Several studies reported that moxibustion was effective in treating constipation. This systematic review assesses the clinical evidence for or against moxibustion for treating Constipation. Twelve databases were searched from their inception to March 2010. Only randomized clinical trials (RCTs) were included if they compared moxibustion with placebo, sham treatment, drug therapy or no treatment. The methodological quality of these RCTs was assessed with the Cochrane risk of bias analysis. All three RCTs included in the study had a high risk of bias. Two included studies found favorable effects of moxibustion. The third RCT showed significant effects in the moxibustion group. Given that the methodological quality of all RCTs was poor, the results from the present review are insufficient to suggest that moxibustion is an effective treatment for constipation. More rigorous studies are warranted.

Background
Chronic constipation is a prevalent health condition with patients typically having bowel movements twice a week or less for at least two consecutive weeks or longer. The Rome II criteria define chronic constipation on the basis of two or more of the following symptoms at least 25% of the time for at least 12 weeks in the preceding year: straining at defection, lumpy/hard stools, sensations of incomplete evacuation and three or fewer bowel movements per week. Currently, there is no optimal therapeutic solution for this condition.

Acupuncture and moxibustion are increasingly used for the treatment of gastrointestinal (GI) diseases. Moxibustion is a Chinese medicine treatment whereby an acupoint is stimulated by the heat generated from burning Artemisia vulgaris. Direct moxibustion is applied to the skin surface, whereas indirect moxibustion is performed with some insulating materials (e.g. ginger, salt) placed between the moxa cone and the skin. The heat is then used to warm the skin at the acupoint.