients. If you come and see me, you will know why I am standing out.
This blog is to introduce latest development and research of acupuncture and offer a chance of awareness of more treatment options for your condition. The blog is for information purpose only.
- My specialised areas include fertility, facial rejuvenation, acne, vulvodynia, various pain conditions, chronic fatigue, neurological conditions, digestive problems
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Kensington: for appointments at Anamaya center Kensington (Mondays, Tuesdays, Thursdays, Fridays, Saturdays) please call at 02030110355 or email at email@example.com
Address: 1 Adam and Eve Mews, Kensington, London W8 6UG
2 min walk from High Street Kensington underground stationHarley Street: for appointments at Harley Street (Wednesdays) please call ALO clinic at 02076368845 or email at firstname.lastname@example.orgAddressSuite 3 Harmont House20 Harley Street, London W1G 9PH5 min walk from Oxford Circus underground stationMy background: I became a qualified medical doctor 25 years ago in Western medicine in China and was well trained in Western medicine together with Chinese medicine in the best Medical University in Beijing, China. Particularly I was trained with Dr Zheren Xuan--famous orthopedics expert and founder of soft tissue surgery in China. Furthermore I had training in dermatology and oral and maxilofacial surgery in China. Also I had training in fertility and had research experiences in uterine smooth muscles and blood vessels in China and the UK. I am dedicated to treat patients with acupuncture and am recognised as one of the world leading acupuncture specialists.
I obtained a PhD degree in the University of Leeds in the UK.
I had post doctoral training and worked as a senior researcher in St George's hospital, London, UK.
I had frequently presented my research findings in the top international conferences in the field.
I have many publications including ebooks and articles.
I have many year clinical experiences. Over the years of practising, I have developed unique treatment approaches for infertility, skin aging, acne, vulvodynia, bladder pain, neck pain, headache, migraine, shoulder pain, back pain, fatigue, hot flushes, nerve pain, chronic prostatitis, Parkison's disease, MS, acid reflex, IBS etc to achieve best treatment results.My devotion and skills are highly praised by my patients.
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