A commentary on “The effect of acupuncture on gastrointestinal recovery after abdominal surgery: a narrative review from clinical trials”

Dear Editor, Abdominal surgery is one of the most common surgeries performed worldwide[1,2]. Abdominal distension, delayed exhaustion and defecation time, loss of appetite, and abdominal pain are among the gastrointestinal dysfunctions that patients are susceptible to following abdominal surgery. These symptoms can raise intestinal pressure, slow the healing of surgical anastomoses, and even result in intestinal obstruction. Concurrently, it may cause the patient’s diaphragm to raise, restrict chest movement, induce dyspnea, and result in lower limb deep vein thrombosis. Postoperative rehabilitation is adversely affected by all of these conditions. Currently, gastrointestinal decompression, gastric motility medications, and urging patients to get out of bed early following surgery are often employed in clinical practice to improve recovery of gastrointestinal function, although the results are not optimal. Acupuncture has drawn a lot of attention lately because to its exceptional ability to reduce pain and enhance gastrointestinal function[3]. Kong et al[4] conducted a narrative review to provide an overview of the development of clinical studies on the use of acupuncture to help patients regain their gastrointestinal functions following abdominal surgery. This study offers a fresh viewpoint on incorporating acupuncture into the ERAS protocol by discussing associated difficulties and processes. Acupuncture can successfully aid in the rehabilitation of bowel sounds, especially in postoperative bowel function, according to a number of studies. Bowel sounds can be recovered much faster and bowel function can be improved with acupuncture. By stimulating specific acupoints, acupuncture can regulate the activity of the autonomic nervous system, especially that of the parasympathetic nerves. Activation of the parasympathetic nervous system stimulates intestinal peristalsis and promotes the secretion of digestive juices, thereby accelerating the recovery of intestinal function. Because they increase bowel motility and modulate the action of the smooth muscles in the intestinal wall, the parasympathetic nerves play a particularly important role in the recovery of bowel sounds. Acupuncture may also help restore intestinal function through improved blood circulation in the gut, thereby enhancing the supply of nutrients and oxygen to the intestines. Anal flatus is a key indicator of intestinal function recovery, closely related to neurological recovery, intestinal motility, as well as flatus expulsion capacity. Acupuncture accelerates anal flatus and enhances intestinal motility via regulating autonomic nervous system activity, particularly the parasympathetic nervous system. The time required for the first passage of gas can be shortened via enhancing intestinal blood circulation, reducing intestinal inflammatory responses, and improving neuro-reflexive intestinal function. Future research should concentrate on the exact mechanisms by which different types of acupuncture influence postoperative recovery, incorporating a more diverse patient population – especially those of varying genders, ages, and underlying conditions – to provide insights into their differential responses to acupuncture treatment. In the meantime, prospective randomized controlled trials should be designed to minimize bias in study design and enhance the clinical applicability and scientific validity of research findings. This letter was conducted according to Transparency in the reporting of Artificial Intelligence – the TITAN guideline[5].