Functional gastrointestinal disorders (FGD) — including functional dyspepsia, irritable bowel syndrome (IBS), and functional constipation — collectively affect more than 40% of the global population and represent one of the leading causes of medical consultations and reduced quality of life. Characterized by chronic gastrointestinal symptoms without an identifiable organic cause, these disorders have multifactorial pathogenesis involving dysregulation of the gut–brain axis, visceral hypersensitivity, and altered intestinal motility. A meta-analysis published in Frontiers in Medicine in March 2025 systematically evaluated the efficacy of auriculotherapy for FGD, gathering 19 randomized clinical trials and 1,681 patients.
The study was conducted by Meng-Yuan Shen, of the First Affiliated Hospital of Zhejiang Chinese Medical University, and colleagues. The auricular interventions evaluated included semipermanent needles, Vaccaria seeds, magnetic beads, and auricular electroacupuncture, applied at points such as Stomach, Large Intestine, Small Intestine, Point Zero, Shenmen, Sympathetic, and Subcortex. The conditions included were functional dyspepsia (FD), irritable bowel syndrome (IBS), and functional constipation (FC), with protocol durations ranging from 2 to 12 weeks. The primary endpoint was the rate of global therapeutic efficacy (proportion of patients with clinically significant improvement in symptoms).
MAIN RESULTS — 19 RCTS, 1,681 PATIENTS
Results by condition: dyspepsia, IBS, and constipation
The subgroup analysis revealed benefits of auriculotherapy in the three conditions evaluated, although with varying magnitudes. For functional dyspepsia, auriculotherapy demonstrated improvement in early satiety, postprandial fullness, nausea, and epigastric discomfort — mechanistically associated with regulation of gastric motility and modulation of the vagus nerve. For irritable bowel syndrome, benefits were evident in both diarrhea-predominant (IBS-D) and constipation-predominant (IBS-C) subtypes, with improvement in abdominal pain, bowel urgency, and stool consistency. For functional constipation, auriculotherapy improved frequency and ease of bowel movements, with results that were particularly consistent in studies using auricular electrical stimulation.
Superior symptomatic response in specific subgroups
The RR = 1.35 (CI 1.21–1.51) represents a clinically relevant benefit: for every group of 100 patients treated with conventional therapy with a 50% response rate, auriculotherapy would produce response in approximately 67.5 — an absolute difference of 17.5 percentage points. The conventional treatments compared in the studies included prokinetics (domperidone, metoclopramide) for dyspepsia, antispasmodics (mebeverine, dicyclomine) for IBS, and osmotic laxatives (lactulose, PEG) for constipation. Auriculotherapy was associated with symptomatic response superior to usual care in specific subgroups (functional dyspepsia, IBS-D, functional constipation), with the additional advantage of a favorable safety profile — without the gastrointestinal adverse effects of prokinetics or the renal effects of chronic laxatives.
Frequently Asked Questions
The meta-analysis demonstrated benefits in all three conditions, but subgroup data suggest that auriculotherapy has particular advantage in functional constipation — where stimulation of the Large Intestine and Rectum points via the vagus nerve produces a concrete prokinetic effect. For IBS, the benefit is consistent but more variable across subtypes. For dyspepsia, the improvement in early satiety and postprandial fullness is well documented. In clinical practice, patients with FGD frequently have overlapping conditions (dyspepsia + IBS in up to 30% of cases), and auriculotherapy has the advantage of treating multiple conditions simultaneously with the same adjusted protocol.
Vaccaria seeds (Wang Bu Liu Xing) are usually kept for 3 to 5 days and then replaced. In hot, humid climates — such as Brazil — the auricular skin can macerate more quickly, and replacement at 3–4 days is recommended. The patient should be instructed to remove the seeds if intense pain, burning, or excessive redness or discharge occurs. Magnetic seeds can be kept a bit longer, up to 5–7 days. The interval between treatment cycles varies according to response: maintain for up to 8–12 consecutive weeks for chronic conditions such as IBS, then evaluate the need for maintenance.
Yes — auriculotherapy has no known drug interactions and can be used in combination with antispasmodics, antidiarrheals (loperamide), laxatives, low-dose antidepressants (used for visceral hypersensitivity), and probiotics. In clinical practice, the combination may allow gradual reduction of medication dose as auriculotherapy response develops — which is particularly advantageous for patients on chronic antispasmodics or who depend on daily laxatives. Any medication adjustment should be discussed with the treating physician.
Founded in 1989 by physicians trained at the University of São Paulo (USP) and specialized in China, CEIMEC is a Brazilian national reference in the teaching and practice of medical acupuncture. With more than 3,000 physicians trained over 35 years, it collaborates with HC-FMUSP and is recognized by the Brazilian Medical College of Acupuncture (CMBA/AMB).