Acupressure Points for Nausea and Digestive Support in Cystic Fibrosis
By Jhoanna Rae Marquez, PT, DAC, INHCLiving with cystic fibrosis often means dealing with digestive challenges that most people don’t think about. Nausea, bloating, abdominal pain, and the general discomfort that comes with pancreatic insufficiency or conditions like distal intestinal obstruction syndrome (DIOS) can significantly impact quality of life. While medications remain the cornerstone of CF management, acupressure offers a simple, accessible technique that may help manage these uncomfortable symptoms between treatments or when nausea strikes at inconvenient times.
Understanding Digestive Issues in CF
The digestive complications in cystic fibrosis aren’t just inconvenient. They’re a direct result of how CF affects the pancreas and intestinal system. When thick mucus blocks pancreatic ducts, digestive enzymes can’t reach the intestines properly. This leads to the gastrointestinal symptoms that many people with CF know all too well: stomach pain, nausea, vomiting, constipation, and bloating. DIOS affects 10 to 24 percent of people with CF and presents with crampy pain, bloating, nausea, and sometimes significant weight loss. Additionally, gastroesophageal reflux disease (GERD) is more common in CF due to excessive coughing and delayed stomach emptying, contributing further to nausea and discomfort.
Recent research shows that gastrointestinal symptoms remain one of the top priorities for the CF community. In surveys conducted in 2018 and 2023, relief of symptoms like stomach pain, bloating, and nausea consistently ranked among the top 10 research priorities according to people living with CF and their families.
What the Research Says About Acupressure
Acupressure, which involves applying pressure to specific points on the body, has been studied extensively for nausea and vomiting across various medical conditions. The evidence is particularly strong for a point called P6 (also known as Neiguan or Pericardium 6), located on the inner wrist.
A 2011 systematic review by Lee and Frazier examined randomized controlled trials of acupressure for symptom management and found that 84 percent of investigators concluded acupressure was effective. The technique showed promise for managing pain, nausea, and other symptoms across different patient populations. For nausea specifically, multiple Cochrane reviews have evaluated P6 stimulation. In postoperative settings with over 3,000 patients studied, P6 stimulation showed consistent effectiveness in reducing both nausea and vomiting. For chemotherapy-induced nausea, studies with more than 1,200 patients found that acupressure was effective for first-day nausea.
The mechanism appears to involve regulating gastrointestinal motility, inhibiting gastric acid secretion, and modulating the autonomic nervous system. When P6 is stimulated, it affects endocrine function and helps adjust how the digestive system responds to triggers that cause nausea.
While specific research on acupressure in CF populations remains limited, one pilot study examined acupuncture (which works on similar principles to acupressure) for pain management in CF patients. The study found acupuncture effective in decreasing pain complaints with no reported side effects. Given that nausea and digestive discomfort are common in CF, and the broader evidence supports acupressure’s safety and effectiveness, this technique may offer value for CF patients managing gastrointestinal symptoms.
Key Acupressure Points
P6 (Neiguan): Located on the inner wrist, approximately three finger widths below the wrist crease, between two tendons. This is the most studied point for nausea.
Research shows it helps regulate stomach function and can reduce nausea intensity within minutes to hours of application.
ST36 (Zusanli): Found on the lower leg, about four finger widths below the kneecap and one finger width away from the shinbone. This point is particularly relevant for digestive issues. Studies show ST36 helps regulate spleen and stomach function, promotes gastrointestinal peristalsis, and can strengthen digestive processes. When combined with P6, the anti-nausea effect appears to be enhanced.
LI4 (Hegu): Located in the webbing between the thumb and index finger. While commonly used for headache relief, LI4 also helps with gastrointestinal function. Research indicates it works synergistically with ST36 to help the stomach function more smoothly and can be particularly helpful for nausea related to stress or tension.
Practical Considerations for CF Patients
Acupressure has several advantages that make it worth considering. It’s noninvasive, has no drug interactions, and can be self-administered. Most studies report minimal to no side effects, with occasional minor skin irritation being the only concern noted. This is particularly relevant for people with CF who already manage multiple medications daily and may experience side effects from their existing treatment regimens.
The technique is also portable. You can use acupressure during treatments, while traveling, or when nausea strikes unexpectedly. Some people use acupressure wristbands that provide continuous gentle pressure to the P6 point, which can be worn during the day for ongoing symptom management.
However, acupressure is not a replacement for prescribed CF treatments. Pancreatic enzyme replacement therapy, medications for DIOS, and treatments for GERD remain essential. Think of acupressure as an additional tool in your symptom management toolbox, something to use alongside your prescribed regimen, not instead of it.
When to Consider Acupressure
Acupressure may be particularly helpful during times when nausea interferes with taking medications or eating, as maintaining nutrition is crucial in CF. It might also help during transitions between treatments, when waiting for medication to take effect, or when experiencing breakthrough symptoms despite medication.
Studies in other chronic conditions have shown that complementary approaches like acupressure can improve comfort levels and reduce the need for rescue antiemetic medications. For CF patients dealing with frequent digestive symptoms, having a non-pharmaceutical option available can provide a sense of control and may reduce medication burden when appropriate.
Starting the Conversation
If you’re interested in trying acupressure for nausea or digestive discomfort, discuss it with your CF care team. They know your specific health situation and can help you integrate this technique safely. Studies show that 76 to 79 percent of children and families affected by CF
already use some form of complementary approach, yet many don’t discuss these with their healthcare providers. Your team wants to support your wellbeing and can provide guidance on using acupressure effectively alongside your medical treatments.
The evidence supporting acupressure for nausea is solid. While we need more CF-specific research, the safety profile and the broader evidence base make this a reasonable complementary approach to consider. For a condition that requires so much from patients and families every day, having additional tools to manage uncomfortable symptoms can make a real difference in daily quality of life.
References:
Lee, E. J., & Frazier, S. K. (2011). The efficacy of acupressure for symptom management: a systematic review. Journal of Pain and Symptom Management, 42(4), 589-603. https://pubmed.ncbi.nlm.nih.gov/21531533/
Lee, A., & Fan, L. T. (2009). Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database of Systematic Reviews. https://pubmed.ncbi.nlm.nih.gov/19370583/
Schloss, J., Colosimo, M., & Vitetta, L. (2013). The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting: a systematic review and meta-analysis. PLOS ONE, 8(12). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0082474
Tabori, H., et al. (2024). Scoring abdominal symptoms in people with cystic fibrosis. Journal of Clinical Medicine, 13(6). https://pubmed.ncbi.nlm.nih.gov/38541878/
Cystic Fibrosis Foundation. The Digestive System.
https://www.cff.org/managing-cf/digestive-system
Kung, E., et al. (2005). Acupuncture pain management for patients with cystic fibrosis: a pilot study. https://pubmed.ncbi.nlm.nih.gov/15844843/
Giangioppo, S., et al. (2016). Complementary and alternative medicine use in children with cystic fibrosis. Complementary Therapies in Clinical Practice, 25, 68-74. https://pubmed.ncbi.nlm.nih.gov/27863612/