Symptomatic Treatment of Acute Traveler’s Diarrhea With Acupuncture at Stomach 36 (ST36) and Large Intestine 4 (LI4) Acupuncture Points

Traveler's diarrhea is a common occurrence affecting many travelers visiting tropical countries. Antidiarrheal medications are the mainstream treatment. We describe a case of typical traveler's diarrhea in a 44-year-old tourist in Cuba, who was treated with acupuncture in addition to rehydration, without the use of any medication (e.g., antibiotics or anti-motility agents). On the seventh day of the trip, the traveler developed sudden onset, profuse watery diarrhea with mild nausea. During a period of eight hours, the patient passed profuse watery stools five times. Two standard acupuncture needles (0.30 x 30 mm) were inserted by an anesthesiologist trained in acupuncture: one at ST36 (stomach meridian 36) on the left leg and one at LI4 (large intestine meridian 4) on the right hand, for a duration of 30-40 minutes. The exact session was repeated a second time after two days. After each session, a decrease in the frequency (defecation only once per day) and severity of diarrhea (stool consistency improved as per the Bristol scale) was observed. Further research on the effectiveness of ST36 and LI4 points acupuncture and acupressure for the symptomatic management of traveler's diarrhea by means of randomized controlled trials is needed, given the lack of contribution to antimicrobial resistance, the low cost, and the minimal equipment needed for acupuncture and acupressure therapy. If confirmed, such an additional treatment option could be useful in rural, remote, or poor resource settings where the availability of antidiarrheal medications might be limited.