Intestinal neurosis, clinically known as Irritable Bowel Syndrome (IBS) per international diagnostic criteria, is a systemic functional gastrointestinal disorder characterized by smooth muscle dysfunction of the intestinal tract. The core clinical manifestations include recurrent abdominal discomfort, abdominal pain, bloating, increased bowel sounds, constipation, and alternating diarrhea and constipation. As a functional disease, IBS presents obvious somatic intestinal symptoms without organic intestinal lesions.
The exact pathogenesis of intestinal neurosis remains incompletely defined. Current clinical studies attribute its occurrence and recurrence to three major contributing factors: psychological stress, intestinal kinetic abnormalities, and dietary imbalance.
Etiological Factors
1. Psychological and Emotional Factors
Symptom onset and aggravation of intestinal neurosis are strongly correlated with emotional stress. Negative emotional states such as anxiety, irritability, depression, and fear disrupt autonomic nervous system regulation, leading to dysfunction in colonic motility and gastrointestinal endocrine secretion. More than half of IBS patients present concurrent neuropsychiatric symptoms, including insomnia, frequent dreaming, irritability, dizziness, and persistent headaches.
2. Intestinal Motility Disorders
Patients with intestinal neurosis exhibit typical intestinal kinetic abnormalities. These include reduced tolerance to rectal distension, decreased resting sigmoid colon pressure during diarrhea episodes, and elevated pressure during constipation. Balloon dilation of the colon can induce diarrhea-like symptoms consistent with IBS manifestations. Intestinal electromyography shows increased low-frequency slow waves in the sigmoid colon, which increases intestinal sensitivity to external stimuli and constitutes the pathological basis of intestinal irritability.
Dysregulated colonic motility heightens intestinal sensitivity to sympathomimetic drugs and cholecystokinin, stimulating excessive colonic mucus secretion and resulting in mucous stool and persistent diarrhea in clinical practice.
3. Dietary Factors
Imbalanced intake of lipids and dietary fiber disrupts normal intestinal peristalsis and metabolic function. In addition, different food types alter the proportional balance of anaerobic and aerobic bacteria in the intestinal flora. For example, excessive wheat-based food intake reduces anaerobic bacteria and increases aerobic bacteria, breaking intestinal microecological balance and triggering functional intestinal disorders.
Clinical Diagnostic Criteria
Intestinal neurosis is characterized by recurrent, alternating gastrointestinal symptoms, including episodic abdominal pain, bloating, diarrhea, constipation, and mucoid stool. Most patients present concomitant psychological symptoms such as dizziness, headache, insomnia, vivid dreams, emotional instability, irritability, anxiety, poor concentration, and reduced work efficiency. In severe cases, patients may exhibit hysteria, frequent sighing, and emotional crying.
Abdominal pain predominantly localizes to the lower abdomen, particularly the left lower quadrant. Symptoms are commonly triggered or worsened by abdominal cold stimulation, cold food intake, and negative emotional fluctuations, accompanied by active bowel sounds. Abdominal pain is typically relieved after flatulence. Most diarrhea episodes occur following abdominal pain, with pain alleviation after defecation. Patients usually have 2 to 5 bowel movements daily with small stool volume. Stools are mostly formed, partially presenting frothy or mucoid features with a large amount of transparent or white mucus. Routine stool examinations show no positive pathological findings.
Diarrhea is easily induced or aggravated by high-fat foods, cold drinks, and spicy irritant foods. A small number of patients develop weight loss due to accelerated intestinal peristalsis, frequent diarrhea, and impaired nutrient absorption.
Constipation is more prevalent in female patients, with bowel movements occurring fewer than three times per week, or once every one to two weeks. Stools are dry and hard, presenting as pellet-like or pencil-shaped feces. Defecation is laborious and prolonged, often lasting more than 30 minutes. Long-term constipation may cause persistent lower abdominal distension, anal fissures, hemorrhoids, halitosis, and dry or bitter mouth sensation.
Most patients exhibit obvious autonomic nervous dysfunction, including spontaneous hyperhidrosis, flushing, unstable blood pressure and pulse, chest tightness, shortness of breath, fatigue, and cold extremities. Some female patients may experience decreased libido.
Clinical Examination Findings
Abdominal percussion reveals hyper-resonance in the middle and lower abdomen; auscultation detects active bowel sounds. Patients with abdominal pain present obvious tenderness in the left lower quadrant without rebound tenderness, with palpable cord-like intestinal tissue. Partial patients have concurrent anal fissures and hemorrhoids. Barium enema imaging indicates segmental colonic spasm and local intestinal stenosis, confirming functional intestinal spasm rather than organic lesions.
Standard Acupuncture Treatment for Intestinal Neurosis
Acupuncture for intestinal neurosis (IBS) is a safe, non-invasive, and clinically effective TCM therapy. Standardized WHO acupoint stimulation regulates autonomic nerve function, repairs intestinal motility disorders, balances intestinal microecology, and relieves stress-induced alternating diarrhea and constipation, achieving stable long-term symptomatic improvement.
Standard Acupoints & Needling Protocol (WHO Standard Coding)
1. Zusanli (ST36, Bilateral)
Location: Approximately 75 mm inferior to Dubi (ST35), one middle-finger breadth lateral to the anterior tibial crest.
Needling Method: Use two 30-gauge, 2-inch filiform needles. After standard aseptic disinfection, perform perpendicular insertion to a depth of 45 mm.
Needling Sensation: Local calf distension and soreness, or radiating tingling extending toward the dorsum of the foot.
2. Tianshu (ST25, Bilateral)
Location: Approximately 50 mm lateral to the center of the umbilicus (Shenque CV8).
Needling Method: Use two 30-gauge, 2-inch filiform needles. After routine aseptic disinfection, insert perpendicularly to a depth of 38 mm to 45 mm.
Needling Sensation: Local abdominal distension and soreness.
3. Fujie (SP14, Left Side)
Location: In the lower abdomen, approximately 33 mm inferior to Daheng (SP15), 100 mm lateral to the anterior midline of the abdomen.
Needling Method: Use a 30-gauge, 1.5-inch filiform needle. After local disinfection, perform perpendicular insertion to a depth of 33 mm.
Needling Sensation: Local lower abdominal distension and soreness.
Clinical Treatment Procedure
Patients are placed in a supine position. All acupoints are needled in accordance with standardized aseptic techniques. Needles are retained for 40 minutes per session without manual manipulation after insertion. Following needle withdrawal, local cupping therapy is applied for approximately 1 minute to activate abdominal qi and blood circulation.
Treatment is administered once daily. A complete therapeutic course consists of 10 consecutive sessions, with a 5-day rest interval before initiating the next course of treatment.
Clinical Discussion & Treatment Principles
Intestinal neurosis (IBS) is often refractory to conventional Western medication. Standardized TCM acupuncture delivers superior and stable therapeutic effects for functional intestinal disorders. However, symptoms are prone to recurrence triggered by emotional depression, insomnia, excessive intake of cold food, and spicy irritant diets.
During treatment, patient education and lifestyle regulation are essential. Patients are instructed to regulate mental emotions, avoid stress and anxiety, and strictly refrain from cold, raw, and irritant foods. Combined with standardized acupuncture intervention to regulate intestinal nerve and peristaltic function, most patients achieve satisfactory clinical recovery and effective prevention of symptom recurrence.