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Systematic review and meta-analysis finds abdominal acupuncture may improve poststroke constipationAcupuncture plus standard care helps poststroke constipation, but evidence remains uncertain

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Key Takeaway
Consider abdominal acupuncture as an adjunct for poststroke constipation, but recognize the evidence is limited by heterogeneity and small studies.

This systematic review and meta-analysis included 943 patients with poststroke constipation across a limited number of studies. The intervention was manual abdominal acupuncture (MAA) or abdominal electroacupuncture (AEA) combined with conventional therapy (CT), compared with CT alone. The primary outcomes were efficacy and time to first bowel movement; stool shape was a secondary outcome.

For efficacy, MAA + CT showed a significant improvement over CT alone (RR = 1.26, 95% CI: 1.13-1.40), and AEA + CT also showed significant improvement (RR = 1.28, 95% CI: 1.19-1.38). Time to first bowel movement was reduced with MAA + CT (MD = -0.61, 95% CI: -1.02 to -0.19) and with AEA + CT (MD = -0.32, 95% CI: -1.09 to -0.46). Results for stool shape were inconclusive due to significant heterogeneity.

The authors noted several limitations: a limited number of studies, small sample sizes, and significant heterogeneity. Trial sequential analysis (TSA) demonstrated unclear cumulative evidence and could not determine the efficacy of abdominal acupuncture compared with CT. Adverse events were not reported.

The findings suggest potential benefit of abdominal acupuncture for poststroke constipation, but the authors emphasize that further high-quality trials are required to confirm these findings and optimize the acupuncture regimen. Clinicians should interpret these results cautiously given the methodological limitations.

This systematic review and meta-analysis looked at how manual abdominal acupuncture and abdominal electroacupuncture compare to standard care alone for patients with poststroke constipation. The researchers combined data from multiple studies involving 943 patients to see if adding acupuncture helped.

The analysis found that adding acupuncture to conventional therapy significantly improved overall effectiveness and reduced the time until the first bowel movement. Both manual and electro-acupuncture showed similar benefits compared to standard care alone.

However, the study results come with important caveats. The number of included studies was limited, and the sample sizes were small. Additionally, there was significant variation in how the treatments were performed across the different studies. Because of these issues, the evidence is not strong enough to fully confirm the benefits.

Further high-quality trials are required to confirm these findings and optimize the acupuncture regimen for treating poststroke constipation. Until more data is available, patients should view these results as preliminary rather than definitive proof of effectiveness.

What this means for you:
Acupuncture plus standard care may help poststroke constipation, but more research is needed to confirm benefits.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
BACKGROUND: Poststroke constipation (PSC) is a prevalent and disabling condition that significantly affects patient quality of life. Although abdominal acupuncture (AA) has demonstrated potential therapeutic effects on PSC, its efficacy remains unclear. This meta-analysis evaluated the efficacy of manual AA (MAA) and abdominal electroacupuncture (AEA) combined with conventional therapy (CT) for PSC. METHODS: A comprehensive literature search was conducted to identify randomized controlled trials comparing the effects of MAA + CT or AEA + CT versus CT alone in PSC treatment. Twelve eligible studies (n = 943) were selected. Primary (efficacy and time to first bowel movement [BM]) and secondary (stool shape) outcomes were evaluated. Trial sequential analysis (TSA) was performed to assess cumulative evidence reliability. RESULTS: Both MAA + CT (relative risk [RR] = 1.26, 95% confidence interval [CI]: 1.13-1.40) and AEA + CT (RR = 1.28, 95% CI: 1.19-1.38) significantly improved efficacy compared with CT alone. Furthermore, MAA + CT (mean difference [MD] = -0.61, 95% CI: -1.02 to -0.19) and AEA + CT (MD = -0.32, 95% CI: -1.09 to -0.46) reduced the time to first BM, albeit evidence regarding stool shape was inconclusive due to significant heterogeneity. TSA demonstrated unclear cumulative evidence and thus could not determine AA efficacy compared with CT. CONCLUSION: MAA + CT and AEA + CT may effectively improve PSC by enhancing efficacy and shortening the time to first BM. Given the limited number of studies, small sample sizes, and significant heterogeneity, further high-quality trials are required to confirm these findings and optimize the acupuncture regimen for PSC treatment.
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