Acupuncture:

Crohn’s & Inflammatory Bowel Disease

Inflammatory bowel disease (IBD), encompassing Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition of the gastrointestinal tract affecting over 6.8 million people globally, with a rising incidence in developing regions.

 

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Definitions and Terms Related to Pain

 

Crohn’s Disease and Inflammatory Bowel Disease 

Acupuncture for Abdominal Pain in Crohn’s Disease and Inflammatory Bowel Disease (IBD) 

Introduction

Crohn’s disease, characterized by transmural inflammation anywhere from mouth to anus, presents with debilitating symptoms including abdominal pain, diarrhea, fatigue, and weight loss, significantly impairing quality of life. Abdominal pain, a hallmark symptom in both active and quiescent Crohn’s disease and IBD, affects 20-50% of patients in remission and is multifaceted, stemming from inflammation, strictures, adhesions, or medication side effects.

Standard treatments like 5-aminosalicylic acid (5-ASA), corticosteroids, and biologics have limited effectiveness for mild-to-moderate cases and carry risks of adverse effects, including infections and organ damage. At Acupuncture is explored here as a non-pharmacological intervention to manage abdominal pain in Crohn’s disease and IBD, offering a safe, cost-effective adjunct to conventional therapies. This section synthesizes evidence on acupuncture’s effectiveness, focusing on abdominal pain, along with suggestions of alternative treatments and synergistic nutraceutical approaches.

This review integrates findings from four key high quality systematic review publications (listed in references below) amd supplemented by additional evidence from randomized controlled trials (RCTs). The primary sources include systematic reviews and meta-analyses on non-pharmacological interventions for Crohn’s disease and IBD. These studies were selected for their focus on acupuncture and related therapies.

Additional database evidence was drawn from peer-reviewed literature on complementary and alternative medicine (CAM), nutraceuticals, and phytonutrients relevant to abdominal pain in IBD. Emphasis has been placed on clinical effectiveness, safety and integrative approaches consistent with Accurate Clinic’s pain management program.

 

Acupuncture for Abdominal Pain in Crohn’s Disease and IBD

Acupuncture, including manual acupuncture (MA), electroacupuncture (EA), and moxibustion (MOX), that modulate neuroinflammatory pathways and gut microbiota, and offer potential relief from abdominal pain in Crohn’s disease and IBD, improving clinical symptoms and quality of life..

General IBD

Acupuncture, particularly combined with moxibustion (MOX), is effective for inducing clinical remission and reducing disease activity in IBD patients. It outperforms placebo and sham interventions in improving abdominal pain and enhancing quality of life.

Mechanism

Acupuncture and  MOX reduce pro-inflammatory cytokines (e.g., TNF-α, IL-6) and enhances anti-inflammatory markers (e.g., IL-10) associated with Crohn’s, reflecting its therapeutic impact on information in the gut. MOX may also modulate gut microbiota to help manage IBD symptoms, including pain, across active and quiescent disease states.

 

Crohn’s Disease-Specific Pain

For Crohn’s disease, acupuncture and moxibustion significantly reduce abdominal pain intensity and frequency, particularly in mild-to-moderate cases. Compared to sham acupuncture, MOX achieves greater reductions in pain, reflecting improved symptom control. Electroacupuncture and herb-partitioned moxibustion also enhance intestinal barrier function and reduce inflammation, contributing to pain reduction. Acupuncture’s effectiveness is most pronounced in mild-to-moderate Crohn’s disease, with limited evidence for severe cases.

Active vs. Remission States

In active IBD, acupuncture and moxibustion induce clinical remission more effectively than placebo, particularly for abdominal pain and disease activity. In remission, acupuncture maintains symptom control, though dietary interventions may be superior for sustaining remission. The optimal treatment protocol involves 3-4 sessions per week for 8-12 weeks, totaling 12-24 sessions, with no additional benefit from prolonged treatment.

Mechanism

Acupuncture’s effects are mediated through vagus nerve stimulation and neuroreceptor modulation, reducing pain perception and inflammation in both active and quiescent states.

 

Alternative Treatments

Beyond acupuncture, other CAM approaches show potential for managing abdominal pain in Crohn’s disease and IBD. Low FODMAP diets reduce pain intensity in some IBD patients by minimizing fermentable substrates, though evidence is inconsistent. The Mediterranean diet, rich in Omega-3 fatty acids, supports gut health and reduces inflammation, potentially alleviating pain. Fecal microbiota transplantation (FMT) improves short-term clinical remission and reduces inflammatory markers like C-reactive protein (CRP), offering an adjunctive approach to pain management.

Psychological interventions, such as cognitive behavioral therapy (CBT) and mindfulness-based therapy, reduce pain perception by easing stress and anxiety, which exacerbate symptoms in IBD. Yoga and physical training enhance quality of life and may indirectly reduce pain through stress modulation and improved gut motility. These alternatives complement acupuncture as part of a multimodal approach..

 

Comparison with Standard Treatments

Standard treatments for Crohn’s disease and IBD include 5-ASA, corticosteroids, immunosuppressants, and biologics. 5-ASA has limited efficacy for Crohn’s disease and may cause side effects like nausea and kidney damage. Corticosteroids induce remission but are ineffective for maintenance and risk bone loss and hyperglycemia. Biologics, effective in severe cases, carry infection risks and high costs.

Acupuncture outperforms sham interventions and matches or exceeds 5-ASA in reducing abdominal pain, with fewer adverse effects. When combined with medications, acupuncture enhances efficacy and supports dose reduction, particularly for corticosteroids. Compared to psychological interventions like CBT, acupuncture is more accessible and cost-effective, making it a practical option for Accurate Clinic’s patients with abdominal pain.

 

Synergistic Approaches with Nutraceuticals and Phytonutrients

Nutraceuticals and phytonutrients offer synergistic benefits with acupuncture, targeting inflammation, gut microbiota, and pain pathways in Crohn’s disease and IBD. Below are key compounds, their mechanisms, dosing recommendations, and safety considerations.

  • Omega-3 Fatty Acids: Anti-inflammatory compounds found in fish oil and fatty fish reduce pro-inflammatory cytokines (e.g., TNF-α, IL-6) and support gut health. Dosing: 1-2 g EPA/DHA daily with meals. Safety: Well-tolerated; may cause mild gastrointestinal upset or bleeding risk at high doses (>4 g). Recommended supplement form: Fish oil capsules.
  • Zinc: Supports intestinal barrier function and modulates immune responses, potentially reducing pain and inflammation. Dosing: 15-30 mg zinc picolinate daily with food. Safety: Long-term high doses (>40 mg) may disrupt copper balance. Recommended supplement form: Zinc picolinate tablets.
  • Magnesium: Reduces neuromuscular excitability and inflammation, supporting pain relief. Dosing: 200-400 mg magnesium citrate or glycinate daily. Safety: Avoid in renal impairment; high doses may cause diarrhea. Recommended supplement form: Magnesium citrate capsules.
  • Curcumin: A polyphenol phyto-nutrient with anti-inflammatory properties, curcumin inhibits NF-κB and reduces cytokine-mediated pain. Dosing: 500-1000 mg curcumin (enhanced formulations for improved bioavailability) daily with food. Safety: Well-tolerated; avoid in patients on anticoagulants. Recommended supplement form: Lipomal or Nano-molecular formulations to enhance absorption.
  • Quercetin: A flavonoid with antioxidant and anti-inflammatory effects, quercetin may reduce neuroinflammation and pain. Dosing: 500-1000 mg daily with food. Safety: Generally safe; may interact with medications like cyclosporine. Recommended supplement form: Quercetin dihydrate capsules.
  • EGCG (Epigallocatechin Gallate): A green tea polyphenol, EGCG reduces inflammation and supports gut microbiota balance. Dosing: 100-200 mg daily, taken in the morning to avoid caffeine-related stimulation. Safety: Monitor for gastrointestinal upset; avoid in patients with liver sensitivity. Recommended supplement form: Decaffeinated green tea extract capsules.

Combining these agents with acupuncture amd/or MOX may enhance pain relief and symptom control by addressing inflammation, gut dysbiosis, and psychological stress. Additionally, Omega-3 fatty acids and curcumin paired with acupuncture may optimize anti-inflammatory effects in active Crohn’s disease. Accurate Clinic can integrate these into personalized treatment plans, with monitoring for interactions and adverse effects.

Conclusion

Acupuncture, particularly combined with moxibustion, is a safe and effective option for managing abdominal pain in Crohn’s disease and IBD, especially in mild-to-moderate cases. It improves quality of life, and modulates inflammation.

Compared to standard treatments like 5-ASA and corticosteroids, acupuncture offers fewer adverse effects and synergistic benefits when combined with medications. Alternative CAM approaches, including low FODMAP diets and CBT, complement acupuncture, while nutraceuticals like Omega-3 fatty acids and curcumin enhance outcomes. As part of. Accurate Clinic’s integrative pain management program, acupuncture addresses both pain and inflammation, improving patient outcomes. Further high-quality RCTs with larger, diverse populations are needed to confirm long-term efficacy and effects in severe disease.

References

  1. Sinopoulou V, Gordon M, Akobeng AK, et al. Interventions for the management of abdominal pain in Crohn’s disease and inflammatory bowel disease. Cochrane Database Syst Rev. 2021;11:CD013531. doi:10.1002/14651858.CD013531.pub2
  2. Jia J, Wu YB, Liu SW, et al. Effectiveness and safety of non-pharmacological therapies for the treatment of inflammatory bowel disease: a network meta-analysis. Front Med (Lausanne). 2025;12:1593483. doi:10.3389/fmed.2025.1593483
  3. Chang ML, Mi KL, Cunningham RR, et al. The efficacy of traditional Chinese medicine for Crohn’s disease treatment: a systematic review and meta-analysis. JGLD. 2025;34(1):98-107. doi:10.15403/jgld-5729
  4. Bae JH, Kang SY, You SE, et al. The effects of acupuncture on Crohn’s disease: a systematic review and meta-analysis. J Pharmacopuncture. 2023;26(3):211-226. doi:10.3831/KPI.2023.26.3.211
  5. Effectiveness and safety of non-pharmacological therapies for the treatment of inflammatory bowel disease- a network meta-analysis – 2025
  6. The Efficacy of Traditional Chinese Medicine for Crohn’s Disease Treatment – A Systematic Review and Meta-Analysis – 2025
  7. The Effects of Acupuncture on Crohn’s Disease- a systematic review and meta-analysis – 2023
  8. Interventions for the management of abdominal pain in Crohn’s disease and inflammatory bowel disease – 2023

Additional References:

  1. Verma K, Singh D, Srivastava A. The impact of complementary and alternative medicine on insomnia: a systematic review. Cureus. 2022;14(8):e28425. doi:10.7759/cureus.28425
  2. Lu G, Chen F, Guo C, Wu J. Acupuncture for senile insomnia: a systematic review of acupoint selection patterns. Arch Gerontol Geriatr. 2024;127:105586. doi:10.1016/j.archger.2024.105586
  3. Yu Y, Li X, Zhu Z, et al. Acupuncture for chronic insomnia disorder: a systematic review with meta-analysis and trial sequential analysis. Front Neurol. 2025;16:1541276. doi:10.3389/fneur.2025.1541276
  4. Jing R, Feng K. Efficacy of intradermal acupuncture for insomnia: a meta-analysis. Sleep Med. 2021;85:66-74. doi:10.1016/j.sleep.2021.06.034
  5. Zhang X, Wang Y, Liu C, et al. The dose-effect relationship between acupuncture and its effect on primary insomnia: a systematic review and meta-analysis. Front Psychiatry. 2025;16:1501321. doi:10.3389/fpsyt.2025.1501321
  6. Sinopoulou V, Gordon M, Akobeng AK, et al. Interventions for the management of abdominal pain in Crohn’s disease and inflammatory bowel disease. Cochrane Database Syst Rev. 2021;11:CD013531. doi:10.1002/14651858.CD013531.pub2
  7. Jia J, Wu YB, Liu SW, et al. Effectiveness and safety of non-pharmacological therapies for the treatment of inflammatory bowel disease: a network meta-analysis. Front Med (Lausanne). 2025;12:1593483. doi:10.3389/fmed.2025.1593483
  8. Chang ML, Mi KL, Cunningham RR, et al. The efficacy of traditional Chinese medicine for Crohn’s disease treatment: a systematic review and meta-analysis. JGLD. 2025;34(1):98-107. doi:10.15403/jgld-5729
  9. Bae JH, Kang SY, You SE, et al. The effects of acupuncture on Crohn’s disease: a systematic review and meta-analysis. J Pharmacopuncture. 2023;26(3):211-226. doi:10.3831/KPI.2023.26.3.211

Emphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

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