The Effectiveness of Osteopathic Treatment in Bowel Constipation Patients: A Clinical Perspective
DOI:
https://doi.org/10.21527/2176-7114.2023.47.13557Keywords:
Osteopaty, constipation, LifestyleAbstract
Introduction: Functional chronic bowel constipation is a motility disorder of great relevance and prevalence worldwide. Objective: Analyze the efficiency of visceral manipulation technique in individuals with bowel constipation diagnose according to Roma III criteria. Methods: This is a crossover clinical study that included individuals of both genders aged between 20 and 40 years who had had bowel constipation symptoms for over one year. Individuals were randomized into two groups: the intervention (IG) and control (CG) groups. A four weeks washout period was given. Each volunteer underwent 24 individual osteopathic sessions, twice a week that lasted up to 30 minutes. Three intervention techniques were performed: two for the large intestine and one for the small intestine. Results: Thirty four patients were recruited but nine were excluded. Our sample consisted in 25 participants, 13 were allocated in the IG and 12 in the CG. No significant difference was found between groups for anthropometric, educational, marital status, proportion of smokers and alcoholics, and VAS for lumbar spine pain measures. Lumbar spine flexibility, was significant increased for the IG (p<0.0001). A higher proportion of patients in the IG presented reduced hard stools, effort to evacuate, incomplete evacuation feeling, anorectal obstruction sensation and manual maneuvers to facilitate evacuation after treatment (p<0.0001). A significant correlation was found between pain (VAS) and the Schober test (r=-0.41). Conclusion: This study was successful in showing that there seems to be a positive effect of the osteopathic treatment for chronic bowel constipation at short and long terms.
References
Gallas S, Knaz H, Methnani J, Maatallah Kanzali M, Koukane A, Bedoui MH, Latiri I. Prevalence and risk factors of functional gastrointestinal disorders in early period medical students: a pilot study in Tunisia. Libyan J Med.2022;17(1):208-229.
Pasin Neto H, Borges RA. Visceral Mobilization and Functional Constipation in Stroke Survivors: A Randomized, Controlled, Double-Blind, Clinical Trial. Cureus. 2020;12(5):e8058.
Alavinejad P, Mousavi Ghanavati P, Alboraie M, Emara M, Baghaee S, Baran B, Ebrahimi Daryani N, Farsi F, Hajiani E, Hashemi SJ, Lak E, Taheri Y, Dangi A. Irritable Bowel Syndrome Demographics: A Middle Eastern Multinational Cross-sectional Study. Middle East J Dig Dis. 2022;14(2):222-228.
Włodarczyk J, Waśniewska A, Fichna J, Dziki A, Dziki Ł, Włodarczyk M. Current Overview on Clinical Management of Chronic Constipation. J Clin Med. 2021;10(8):1.738.
Deng Q, Yu KL, Liu ZY, Shen Z, Wang YH, Song YM, Wang CJ, Xu XP, Wang JW. Outcomes of a modified Bresler procedure for the treatment of rectocele with rectal intussusception. Gastroenterol Rep (Oxf). 2020;8(6):457-464.
Boronat AC, Ferreira-Maia AP, Matijasevich A, Wang YP. Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review. World J Gastroenterol. 2017;23(21):3.915-3.927.
Liu L, Milkova N, Nirmalathasan S, Ali MK, Sharma K, Huizinga JD, Chen JH. Diagnosis of colonic dysmotility associated with autonomic dysfunction in patients with chronic refractory constipation. Sci Rep. 2022;12(1):12051.
Mercadante S, Adile C, Ferrera P, Cortegiani A, Casuccio A. Symptom Expression in Patients with Advanced Cancer Admitted to an Acute Supportive/Palliative Care Unit With and Without Delirium. Oncologist. 2019;24(6):e358-e364.
Silveira EA, Santos ASEAC, Ribeiro JN, Noll M, Dos Santos Rodrigues AP, de Oliveira C. Prevalence of constipation in adults with obesity class II and III and associated factors. BMC Gastroenterol. 2021;21(1):217.
Mearin F, Ciriza C, Minquez M, Rey E, Mascort JJ, Peña E, Cañones P, Júdez J. Clinical practice guidelines: irritable bowel syndrome with constipation and functional constipation in adults: concept, diagnosis, and healthcare continuity. Aten Primaria 2017;1:42-55.
Mari A, Mahamid M, Amara H, Baker FA, Yaccob A. Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management. Korean J Fam Med. 2020;41(3):139-145.
Vale, JR do et al. Effectiveness of the ostheopatic treatment in intestinal constipation: a systematic review. dig, 2017;68-74.
Martin-McGill KJ, Bresnahan R, Levy RG, Cooper PN. Ketogenic diets for drug-resistant epilepsy. Cochrane Database Syst Rev. 2020;24;6(6):CD001903.
Vork L, Weerts ZZRM, Mujagic Z, Kruimel JW, Hesselink MAM, Muris JWM, Keszthelyi D, Jonkers DMAE, Masclee AAM. Rome III vs Rome IV criteria for irritable bowel syndrome: A comparison of clinical characteristics in a large cohort study. Neurogastroenterol Motil. 2018;30(2). Doi: 10.1111/nmo.13189
Amjad F, Mohseni Bandpei MA, Gilani SA, Arooj A. Reliability of modified-modified Schober's test for the assessment of lumbar range of motion. J Pak Med Assoc. 2022; 72(9):1.755-1.759.
Villalta Santos L, Lisboa Córdoba L, Benite Palma Lopes J, Santos Oliveira C, André Collange Grecco L, Bovi Nunes Andrade AC, Pasin Neto H. Active Visceral Manipulation Associated With Conventional Physiotherapy in People With Chronic Low Back Pain and Visceral Dysfunction: A Preliminary, Randomized, Controlled, Double-Blind Clinical Trial. J Chiropr Med. 2019;18(2):79-89.
Lam C, Amarasinghe G, Zarate-Lopez N, Fikree A, Byrne P, Kiani-Alikhan S, Gabe S, Paine P. Gastrointestinal symptoms and nutritional issues in patients with hypermobility disorders: assessment, diagnosis and management. Frontline Gastroenterol. 2022;14(1):68-77.
CHRIS' DELANEY, Joseph A.; SUISSA, Samy. The case-crossover study design in pharmacoepidemiology. Statistical methods in medical research. 2009;18(1):53-65.
Coutinho, Cleiton Luiz De Almeida et al. Influence of chiropratic adjustment on the lumbar segment of healthy men individuals submitted to movement amplitude analysis by the Schober Test. 2021;2(1):22-31.
Martínez-Ochoa, M. J., Fernández-Domínguez, J. C., Morales-Asencio, J. M., Gonzalez-Iglesias, J., Ricard, F., Oliva-Pascual-Vaca, A. Effectiveness of an osteopathic abdominal manual intervention in pain thresholds, lumbopelvic mobility, and posture in women with chronic functional constipation. The Journal of Alternative and Complementary Medicine. 2018;24(8),816-824.
Martínez-Ochoa, María José et al. Effectiveness of an osteopathic abdominal manual intervention in pain thresholds, lumbopelvic mobility, and posture in women with chronic functional constipation. The Journal of Alternative and Complementary Medicine. 2018;24(8):816-824.
Muchtar NJ, Helianthi DR, Nareswari I. Effectiveness of Acupuncture for Management in a Hospitalized Geriatric Patient with Constipation. Med Acupunct. 2020;32(2):116-120.
Han D, Iragorri N, Clement F, Lorenzetti D, Spackman E. Cost Effectiveness of Treatments for Chronic Constipation: A Systematic Review. Pharmacoeconomics. 2018;36(4):435-449.
Khan O, Shankar PR, Parikh AD, Cohan RH, Keshavarzi N, Khalatbari S, Saad RJ, Davenport MS. Radiographic stool quantification: an equivalence study of 484 symptomatic and asymptomatic subjects. Abdom Radiol (NY). 2019;44(3):821-827.
Sailer M. Slow transit constipation. Chirurg. 2022;93(1):103-112.
Rijnaarts I, de Roos NM, Wang T, Zoetendal EG, Top J, Timmer M, Hogenelst K, Bouwman EP, Witteman B, de Wit N. A high-fibre personalised dietary advice given via a web tool reduces constipation complaints in adults. J Nutr Sci. 2022;28(11):e31.
Gleberzon BJ. A narrative review of the published chiropractic literature regarding older patients from 2001-2010. J Can Chiropr Association. 2011;2:76-95.
Arcanjo GN, Pires JLVR, Jacinto MEM, Colares JM, Belo LMC, Lima POP, Vilaça-Alves J. Comparison of the Effect of Osteopathic Manipulations and Exercises on the Myoelectric Activity of the Pelvic Floor: A Randomized Controlled Trial. J Chiropr Med. 2022;21(2):97-107.
Ascanelli S, Portinari M, Canella M, Solari S, Dall'Omo F, Danese S, De Troia A, Carcoforo P. Obstructed defecation syndrome associated with paradoxical puborectalis contraction: osteopathic treatment versus anal biofeedback. Results of a pilot study. Tech Coloproctol. 2021;25(5):589-595.
Carleo B, Anderson K, Prevost CP, Pohlman KA. Patient-centered outcomes used in pediatric focused manual therapies research studies: a secondary data analysis of a systematic review. J Patient Rep Outcomes. 2021;5(1):31.
Tamburella F, Princi AA, Piermaria J, Lorusso M, Scivoletto G, Masciullo M, Cardilli G, Argentieri P, Tramontano M. Neurogenic Bowel Dysfunction Changes after Osteopathic Care in Individuals with Spinal Cord Injuries: A Preliminary Randomized Controlled Trial. Healthcare (Basel). 2022;10(2):210.
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