Auricular Acupuncture for Post-Stroke Constipation

Post-stroke constipation (PSC) is one of the most common gastrointestinal complications after stroke and is associated with prolonged hospitalization, impaired rehabilitation, reduced quality of life, and poorer functional outcomes. Conventional management, including laxatives, dietary modification, and bowel training, may improve constipation symptoms; however, many patients continue to experience persistent bowel dysfunction despite these treatments. Therefore, safe and effective adjunctive therapies are needed to optimize bowel management during stroke rehabilitation.

Auricular acupuncture is a non-pharmacological intervention that has been increasingly used to manage gastrointestinal disorders. Previous experimental and clinical studies suggest that stimulation of specific auricular acupoints may regulate autonomic nervous system activity, improve gastrointestinal motility, and modulate the gut-brain axis. Although several studies have reported beneficial effects of auricular acupuncture for constipation, evidence regarding its effectiveness in patients with post-stroke constipation remains limited, particularly from randomized sham-controlled clinical trials.

This study was conducted to evaluate the effectiveness and safety of auricular acupuncture as an adjunct to standard care in hospitalized patients with post-stroke constipation. Participants were randomly assigned to receive either auricular acupuncture plus standard care or sham auricular acupuncture plus standard care. Constipation severity, intestinal symptoms, bowel function, and adverse events were evaluated during the intervention period to compare the therapeutic effects between the two groups.

The findings of this study are expected to provide additional clinical evidence regarding the role of auricular acupuncture as an adjunctive treatment for post-stroke constipation and may contribute to the development of evidence-based rehabilitation strategies for patients recovering from stroke.

Inclusion criteria

• Adults aged 18 years or older.
• Hospitalized patients with stroke confirmed by computed tomography (CT) or magnetic resonance imaging (MRI)
• Glasgow Coma Scale score >= 14
• Diagnosed with constipation according to the Constipation Assessment Scale (CAS) with a score > 2 and constipation duration of less than 1 week
• No history of gastrointestinal study
• Receiving routine rehabilitation therapy, including body acupuncture, massage therapy, and physical rehabilitation according to the hospital protocol
• Able to provide written informed consent

Exclusion criteria

• Inability to cooperate with study procedures because of cognitive impairment, psychiatric disorders, or severe communication difficulties after stroke.
• Skin lesions or infection involving the auricle.
• Pregnancy.
• Acute illness, exacerbation of chronic disease, malignant tumors, cancer, or severe dermatological disorders.
• Current use of medications known to cause constipation, including antidepressants, opioid analgesics, iron supplements, calcium channel blockers, or antacids.