The objective of the Dr Bramati PhD, BSc (Hons) Ost Med, DO, ND Osteopath & Naturopath thesis entitled ‘Effectiveness of Visceral Osteopathic Treatment on Gastrointestinal Indicators and Behaviour Patterns in Autistic Children; Using Questionnaire and Biochemical Markers to Measure Outcomes’ and published research (Bramati-Castellarin et al., 2016) was to investigate the effect of visceral osteopathy on GUT gastrointestinal symptoms as well as behaviour patterns in autistic children. According to the study, there were some positive symptomatic changes.
The study aimed investigate the use of abdominal manual intervention on autistic children suffering from gastrointestinal signs and symptoms. The possible connection between changing behaviour signs and symptoms and the gastrointestinal condition in these children, as well as the lack of an appropriate low-invasive gastrointestinal treatment led the researcher to study the possible effects of application of VOT in these autistic children (Bramati-Castellarin et.al 2016).
The novel approach of this project has indicated that this low-invasive form of manual intervention could have a significant and important impact on the quality of life and wellbeing of autistic children who suffer from gastrointestinal complaints. The study does not claim to cure autism nor its comorbidities.
Viscera and its role in health
Gut Brain – Axis and quality of life
It is well researched that stresses may potentially threaten gastrointestinal homeostasis by affecting the gut-brain axis, consequently becoming a precursor of functional gastrointestinal diseases. A study by Konturek et al (2011) suggested that several areas of gut physiology could be affected by stress, including gut mobility, gastrointestinal secretion, gut permeability, blood flow in the gut mucosa, and visceral sensitivity. These factors were also implicated in a study on the effects of stress on functional dyspepsia, where the authors suggested that psychological distress is directly linked to GI (gastrointestinal) symptoms (Aro et al., 2009). According to Blomhoff et al. (2001), the co-morbidity of the GI system and anxiety has a direct effect on severity and duration of GI symptoms, possibly explaining the mind and body relationship. Blomhoff et al. (2001), showed that increased activity in the gut-brain axis affects the enteric nervous system ( nervous system internal to the gut) and the central nervous system (CNS) nerve receptors and it seems that phobic anxiety hyper-activates the visceral frontal region of the cortex influencing GI symptomatology (Blomhoff et al., 2001). The gut-brain axis has also been proposed in a study where depression-like symptoms were induced in mice. According to Park et al. (2013), symptoms of depression alter both colonic motor activity and the microbial profile, most likely via the hypothalamic-pituitary axis.
The viscera are a collection of organs in the abdominal cavity that generally respond to the internal physiological motion guided by the involuntary movement of the diaphragm in respiration; the internal motility of the viscera such as peristaltic movement; cardiac movement and blood and lymph circulation; and via skeletal movement such as walking, running, or exercising (Barral and Mercier, 2006, Barral and Mercier, 2007, Stone, 1999). This motion and motility and the influence on the viscera is constantly present throughout life. Studies focusing on mobilisation of this area are suggesting improvement of the GI symptoms. Hoge et al. (2012) demonstrated that manual lymphatic pumping techniques (LPTs) significantly increased thoracic and intestinal duct lymph flow enhancing the immune system.
A systematic review analysing 10 randomized controlled trials regarding the effect of abdominal massage (AM) on gastrointestinal functions (GFs) where 464 patients met the inclusion criteria concluded that there was promising evidence for positive effectiveness of abdominal massage on the gastrointestinal function (Dehghan M, Malakoutikhah A, Ghaedi Heidari F, Zakeri MA. The Effect of Abdominal Massage on Gastrointestinal Functions: a Systematic Review. Complement Ther Med. 2020 Nov;54:102553.).
The health and function of our gastrointestinal system is paramount to maintain and/or improve our quality of life.
BRAMATI-CASTELLARIN, I., PATEL, V. B. & DRYSDALE, I. P. Repeat-measures longitudinal study evaluating behavioural and gastrointestinal symptoms in children with autism before, during and after visceral osteopathic technique (VOT). Journal of Bodywork and Movement Therapies – In Press 2016
Evaluation of behavioural and gastrointestinal symptoms in autistic children after visceral osteopathic treatment – International Journal of Osteopathic Medicine Volume 16, Issue 1, March 2013, Pages e13-e14 Special Issue: Osteopathic Principles
ATTALI, T. V., BOUCHOUCHA, M. & BENAMOUZIG, R. 2013. Treatment of refractory irritable bowel syndrome with visceral osteopathy: short-term and long-term results of a randomized trial. J Dig Dis, 14, 654-61.
BARRAL, J. P. & MERCIER, P. 2007. Visceral manipulation II, Seattle, Eastland Press.
BRAMATI-CASTELLARIN, I., PATEL, V. B. & DRYSDALE, I. P. 2016. Repeat-measures longitudinal study evaluating behavioural and gastrointestinal symptoms in children with autism before, during and after visceral osteopathic treatment (VOT). Journal of Bodywork and Movement Therapies.
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