Efficacy of Abdominal Acupuncture in Poststroke Constipation: A Systematic Review and Meta-Analysis With Trial Sequential Analysis.

Constipation is a common and frustrating problem after stroke, affecting quality of life for many patients. Researchers conducted a systematic review and meta-analysis to determine whether abdominal acupuncture could help treat poststroke constipation when added to standard care. The study analyzed 12 randomized controlled trials involving 943 patients who received either manual abdominal acupuncture or abdominal electroacupuncture (where gentle electrical stimulation is applied through the needles) combined with conventional treatment, compared to conventional treatment alone. The results showed that both types of abdominal acupuncture significantly improved treatment effectiveness compared to standard care alone. Patients receiving acupuncture also experienced their first bowel movement sooner—manual abdominal acupuncture reduced this time by about 0.6 days, while electroacupuncture reduced it by about 0.3 days. However, the researchers noted several limitations: the studies included were small, there was significant variation between studies, and additional analysis suggested the cumulative evidence wasn't yet conclusive. While these findings are promising and suggest abdominal acupuncture may be a helpful addition to conventional constipation treatment after stroke, the researchers emphasized that more high-quality, larger studies are needed to confirm these benefits and establish the best acupuncture protocols. If you're considering acupuncture for poststroke constipation, consult with a licensed acupuncturist experienced in treating neurological conditions.

This systematic review and meta-analysis evaluated abdominal acupuncture efficacy for poststroke constipation across 12 RCTs (n=943). Both manual abdominal acupuncture plus conventional therapy (MAA+CT) and abdominal electroacupuncture plus conventional therapy (AEA+CT) demonstrated statistically significant improvements compared to CT alone. MAA+CT showed RR=1.26 (95% CI: 1.13-1.40) for treatment efficacy and MD=-0.61 days (95% CI: -1.02 to -0.19) for time to first bowel movement. AEA+CT demonstrated RR=1.28 (95% CI: 1.19-1.38) for efficacy and MD=-0.32 days (95% CI: -1.09 to -0.46) for first BM. Stool shape data showed significant heterogeneity and remained inconclusive. Trial sequential analysis indicated insufficient cumulative evidence to definitively establish efficacy. Clinical takeaway: Abdominal acupuncture shows promise as adjunctive PSC therapy, but methodological limitations including small sample sizes and heterogeneity necessitate additional high-quality trials before definitive clinical recommendations.