title: Osteopathy decreases the severity of IBS-like symptoms associated with Crohn's disease in patients in remission.
abstract: BACKGROUND
  Osteopathy may decrease the severity of irritable bowel syndrome (IBS). About 35% of patients with quiescent Crohn's disease (CD) continue to suffer from IBS-like symptoms with impaired quality of life (Qol). We aimed to evaluate the effect of osteopathy on the severity of IBS-like symptoms in quiescent CD patients.
  
  
  METHODS
  We prospectively included 38 patients with CD on remission over 12 months while receiving infliximab every 8 weeks. Patients were randomized 2/ 1 to receive three sessions of standardized osteopathy (n=25) at 15, 30, and 45 days after the last infusion of infliximab or simple follow-up. The severity of IBS-like symptoms, psychological factors, and its impact on Qol were assessed using questionnaires.
  
  
  RESULTS
  Compared with baseline, the severity of IBS-like symptoms was significantly reduced in patients receiving osteopathy. The decrease was significantly more pronounced in patients receiving osteopathy at day 30 [-38.4 (-76.1 to 10.2) vs. 32.2 (-16.6 to 41.6), P=0.01], day 45 [-36.7 (-74.4 to 25.3) vs. 32.2 (-16.6 to 41.6), P=0.04], and day 60 [-39.5 (-60.9 to -9.2) vs. 6.1 (-38.7 to 28.5), P=0.05] with a concomitant increase in Qol (P=0.09 at day 30, P=0.02 at day 45, P=0.3 at day 60). Compared with baseline, the severity of fatigue was significantly reduced in patients receiving osteopathy, whereas depression and anxiety remained unchanged.
  
  
  CONCLUSIONS
  Three sessions of osteopathy reduced the severity of IBS-like symptoms associated with CD in remission. Osteopathy should be viewed as a helpful therapeutic option to reduce the severity of abdominal pain and discomfort in patients with CD but in remission with IBS-like symptoms.
authors.affiliation: aDepartment of Hepato-Gastroenterology and Oncology. Archet 2 Hospital, CHU of Nice, University of Nice Sophia Antipolis, 06202 Nice Cedex 03 bDepartment of Immunology and Biology, EA 6302 Immune Tolerance, Archet 1 Hospital, Univesrity of Nice Sophia Antipolis cATMAN Osteopathy Center, Sophia Antipolis, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Piche
authors.forename: Dorsa
authors.initials: D
authors.lastname: Pishvaie
authors.forename: Diane
authors.initials: D
authors.lastname: Tirouvaziam
authors.forename: Jerome
authors.initials: J
authors.lastname: Filippi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Dainese
authors.forename: Marie
authors.initials: M
authors.lastname: Tonohouhan
authors.forename: Laurianne
authors.initials: L
authors.lastname: DeGalleani
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Nébot-Vivinus
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Payrouse
authors.forename: Xavier
authors.initials: X
authors.lastname: Hébuterne
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004334:Drug Administration Schedule; D005260:Female; D005602:France; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D006801:Humans; D000069285:Infliximab; D008297:Male; D026301:Manipulation, Osteopathic; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab