Home G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS?
Article Open Access

G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS?

  • Michael A. Seffinger and Anna Halbeisen
Published/Copyright: May 1, 2014
Download Article (PDF)
Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 114 Issue 5

Attali TV, Bouchoucha M, Benamouzig R. Treatment of refractory irritable bowel syndrome with visceral osteopathy: short-term and long-term results of a randomized trial. J Dig Dis.2013;14(12);654-661. doi:10.1111/1751-2980.12098.

Visceral sensitivity is found in 60% of irritable bowel syndrome (IBS) patients and is theorized to contribute to abdominal pain and intestinal motor abnormalities.1-3 Direct palpation, evaluation, diagnosis, and management of the viscera have been used to treat patients since the time of Andrew Taylor Still, MD, DO.4 In 2012, a study by Florance et al5 revealed a greater reduction in IBS severity score and improvement of quality of life with visceral manipulation compared with massage therapy. In 2013, a randomized crossover trial by Attali et al on the same topic used the additional objective measures of rectal sensitivity and colonic transport time.

Thirty-one voluntary refractory IBS patients participated in Attali et al's study (8 men, 23 women; mean [SD] age and body mass index of 50 [2] years and 25.1 [4.0], respectively). The patients were randomly assigned to group A or group B. Participants in group A received 3 sessions of massage therapy and then 3 sessions of visceral manipulation at 2-week intervals. Participants in group B received the same interventions in reverse order. All techniques were performed by a single osteopath who trained in France and who has a clinical practice in Paris (personal communication, March 2014). The osteopath applied “global” and “local vibratory” techniques to the tender visceral areas as determined by abdominal palpation. The massage therapy used similar hand placements but did not involve visceral manipulation, only abdominal wall massage.

After massage therapy, participants in group A reported decreased abdominal distention (P=.026) and abdominal pain (P=.001). After visceral manipulation, participants in this group reported further decreased diarrhea (P=.036), abdominal distention (P=.002), and abdominal pain (P=.003). Patients in group B reported improvement in the following symptoms after visceral manipulation: constipation (P=.022), diarrhea (P=.016), abdominal distention (P=.001), and abdominal pain (P=.005). For the same group, no significant differences in symptom severity were reported after massage therapy. Crossover analysis revealed a decrease in self-reported diarrhea (P=.016), abdominal distention (P=.043), and abdominal pain (P=.013) after visceral manipulation. At 1-year follow-up, participants reported persistent amelioration of diarrhea (P=.029), abdominal distention (P=.001), and abdominal pain (P<.001). Visceral manipulation improved rectal sensitivity (P<.05), whereas massage therapy alone did not have a significant effect. Neither treatment had a statistically significant impact on colonic transit time.

The study of Attali et al supports previous research that has shown visceral osteopathy to be beneficial in patients with IBS. As a well-designed feasibility study, it will enable power analysis to determine appropriate sample size for future clinical trials. Further investigations with objective measures are warranted.

References

1 Hundscheid HW Pepels MJ Engels LG Loffeld RJ . Treatment of irritable bowel syndrome with osteopathy: results of a randomized controlled pilot study. J Gastroenterol Hepatol.2007;22(9):1394-1398.10.1111/j.1440-1746.2006.04741.xSearch in Google Scholar PubMed

2 Grover M Kanazawa M Palsson OS et al. . Small intestinal bacterial overgrowth in irritable bowel syndrome: association with colon motility, bowel symptoms, and psychological distress[published online May 9, 2008]. Neurogastroenterol Motil.2008;20(9):998-1008. doi:10.1111/j.1365-2982.2008.01142.x.10.1111/j.1365-2982.2008.01142.xSearch in Google Scholar PubMed PubMed Central

3 Hebgen E . Viszeralosteopathie – Grundlagen und Techniken. 3rd ed.Stuttgart, Germany: Hippokrates Verlag; 2011.Search in Google Scholar

4 Lossing K . Visceral manipulation. In: ChilaA, executive ed. Foundations of Osteopathic Medicine. 3rd ed.Baltimore, MD: Lippincott, Williams & Wilkins; 2011:845.Search in Google Scholar

5 Florance BM Frin G Dainese R et al. . Osteopathy improves the severity of irritable bowel syndrome: a pilot randomized sham-controlled study. Eur J Gastroenterol Hepatol.2012;24(8):944-949. doi:10.1097/MEG.0b013e3283543eb7.10.1097/MEG.0b013e3283543eb7Search in Google Scholar PubMed

Published Online: 2014-05-01
Published in Print: 2014-05-01

© 2014 The American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Articles in the same Issue

  1. Editorial
  2. The Journal of the American Osteopathic Association: The Next Generation
  3. Wikipedia: Proceed With Caution
  4. Letters
  5. Osteopathic Graduate Medical Education: New Research Standards Needed
  6. An Unexpectedly Progressed Lumbar Herniated Disk
  7. Response
  8. AOA Communication
  9. Official Call
  10. Original Contribution
  11. Somatic Dysfunction and Use of Osteopathic Manual Treatment Techniques During Ambulatory Medical Care Visits: A CONCORD-PBRN Study
  12. Association of Low Back Pain, Somatic Dysfunction, and Lumbar Bone Mineral Density: Reproducibility of Findings
  13. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions
  14. Clinical Practice
  15. Effect of Osteopathic Manipulative Therapy in the Attentive Performance of Children With Attention-Deficit/Hyperactivity Disorder
  16. Management of Ionizing Radiation Injuries and Illnesses, Part 2: Nontherapeutic Radiologic/Nuclear Incidents
  17. Special Communication
  18. The ‘little m.d.’ or the ‘Big D.O.’: The Path to the California Merger
  19. The Somatic Connection
  20. Manual Therapy Shown to Be Effective for Tension-Type Headache
  21. OMT Improves Acute Hemodynamic Control in Pregnancy by Means of Improved Venous Return
  22. Several Manual Therapies Proven Beneficial for Patients With Chronic Neck Pain
  23. How Much of Your Low Back Pain Is Really in Your Head?
  24. Mechanical Changes of the Brain During Sleep Clear Metabolites and Provide Key Mechanism for Sutherland's Cranial Respiratory Impulse
  25. G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS?
  26. Clinical Images
  27. Sever Disease (Calcaneal Apophysitis)
  28. In Your Words
  29. To an Intern: What if You Were the Patient?
https://doi.org/10.7556/jaoa.2014.079
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. Editorial
  2. The Journal of the American Osteopathic Association: The Next Generation
  3. Wikipedia: Proceed With Caution
  4. Letters
  5. Osteopathic Graduate Medical Education: New Research Standards Needed
  6. An Unexpectedly Progressed Lumbar Herniated Disk
  7. Response
  8. AOA Communication
  9. Official Call
  10. Original Contribution
  11. Somatic Dysfunction and Use of Osteopathic Manual Treatment Techniques During Ambulatory Medical Care Visits: A CONCORD-PBRN Study
  12. Association of Low Back Pain, Somatic Dysfunction, and Lumbar Bone Mineral Density: Reproducibility of Findings
  13. Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions
  14. Clinical Practice
  15. Effect of Osteopathic Manipulative Therapy in the Attentive Performance of Children With Attention-Deficit/Hyperactivity Disorder
  16. Management of Ionizing Radiation Injuries and Illnesses, Part 2: Nontherapeutic Radiologic/Nuclear Incidents
  17. Special Communication
  18. The ‘little m.d.’ or the ‘Big D.O.’: The Path to the California Merger
  19. The Somatic Connection
  20. Manual Therapy Shown to Be Effective for Tension-Type Headache
  21. OMT Improves Acute Hemodynamic Control in Pregnancy by Means of Improved Venous Return
  22. Several Manual Therapies Proven Beneficial for Patients With Chronic Neck Pain
  23. How Much of Your Low Back Pain Is Really in Your Head?
  24. Mechanical Changes of the Brain During Sleep Clear Metabolites and Provide Key Mechanism for Sutherland's Cranial Respiratory Impulse
  25. G.I. Joe: Could Visceral Osteopathy Help Fight the War against IBS?
  26. Clinical Images
  27. Sever Disease (Calcaneal Apophysitis)
  28. In Your Words
  29. To an Intern: What if You Were the Patient?
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 12.9.2025 from https://www.degruyterbrill.com/document/doi/10.7556/jaoa.2014.079/html
Scroll to top button