I. INTRODUCTION #

Irritable Bowel Syndrome (IBS) refers to a set of symptoms primarily affecting the gastrointestinal system. According to the National Institute for Diabetes and Digestive and Kidney Diseases, it is estimated that 15% of the population in the developed world suffers IBS. Chronic IBS has affected 26.9% of adults in the United States with an increased economic burden (Sandler, Stuart, and Liberman, 2010). The total cost of IBS is estimated $200 billion worldwide (McFarland, 2008). The general prevalence of IBS around the world is approximately 11% (Hungin, 2003) with the majority being adult females (Lovell and Ford, 2012). The primary symptoms include cramping, pain, gas, constipation alternating with loose stool, sense of urgency to defecate, distention of the lower abdomen, and poor appetite. 

Within the conventional medical care umbrella, the cause of IBS is viewed to be unknown and incurable although the onset is closely related to psychological stress (Drossma, Camerilli, and Mayer, 2002). IBS occurs more often in high stress work environments (Pan, Lu, & Ke, 2000) and has a greater frequency in women than men (Grundmann & Yoon, 2010). IBS is considered to be a diagnosis of exclusion as most patients present without inflammatory, anatomic, metabolic, or neoplastic factors to define the etiology and pathophysiology. For a disease to be defined through diagnosis there must be objectively measurable abnormalities. If examinations do not reveal measurable and objective disease indications, then the condition is regarded as a functional illness or syndrome, in which case treatment is either not offered or it is only aimed at symptom relief. Drugs aimed at symptom relief do not stop the condition or prevent it from worsening. These drugs also cause undesirable side effects. Once the symptoms progress to the state of a measurable disease, treatment becomes  based on interruption of the disease mechanism. For example using antibiotics to treat an infection, which was caused by poor gut health, without improving the gut health. Assessment of digestive system functions related to pathology, and treatment to improve normal function, is not currently covered in conventional care approaches.

Over the last few years, the modern field of medicine has regained a sense of importance to the gastrointestinal system as it relates to the physiologies and pathologies of the rest of the body. Although other medical modalities, such as Acupuncture and Oriental Medicine (AOM), often view systemic patterns of disease as having started in the gut, it is a relatively new trend in conventional care. Terms such as “leaky gut” for the first time are being used to connect the digestive system to disorders such as depression, anxiety, headaches, allergies, acne, eczema, arthritis, fibromyalgia, and other chronic states of inflammation as well as autoimmune disorders. The need for care models aimed at treating the functions of the gastrointestinal system and restoring its normal physiology is at an all-time high. This window of opportunity is what makes the timing and topic of this research relevant and important. 

In AOM, which uses acupuncture and moxibustion for treatment, the function of the system and the disease of the system are inseparable. Pathogenesis is described based on how the functional problem results in the disease pattern. The acupuncture and moxibustion approach to treatment intrinsically includes the restoration of function that originally caused the disease. It is only by treating the cause, or the root of a condition, that long term health can be restored. 

There are many studies on the use of acupuncture in the treatment of IBS. This review is significant because of the timing in public awareness and consumer demand, medical trends regarding gastrointestinal health, and time period of research data collected. This review only includes studies within the last five years and it includes studies using moxibustion, which are not as common as acupuncture studies. The purpose of this review is to analyze current research studies, including treatment strategies when possible, and present evidence that the combination of acupuncture and moxibustion is a valid and effective treatment option for patients suffering IBS.