Treatment of Refractory Irritable Bowel Syndrome with Visceral Osteopathy: Short-Term and Long-Term Results of a Randomized Trial.
According to the low efficiency of available drugs in irritable bowel syndrome, a growing interest in alternative therapies is observed. The aim of this study was to apply a robust methodology to evaluate the effectiveness of visceral osteopathy for irritable bowel syndrome. 31 consecutive refractory irritable bowel syndrome patients were prospectively included in a randomized, cross-over placebo-controlled study. Before and after each phase of the study, we report a qualitative evaluation of depression and a quantitative evaluation of four symptoms: constipation, diarrhea, abdominal distension, and abdominal pain, using Visual Analog Scales, measures of rectal sensibility and colonic transit time. One year later, assessment of symptoms was performed in all patients again. Visceral osteopathy was associated with significant improvements of self reported diarrhea, abdominal distension and abdominal pain without change of constipation. Visceral osteopathy was also associated with decreased rectal sensitivity: increase in threshold, constant sensation, and maximum tolerable volume (P<0.001). To the contrary, when patients were undergoing placebo manipulations, no significant evolution of rectal sensitivity was observed. Modifications of depression and total or segmental colonic transit times were not observed. One year after the end of this trial, diarrhea, abdominal distension and abdominal pain were significantly lower as compared to inclusion (P<0.05). This study suggests that visceral osteopathy improves short-term and long-term abdominal distension and pain and decreases rectal sensitivity in irritable bowel syndrome patients.
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