Effectiveness of Acupuncture in Treating Dysphagia

Introduction

Dysphagia, or difficulty in swallowing, is a significant age-related issue and a major health concern in older populations. Dysphagia can occur during the oropharyngeal or esophageal phase of swallowing. It is a significant risk factor that may lead to malnutrition and aspiration pneumonia, which can become life-threatening if the condition becomes severe. It is also a frequent complication of stroke due to the interruption or dysfunction of neural pathways (Hinkle & Cheever, 2014). Approximately 75% of oropharyngeal dysphagia cases are due to neurological causes such as stroke, Parkinson's disease, and dementia (White, O'Rourke, Ong, Cordato, & Chan, 2008).

Prevalence and Current Treatments

The reported study indicates that dysphagia affects between 37% and 78% of stroke patients, and it persists in 11-50% of post-stroke patients six months after the onset of stroke (Martino et al., 2005). Currently, standard practice mainly focuses on minimizing the risk of aspiration or choking, such as using a nasogastric tube for feeding, positioning, and dietary modifications (e.g., using thickeners), rather than addressing the underlying causes. Furthermore, there is no recommended routine clinical treatment for dysphagia after a stroke. Although current practices indicate that neuromuscular electrical stimulation (NMES) combined with swallowing rehabilitation training may be effective for post-stroke patients with dysphagia, the method may not be applicable to all patients due to specific situations and does not evaluate long-term effects (Park, Kim, Oh, & Lee, 2012). Additionally, research shows a relationship between swallowing function and quality of life. There is a lower quality of life score in those with dysphagia compared to those without, indicating that dysphagia adversely affects the quality of life (Eslick & Talley, 2008).

Acupuncture as an Alternative Treatment

Acupuncture has been widely used as an intervention for complications after stroke in Asian regions. A new method, combining acupuncture with swallowing training, known as He’s Santong Needling method, has been introduced. Studies have shown that acupuncture can improve blood supply and circulation in the brain region, regulate the connection of the cortex involved in swallowing reflex, and coordinate motor movement of the muscles related to swallowing. It regulates the Qi and blood of swallowing-related meridians and collaterals. The treatment is performed five days a week for four weeks, using three different acupuncture procedures: Weitong (normal needling), Wentong (Fire needling, which provides mechanical and thermal stimulation), and Qiangtong (Bloodletting), which provide synergistic effects. When combined with swallowing rehabilitation training, such as appropriate dietary modification and direct behavioral exercises (e.g., effortful swallowing), it may be beneficial to dysphagia patients.

Conclusion

In conclusion, while current practices focus on managing the symptoms and risks associated with dysphagia, alternative treatments like acupuncture offer promising potential in addressing the underlying issues. Further research is needed to explore the long-term effectiveness and applicability of such treatments to enhance the quality of life for individuals suffering from dysphagia.

References

Eslick, G. D., & Talley, N. J. (2008). Dysphagia: Epidemiology, risk factors and impact on quality of life—a population-based study. Alimentary Pharmacology & Therapeutics, 27(10), 971-979.

Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's Textbook of Medical-Surgical Nursing. Lippincott Williams & Wilkins.

Martino, R., Foley, N., Bhogal, S., Diamant, N., Speechley, M., & Teasell, R. (2005). Dysphagia after stroke: Incidence, diagnosis, and pulmonary complications. Stroke, 36(12), 2756-2763.

Park, J. S., Kim, J. K., Oh, J. C., & Lee, J. C. (2012). Effects of neuromuscular electrical stimulation on swallowing function in acute stroke patients with dysphagia. Annals of Rehabilitation Medicine, 36(6), 873-879.

White, G. N., O'Rourke, F., Ong, B. S., Cordato, D. J., & Chan, D. K. (2008). Dysphagia: Causes, assessment, treatment, and management. Journal of Clinical Neuroscience, 15(7), 735-740.