Dr. Arthur de Lorimier placed a firm hand on 9-year-old Moncerrat Torres’ left ankle, looking into her brown eyes as he pushed an acupuncture needle into the top of her foot, just a few inches from her big toe.
Her mother, Maribel Torres, stood in the corner of the room for moral support, but the girl didn’t wince. The long, thin needles used in the traditional Chinese medicine cause discomfort, Torres said, but it’s a small price to pay for relief from the irritable bowel syndrome that once plagued Moncerrat day and night.
De Lorimier, a pediatric gastroenterologist at UC Davis Children’s Hospital, was searching for pressure points on Moncerrat’s body that he hoped would ease the pain in her abdomen. He’s one of the only physicians in his field using acupuncture on children with functional abdominal disorders.
These children have digestive systems that look just like anyone else’s, but are hypersensitive to stretch pain, or the gut’s reaction to taking in food, de Lorimier said. When a child with a functional abdominal disorder eats, their brain sends intense pain signals to their digestive system, which tenses up and moves the food irregularly, often resulting in nausea, diarrhea, constipation and vomiting.
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“They have a much more varied motility pattern from day to day, and they have a lowered pain threshold for stretch,” de Lorimier said. “We know there are certain triggers. Fear is a trigger, stress is a trigger, anxiety is a trigger. Eating too much or eating fatty foods can be a trigger.”
The disorder affects an estimated 5 to 10 percent of children, and some experts believe it’s become more prevalent as children have become busier and more digitally focused. Doctors typically recommend changes in diet and exercise, and often prescribe antidepressants to reduce the fear and anxiety that seem to bring on the digestion issues.
De Lorimier, a former military physician, said he was tired of putting children who were in pain on drugs that numbed them. He’d previously received acupuncture training for service members with post-traumatic stress disorder, and he wondered if the practice, which has become popular for relaxation and chronic pain reduction, would work on his pediatric gastrointestinal patients.
So when he got to UC Davis in 2015, he was told he could give it a try on two conditions – that the child’s parents fully understand and consent to acupuncture, and that they have insurance or otherwise the money to cover it. Most insurance plans do not pay for acupuncture.
Maribel Torres said she was completely out of answers for her daughter when de Lorimier offered to try acupuncture. The girl’s bowel pains had flared up suddenly in May, Torres said, and Moncerrat, usually a happy child, would cry out from pain after meals and vomit during the night. She gave up eating many of her favorite foods, including beans and peppers, and struggled to participate in swimming, soccer and other activities at school.
“It was almost every day crying about the pain,” Torres said. “We went to Disneyland, and it was not like a normal kid having fun. It was just pain for three days after eating something. Then she’d want to eat something again, but she was afraid.”
After the first three acupuncture sessions with de Lorimier, Moncerrat began to report fewer stomach aches, Torres said. They continued seeing him through October, and Moncerrat became less afraid to eat. They returned again recently to be sure the symptoms would stay at bay.
“I wasn’t sure I should eat because maybe something would go wrong, but now I can eat and it doesn’t always hurt,” Moncerrat said.
De Lorimier has performed about 260 treatments on 18 patients, and finds it’s helpful for about three-quarters of them. But even he doesn’t know exactly why it works, he said.
“The traditional Chinese teaching with acupuncture is that you’re trying to move stagnant energy, or chi, through the body,” he said. “What’s known from PET scans is there are certain parts of the body that follow acupuncture points, and if you stick in a needle you’ll stimulate the amygdala and prefrontal cortex in such a way that it modifies your perception of pain, in the same way that the drugs seem to raise pain thresholds.”
Acupuncture for children with abdominal pain is largely unstudied, but the American Academy of Pediatrics declared in 2011 that the procedure is generally safe for children when performed by trained professionals. Dr. Ann Ming Yeh, who performs acupuncture on 15 to 20 patients per month at Lucile Packard Children’s Hospital Stanford, believes she and de Lorimier are the only two pediatric gastroenterologists using the practice regularly.
They’re working together to research the practice, she said.
Yeh said the needles, when applied to certain pressure points, help tense children get into “rest and digest” mode. At her clinic, she also introduces them to hypnosis, herbal remedies and other aspects of integrative medicine that might help calm them.
“When (the tests) are negative but the kid’s still not doing well, we try to add some more tools to the tool kit from a non-pharmacological standpoint to help children with a more holistic approach,” Yeh said. “Because of this, there are now more pediatric (gastrointestinal) docs interested in integrative medicine.”
Dr. Michael Lawson, a retired Kaiser Permanente gastroenterologist and co-author of “The Gut Solution,” a manual for parents whose children have functional abdominal disorders, said he’s never heard of acupuncture being used on child patients but isn’t surprised that it works. His own program encourages anxiety-reducing practices such as deep breathing, self-guided imagery and time away from screens.
“These patients are so complicated and so different, you’re not going to have one solution for the whole lot,” Lawson said. “The most unifying treatment is to work on the anxiety – that seems to be the best way of helping these patients.”