Combined Colon Hydrotherapy and Catgut Embedding at the Fujie (SP14) Acupoint for Treating Slow Transit Constipation: a clinical efficacy and safety study

Objectives: Chronic idiopathic constipation, particularly slow transit constipation (STC), affects 2%-4% of the global population.It is characterized by impaired colonic transit and defecation difficulties.This study evaluated the safety and efficacy of combining colon hydrotherapy with catgut embedding at the Fujie (SP14) acupoint for treating STC.Methods: In this single-center, randomized, open-label exploratory trial, 32 adult patients with STC were assigned to a combined group (colon hydrotherapy plus Fujie acupoint catgut embedding; n = 17) or a hydrotherapy group (colon hydrotherapy alone, n = 15).The primary outcome was the change from baseline in the total Patient Assessment of Constipation Symptoms (PAC-SYM) score at 4 weeks.Secondary outcomes included PAC-SYM subscale scores, post-treatment colonic transit marker retention, Patient Assessment of Constipation Quality of Life (PAC-QOL) scores, and safety outcomes.Results: Both groups showed reductions in PAC-SYM scores after treatment.At 4 weeks, the combined group had a lower PAC-SYM total score than the hydrotherapy group (6.59 ± 2.96 vs. 8.81 ± 2.39, p = 0.028).The post-treatment Day-5 marker retention was significantly lower in the combined group than in the hydrotherapy group (4.35 ± 0.61 vs. 5.47 ± 1.13, p < 0.05), whereas the Day-3 between-group difference was not significant.PAC-QOL scores improved in both groups; greater improvements were observed in physical discomfort, psychosocial discomfort, and dissatisfaction in the combined group.However, because the Worries and Concerns domain differed at baseline, the results were interpreted cautiously.No serious adverse events were observed during the study.Conclusion: Compared with hydrotherapy alone, combined colon hydrotherapy and Fujie acupoint catgut embedding improved constipation symptoms, selected quality-of-life domains, and post-treatment Day-5 colonic transit outcomes, with no major safety issues observed over the 4-week treatment period.However, larger registered trials with longer follow-up and baseline-adjusted analyses are required to confirm these findings.