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Irritable bowel syndrome (IBS), one of the most common gastrointestinal disorders, and is common in childhood. It is characterized by abdominal pain or discomfort with no organic or metabolic etiology. The abdominal pain and discomfort are associated with changes in defecation or stool form. We report a pediatric patient with IBS, who was successfully treated with acupuncture and moxibustion.<br>The patient was a 10-year-old girl, who had developed IBS 3 years previously. She had abdominal pain accompanied by bowel movements with soft stool five times per day. The patient was treated with acupuncture and moxibustion according to the theories of traditional Chinese medicine. In addition, we used the Gastrointestinal Symptoms Rating Scale (GSRS) to evaluate her quality of life. She received acupuncture and moxibustion treatment at two sessions/week during the first 6 weeks, followed by only one session/week later. One month after the treatment was started, her GSRS score began to improve and her abdominal pain and bowel movements were reduced. Compared with baseline, her GSRS score was improved at 2 months and 1 year after the acupuncture was started. In conclusion, acupuncture and moxibustion treatment was effective in the present pediatric IBS patient.
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<b>Objective: </b>In this study, we evaluated the change in degree of recognition and understanding of palliative care as pharmacy students’ years advanced.<br><b>Methods: </b>A questionnaire survey consisting of 11 items about recognition of narcotics and 27 items about understanding of palliative care was conducted with first- to fifth-year pharmacy students. We divided the questions about the image of narcotics into groups and classified the questions about their knowledge of palliative care into the categories based on some reports.<br><b>Results: </b>Among the three groups of questions about the image of narcotics, the degree of “right recognition of narcotics” increased, and those of “wrong recognition of narcotics” and “sense of resistance to narcotics” decreased as pharmacy students’ years advanced. Additionally, questions about their knowledge of palliative care were categorized into three: “basic guidelines for cancer pain relief and methods of narcotic use,” “role of pharmacists in palliative care and support for patients,” and “pharmacologic characteristics of narcotics.” Their degree of understanding of each category increased with an increase in years. Both the recognition of narcotics and understanding of palliative care changed in the fourth- and fifth-grade year students compared to the first-, second-, and third-year ones.<br><b>Conclusion: </b>These results suggest that the recognition and understanding of palliative care changed along the same trends as pharmacy students’ years advanced. Therefore, it is important that pharmacy students acquire appropriate knowledge to play an active role in palliative care.
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[Objective]There are few reports of inpatients who received acupuncture treatment in departments of internal medicine in Japan. The aim of this analysis is to clarify such information by reviewing patients who received acupuncture treatment during admission to our department of internal medicine at Gifu University Hospital. Our department is organized into three subdepartments of cardiology, respirology, and nephrology.<BR>[Methods]We surveyed the chief complaint for acupuncture treatment, basic disease for admission and the number and period of acupuncture treatment of inpatients who received acupuncture treatment in our department from July 2004 through March 2007. <BR>[Results]Two hundred and sixty-six patients received acupuncture treatment and they had 429 symptoms. <BR>The chief complaint was the side effects of chemotherapy for cancer treatment (n = 84), that is, nausea, anorexia, dysethesia and so on. Other symptoms were dyspnea or shortness of breath (n = 49), pain originating from cancer (n = 38), pain originating from skeletal muscle (n = 38), anorexia (n = 25), and general fatigue (n = 18). Several symptoms were cough, edema, constipation or diarrhea, conscious disturbance, insomnia, paralysis, etc. <BR>Of the chief complaints, 86.4%were closely connected with diseases or treatments for admission.<BR>The mean number of patients who received acupuncture was 10.0/day. This was equal to about 20%of all patients (53beds) per day in our department.<BR>[Conclusion]There were many patients whose chief complaints for acupuncture were closely connected with disease for admission. It is suggested that acupuncture treatment is accepted as one of treatments of internal medicine for inpatients in our department.
ABSTRACT
[Background] Elderly people often have disturbances of bowel habits, including irritable bowel syndrome (IBS). IBS is one of the most common gastrointestinal disorders, affecting more than 15% of the general population. It is characterized by a wide variety of persistent symptoms (abdominal pain or discomfort, bloating, transit disorders) without any clear organic causes. Because medical treatments are sometimes ineffective, some patients with IBS seek alternative therapies to manage the condition. There is very little research examining IBS in the elderly. We report two elderly patients with IBS successfully treated with acupuncture.<br>[Cases and Methods] A 72-year-old woman and an 88-year-old man with IBS were treated with acupuncture according to theory of traditional Chinese medicine. Gastrointestinal Symptoms Rating Scale (GSRS), frequency of defecation, softness of the stool, intensity of abdominal pain or abdominal fullness were recorded over the periods.<br>During the treatment period, both patients showed a remarkable improvement in lower abdominal pain, bloating and quality of life evaluated with GSRS.<br>[Result and Discussion] In both cases, acupuncture treatment was effective for alleviating abdominal symptoms with IBS. The result of these cases indicated that acupuncture might be useful for the management of the condition with elderly IBS.
ABSTRACT
[Background/aim] Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, affecting more than 15 % of Western populations. It is characterized by a wide variety of persistent symptoms (abdominal pain or discomfort, bloating, transit disorders) without any clear organic causes. Because medical treatments are sometimes ineffective, some patients with IBS seek alternative therapies to manage the condition. The aim of the present study was to investigate the clinical effect of acupuncture treatment in patients with IBS.<BR>[Method] Four patients with IBS were treated with acupuncture according to the way of Traditional Chinese Medicine. We employed reversal single-case study design in which an acupuncture treatment period (“period B”) was alternated with no treatment period (“period A”). Ten or twenty times acupuncture therapies were performed during the “period B” and the length of the “period A” was comparable with the “period B” GSRS, frequency of defecation, softness of the stool, intensity of abdominal pain or abdominal fullness, and POMS were recorded over the periods.<BR>[Results] During the “period B”, three patients showed a remarkable improvement in lower abdominal pain, abdominal fullness and QOL evaluated with GSRS, while the psychological condition evaluated with POMS showed inconsistent changes without a remarkable improvement.<BR>[Conclusion] The result of our study indicated that acupuncture might be useful for the management of IBS.
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Episodic angioedema with eosinophilia (EAE) is an idiopathic condition characterized by recurrent symptoms such as angioedema, urticaria, and eosinophilia. We report a case of a 25-year-old woman with the non-episodic variant of this condition (NEAE) who was treated with acupuncture.<br>The patient presented with a two-week history of generalized itching and angioedema. Erythema, bilateral limb edema, and swelling and pain of both wrists and ankles were noted. As antiallergic medication administered for several days was ineffective, she was admitted to our hospital. Hematologic investigations revealed a white blood cell count of 11850/mm<sup>3</sup> with 64.2% eosinophils (7610/mm<sup>3</sup>). Histopathologic examination of a cutaneous biopsy specimen indicated an eosinophilic infiltration localized around blood vessels in the superficial dermal layers. NEAE was diagnosed on the basis of these findings. Acupuncture treatment was performed according to Traditional Chinese Medical theory. Itching was alleviated following acupuncture treatments and relapsed on days when acupuncture was not administered. However, edema and itching gradually diminished between acupuncture treatments, in parallel with resolution of the peripheral eosinophilia. In this case, acupuncture treatment was effective for alleviating itching in NEAE.
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[Objective] It is necessary to administer anti-cholinergic agents or glucagon during gastroscopy for inhibition of gastric peristalsis. However, application of these drugs are limited in patients with glaucoma, hypertension, benign prostate hyperplasia, heart disease, or diabetes mellitus because of possible adverse events.<BR>Based on the report that acupuncture stimulation at CV 12 (Zhonguan, Chukan) inhibited gastric activity, we studied whether the acupuncture at CV 12 could be applicable as an alternative to these drugs.<BR>[Method] Subjects in the present study were 60 patients who underwent gastroscopy at Meiji University of Oriental Medicine Hospital. They were allocated into two groups; acupuncture group (mean [SD] age, 66 [10]) and drug group (mean [SD] age, 64 [13])<BR>Patients in the acupuncture group were given manual stimulation at CV 12 with an acupuncture needle for 10 minutes before examination and during gastroscopy.<BR>After examination, a gastroscopist evaluated the magnitude of the peristalsis and disturbance during the examination using the visual analogue scale (VAS) and a 4-grade categorical scale.<BR>Patients in the drug group were pre-administered anti-cholinergic drug or glucagon, and evaluated with the same scale.<BR>[Results and Discussion] Inhibition score in the acupuncture group was lower but not statistically significant, as compared with the drug group, and the effect of acupuncture stimulation was acceptable to allow examination of the patients without severe disturbance. <BR>Acupuncture may be a useful non-pharmacologic alternative to anti-cholinergic drugs and glucagon to inhibit gastric movement during gastroscopy, when these drugs could not be administered.
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A 69-year-old man, who had undergone coronary artery bypass grafting using the right gastroepiploic artery 2 years previously, was hospitalized with acute epigastralgia. Gastroscopy showed an early gastric cancer in the greater curvature of the corpus and ultrasonography of the abdomen revealed acute cholecystitis due to a stone impacted in the cystic duct. The subtotal gastrectomy and the cholecystectomy with preservation of the right gastroepiploic artery graft were performed. The surgical margin of the resected specimen was negative for cancer. The postoperative course was uneventful. After coronary artery bypass grafting using the right gastroepiploic artery, annual gastroscopy is recommended.