How acupuncture gave one patient with chronic nausea her life back

The notoriously choppy waters below South America punctuated a cruise that had taken Jessica Frazier all the way to Antarctica.

She felt sick, but it was the kind of sea sickness anyone might experience in that situation. 

It wasn’t the debilitating nausea that, just two years ago, had made her barely able to leave her Michigan home, much less travel the world.

“I had three acupuncture appointments before I left because I was so worried about being able to eat,” Frazier said.

“Boy oh boy was I glad for those appointments.”

Frazier hadn’t been as eager for her first appointment with the acupuncture clinic within Michigan Medicine’s Division of Gastroenterology and Hepatology.

Acupuncturist Henry A. Buchtel, L.Ac., M.S., remembers Frazier telling him, “The only reason I'm here is because of that badge you're wearing that says Michigan Medicine.”

Frazier was, by her own admission, skeptical. But at 25 years old, she had developed nausea so debilitating that she could scarcely eat, couldn’t sleep and had lost a job she had just started.

With no obvious physical cause for her symptoms, her gastroenterologist at Michigan Medicine suggested they try a variety of techniques to improve her quality of life. Dietary changes didn’t seem to help, so acupuncture was suggested.

Frazier doesn’t love needles and had no experience with acupuncture. She found Buchtel to be friendly and diligent in their first meeting, but she remained wary. 

“He told me he was going to put a needle on my lip, and I was like, Oh, you are crazy,” Frazier said.

“Luckily, he had already put needles in my legs so I couldn’t get up.”

Despite her low expectations, Frazier felt an improvement in her symptoms that same week. Her nausea didn’t go away — and she still struggled to eat — but her energy returned. 

After six months of weekly sessions with Buchtel, she has gotten much of her life back. She has a new job, the energy to play with her dogs and the ability to hold down food. She can sleep. Her nausea is still there, but it has receded into the background.

“My quality of life has improved immensely,” Frazier said.

“And because it worked, I was more open to trying more things to get the most out of the acupuncture.”

An integrated approach

Despite evidence that acupuncture can be an effective treatment for certain gastrointestinal symptoms, its availability as a treatment in the United States remains limited.

In May 2023, Michigan Medicine’s Division of Gastroenterology and Hepatology became the first large academic division in the country to offer acupuncture treatment at its GI clinic.

“Michigan Medicine gastroenterologists have been trailblazers in multidisciplinary care of patients with digestive disorders, incorporating specialized GI dietitians and behavioral psychologists into our practice,” said William D. Chey, M.D., H. Marvin Pollard Professor and Chief of the Division of Gastroenterology and Hepatology.

“We felt that adding an acupuncture was the next logical step for our patients.”

Now, nearly two years later, over 100 patients like Jessica Frazier have made nearly 500 visits to University of Michigan Health facilities for acupuncture treatments.

An Ann Arbor native, Henry A. Buchtel moved to China in 2001 and studied at Hunan University of Chinese Medicine. There, acupuncture is integrated into the larger healthcare system. Buchtel remembers patients arriving at the hospital in China and being sent directly to acupuncture, depending on their symptoms.

Returning the United States, however, he noticed that the patients who came to his private acupuncture practice tended to already have faith in the treatment.

So Buchtel jumped at the opportunity to work with Michigan Medicine’s gastroenterology department to reach patients like Frazier, who could benefit from treatment but who wouldn’t necessarily seek it out on their own.

The relationship between the U-M Health gastroenterologists and Buchtel seems mutually beneficial. Doctors can lend their credibility to get patients in the door, and then Buchtel can keep them coming back through results.

Frazier is typical of the patients he sees at U-M: people for whom the symptoms are clear, but the causes aren’t always obvious. In addition to patients with chronic nausea, Buchtel sees many people with irritable bowel syndrome and idiopathic constipation.

These cases benefit from acupuncture’s unique properties to tone down sensations.

“There exists a fairly strong understanding of the changes that are happening primarily in the brain that explain the efficacy,” Buchtel said.

“Still, the question remains, how does it get from the needle to the brain?”

Toning down discomfort

Before every session, Buchtel reviews how Frazier felt since their last session, asking her to rate her nausea from 1 to 10 for each day of the previous week. Initially, the practice confused Frazier. Then she realized it gave Buchtel a means to track what was working.

In addition to measuring whether the acupuncture was working this practice reflects how acupuncture works.

Frazier describes a numbness that makes the nausea less intense. Buchtel relays an analogy from Daniel J. Clauw, M.D., director of U-M’s Chronic Pain and Fatigue Research Center, of a guitar amplifier knob.

“In some chronic pain patients, the knob is turned up really high,” Buchtel said.

Acupuncture might not solve the root source of the pain, but it can turn down the knob on the amplifier – i.e., change the brain’s sensitivity to the discomfort. 

While it might not eliminate a patient’s nausea, it can help, as in Frazier’s case, to stomach the rough seas of the Drake Passage. 

Buchtel still treats Frazier, and they’ve increased the number of needles as they tackle a variety of other problems related to her nausea, like cramping.

Now, Frazier’s only issue with acupuncture as a treatment for GI problems is that it’s not more widely available.

“Henry Buchtel just wants to help was the impression I got from the first time I met him,” Frazier said.

“And I would say not much has changed other than the fact that he's quite busy.”

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