title: Treatment of refractory irritable bowel syndrome with visceral osteopathy: short-term and long-term results of a randomized trial.
abstract: OBJECTIVE
  In light of the low efficiency of available drugs in treating irritable bowel syndrome (IBS), there has been a growing interest in its alternative therapies. The aim of this study was to evaluate the effectiveness of visceral osteopathy for IBS.
  
  
  METHODS
  In total, 31 consecutive refractory IBS patients were prospectively included in a randomized, crossover placebo-controlled study. Qualitative evaluation of depression and four symptoms including constipation, diarrhea, abdominal distension and abdominal pain before and after each phase of the study were conducted using visual analog scales, measures of rectal sensitivity and colonic transit time. One year after the study, the assessment of symptoms was performed again in all patients.
  
  
  RESULTS
  Visceral osteopathy was associated with a significant amelioration of self-reported diarrhea, abdominal distension and abdominal pain, while constipation did not change significantly after this therapy. It was also associated with decreased rectal sensitivity, presenting as an increase in threshold volume, constant sensation volume and maximum tolerable volume (P < 0.001). However, no significant evolution of rectal sensitivity was observed when patients underwent placebo manipulations. Modifications of depression and total or segmental colonic transit time were not observed. One year after the end of this trial, symptom scores of diarrhea, abdominal distension and abdominal pain were significantly lower than those at enrollment (P < 0.05).
  
  
  CONCLUSIONS
  This study suggests that visceral osteopathy improves short-term and long-term abdominal distension and pain, and also decreases rectal sensitivity in IBS patients.
authors: Service de Gastroentérologie, Hôpital Avicenne, Bobigny, France.
authors: Thu-Van
authors: TV
authors: Attali
authors: Michel
authors: M
authors: Bouchoucha
authors: Robert
authors: R
authors: Benamouzig
mesh_terms: D015746:Abdominal Pain / Q000534:rehabilitation; D003106:Colon / Q000503:physiopathology; D003248:Constipation / Q000534:rehabilitation; D018592:Cross-Over Studies; D003967:Diarrhea / Q000534:rehabilitation; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods*; D008875:Middle Aged; D010641:Phenotype; D012007:Rectum / Q000294:innervation; D012684:Sensory Thresholds; D016896:Treatment Outcome
keywords: abdominal distension; abdominal pain; irritable bowel syndrome; osteopathic manipulative treatment; rectal sensitivity