Electroacupuncture alleviates symptoms and identifies a potential microbial biomarker in patients with constipation-predominant irritable bowel syndrome.

Irritable bowel syndrome with predominant constipation (IBS-C) is a chronic gastrointestinal disorder that significantly impacts the quality of life of patients and currently lacks a definitive treatment. The use of electroacupuncture (EA) has demonstrated clinical efficacy in treating IBS-C and the gut-brain axis modulation, though its mechanisms remain unclear. To investigate gut-brain-microbiota axis alteration and EA-associated microbial changes in IBS-C patients and treatment responders. This study consisted of two phases. The first phase was a cross-sectional study recruiting sixteen IBS-C patients and 16 healthy controls. Baseline fecal samples were collected to assess gut microbiota profiles between the two groups. The second phase was an observational longitudinal study in which the 16 IBS-C patients underwent nine EA sessions over one month. Gut microbiota profiles and clinical outcomes were assessed post-treatment course and at a one-month follow-up. IBS-C patients exhibited significant gut dysbiosis, as indicated by altered beta diversity compared to healthy controls. EA significantly improved clinical outcomes and gut dysbiosis, with sustained therapeutic effects and normalization of neurotransmitter-related metabolic pathways observed at one-month follow-up. Notably, the gut bacterium Senegalimassilia was positively associated with symptom improvement, suggesting its potential as a predictive biomarker of EA responsiveness. These findings support the integration of EA into IBS-C management and highlight Senegalimassilia as a candidate microbial biomarker for treatment response.