Abstract

Functional constipation (FC) is a common and often recurrent functional bowel disorder that seriously affects the quality of life of affected individuals and incurs a significant economic burden on both the individual and society. There is accumulating evidence that intestinal dysbiosis contributes to constipation and that rebalancing the gut microbiota may be a novel therapeutic modality for FC. Electroacupuncture (EA) has been shown to restore the gut microbiota to normal levels in a variety of diseases. Additionally, several high-quality clinical studies have confirmed that EA is an effective, sustained, and safe treatment for FC. However, whether the effects of EA are secondary to changes in the gut microbiota and how EA modulates intestinal dysbiosis induced by constipation are unknown. Therefore, here, we focused on the potential regulatory mechanisms of EA on diphenoxylate-induced constipation in mice by analyzing structural changes in the gut microbiota. Our results showed that EA treatment effectively rebalanced the gut microbiota of constipated mice, mainly by decreasing the Firmicutes/Bacteroidetes ratio, which may represent one way in which EA promotes gastrointestinal motility and alleviates constipation. Our findings lay the foundation for further mechanistic and clinical research into the application of EA in patients with FC.

Highlights

  • Functional constipation (FC) is a common functional bowel disorder without identifiable structural or biochemical abnormalities [1]

  • After four weeks of modeling, the fecal pellet number, wet weight, and fecal water contents were significantly lower, and the first black stool defecation time was significantly longer in slow transit constipation (STC) and STC.EA mice compared with normal control (NC) mice (P < 0.05, Figures 2(a)–2(d)), indicating that mice in the STC and STC.EA groups successfully modeled STC. ere were no significant differences between the STC and STC.EA groups (P > 0.05)

  • The symptoms of constipation were significantly improved in STC.EA compared to STC mice (P < 0.05, Figures 2(a)–2(d)). e intestinal transit rate was calculated to assess gastrointestinal motility and, compared with the NC group, the STC group had a significantly shorter intestinal transit rate (P < 0.05, Figure 2(e)), but EA significantly increased the intestinal transit rate compared to the STC group (P < 0.05, Figure 2(e))

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Summary

Introduction

Functional constipation (FC) is a common functional bowel disorder without identifiable structural or biochemical abnormalities [1]. FC can be recurrent and refractory to treatment, resulting in significant pain and an impaired quality of life [2, 4]. Conventional treatments include medical therapies such as fiber, osmotic and stimulant laxatives, and selective 5-hydroxytryptamine receptor 4 (5-HT4) agonists to relieve constipation when lifestyle modifications are ineffective [8]. Nearly half of patients with FC are Evidence-Based Complementary and Alternative Medicine dissatisfied with current medical approaches due to a lack of response, drug dependence, and unpleasant side-effects [9]. Patients are urgently seeking effective, safe, and nontoxic treatment alternatives

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