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Understanding the role of osteopathic manipulative medicine in the management of gastrointestinal disorders and symptoms: a survey study

Journal: The American Journal of Gastroenterology Date: 2019/10, 114Pages: S1558‐. doi: Subito , type of study: cross sectional study

Free full text   (https://journals-lww-com.rsm.idm.oclc.org/ajg/Fulltext/2019/10001/Understanding_the_Role_of_Osteopathic_Manipulative.2829.aspx)

Keywords:

gastrointestinal disease [7]
osteopathic manipulative treatment [2973]
OMT [2951]
colon [13]
conference abstract [108]
constipation [34]
gastrointestinal symptom [2]

Abstract:

INTRODUCTION: Patients with gastrointestinal (GI) disorders can present with a myriad of symptoms. Osteopathic Manipulative Medicine (OMM) is a well‐established anatomy‐based modality where adjustments to the neuromusculoskeletal system may restore motility of the viscera via regulation of the autonomic nervous system. OMM is performed by specially trained physicians using palpatory skills to diagnose and treat illnesses. Pharmacologic therapies often lack efficacy for some GI symptoms, so OMM could be a safe and effective alternative treatment. Our aim was to study the clinical use of OMM in the management GI symptoms, and begin to understand which conditions it might be best suited for. METHODS: We conducted a web‐based survey study targeting academic osteopathic physicians practicing OMM throughout the US. In this 16‐item questionnaire, physicians were asked about their use, outcomes, and preferences pertaining to OMM for treating GI symptoms. Data on the types of GI disorders encountered, duration and modality of techniques used, and the respondent's departmental specialty were gathered. Online surveys were followed by a detailed telephone interview. RESULTS: A total of 220 emails were sent and 64 surveys were completed (29%). Ninety‐one% of respondents utilized OMM for GI symptoms. Constipation was the most commonly encountered GI symptom with the best response to OMM (87%) followed by bloating (56%) and heartburn (55%). Visceral manipulation techniques such as mesenteric release and colonic stimulation were the most commonly used OMM modalities (98% of respondents). Only 13% of the respondents reported adverse events with transient pain and fatigue being the most common complaints post‐OMM. Telephone interviews revealed that nearly 50% of patients achieved a sustained response after 3‐4 months of OMM. Respondents did not report a difference to OMM response in patients on chronic narcotics compared to those not on opioids. CONCLUSION: The results of this study suggest that a multifaceted therapeutic approach utilizing OMM may have a role in the management of GI disorders. OMM is a safe and cost‐effective approach that can be performed in an inpatient or outpatient setting. OMM could also have applications in treating patients with functional GI disorders such as IBS and other motility‐related disorders of the brain‐gut pathway. Randomized controlled trials and prospective studies need to be conducted to build an evidence‐based rationale for OMM in patients with GI disorders. (Figure Presented).


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