Osteopathy and Irritable Bowel Syndrome

Abstract

It is known that Osteopathy improves the Irritable Bowel Syndrome patient’s quality of life. In this article, we studied the literature to bring explanations about the treatment mechanism and the pathology origins.

The IBS treatment using osteopathy improves the symptoms within 6 months

 

Definition of Irritable Bowel Syndrome

Abdominal pain, constipation and diarrhoea are all typical symptoms of irritable bowel syndrome (IBS).

Although IBS is not dangerous, the symptoms can be very painful and bothersome. Most people who have IBS have a mild form, which they can cope with quite well without getting any treatment. But sometimes the symptoms are so strong that they significantly affect people’s everyday lives and can cause distress.

 

Main causes

Post-infectious, stress (gut-brain axis), small intestinal bacterial overgrowth, dysbiosis, active infections, depression, antibiotic use, etc. are the most common sources of IBS.

Stress seems to be the main cause of IBS, and if not, the main trigger. The gut-brain axis, a bilateral communication path identified in some 1990s publications, showed that the hypothalamic-pituitary-adrenal axis had a major influence on the development of IBS due to its long lasting stimulation during the microbial colonization of the gastro-intestinal tract.

An overlap with pathologies such as fibromyalgia and chronic fatigue syndrome seen on patients who suffer from IBS, and their high stress level involves a disruption of stress system.

Evidence has demonstrated that the release of high levels of proinflammatory cytokines during acute enteric infection causes increased gut permeability leading to translocation of the commensal bacteria across the epithelial barrier resulting in significant damage to local tissues which is likely to result in chronic gut abnormalities in sensitive individuals. However, increased gut permeability is strongly associated with IBS regardless of whether IBS was initiated by an infection or not.

The purpose of this article is to explain the main principles of IBS Osteopathy treatment for patients to realise that not only allopathic medicine can help. A proper diet, and in some cases, a proper medication has to be part of the global treatment.

 

What is Osteopathy?

Osteopathy is a therapy invented in 1874 by Andrew Taylor Still in the USA. Its definition remains the same and literally means “disease of bone”, but has evolved a lot among its past 140 years of existence.

We consider that there are about 10 classes of techniques in modern osteopathy:

-       Cranial Osteopathy,

-       Visceral Osteopathy,

-       Mitchell technique,

-       Jones technique,

-       HVLA technique,

-       High velocity thrust,

-       Functional technique,

-       Fascial technique,

-       Soft tissue technique,

-       Articulation mobilisation, etc.

People often think that there are osteopaths who crack and other who don’t. Osteopathy is a global therapy and there should not be such a distinction. Regarding the type of patient and the type of pathology (its chronicity, its intensity, its location, etc.), the osteopath will adapt his treatment.

The main goal is to recover soft tissues (muscles, ligaments, capsules, etc.) in order to recover joint mobility. The consequences are:

-       Better joint mobility,

-       Improvement of vascularisation,

-       Energy recovery.

 

Treatment of IBS with Osteopathy

Irritable Bowel Syndrome is a visceral disorder. The main osteopathy approach will be a visceral approach, depending on the acuteness of the pathology.

If the patient is in an acute stage (VAS 6-8 out of 10), the session will be shorter than an average session, because his recovery capacity will be diminished. The point will therefore to decrease his symptoms in order to improve his recovery capacity.

In the other hand, if the patient is in a chronic stage (VAS 2-3 out of 10), the session will be longer and the osteopathy work deeper.

The lesions caused on intestinal tissues on the IBS development process have to be fixed in order to decrease the symptoms. To fix a lesion, osteopathy uses tissue flexibility. The tissue mobilization increases the local vascularisation and its main goal is to bring proteins that will help tissue recovery.

To do so, the osteopath will use different techniques depending on the intensity of the pathology, and the patient medical history. A local visceral approach is only a part of the treatment. A cranial approach will help recovering a good function of the HPA axis and a structural spine treatment will recover the sympathetic short tract axis. The point is to recover a good homeostasis.

Osteopathy improves the severity of IBS symptoms and its impact on quality of life at the beginning of the treatment, and significantly after 6 months of treatment, according to an article published in 2007 and one in 2013.

 

Keywords

Osteopathy; Vascularization; Homeostasis; Irritable bowel syndrome; Visceral hypersensitivity

 

References

Hundscheid HW1, Pepels MJ, Engels LG, Loffeld RJ. (Sept 2007). Treatment of irritable bowel syndrome with osteopathy: results of a randomized controlled pilot study. PMID: 17716344

Florance BM1, Frin G, Dainese R, Nébot-Vivinus MH, Marine Barjoan E, Marjoux S, Laurens JP, Payrouse JL, Hébuterne X, Piche T. (Aug 2012). Osteopathy improves the severity of irritable bowel syndrome: a pilot randomized sham-controlled study. PMID: 22546751

Fukudo S, Nomura T, Muranaka M, Taguchi F; Nomura; Muranaka; Taguchi (1993). "Brain-gut response to stress and cholinergic stimulation in irritable bowel syndrome. A preliminary study". J. Clin. Gastroenterol. 17 (2): 133–41. doi:10.1097/00004836-199309000-00009. PMID 8031340

Beatty JK, Bhargava A, Buret AG (2014). "Post-infectious irritable bowel syndrome: mechanistic insights into chronic disturbances following enteric infection". World J. Gastroenterol. 20 (14): 3976–85. doi:10.3748/wjg.v20.i14.3976. PMC 3983453. PMID 24744587