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Journal of Complementary and Integrative Medicine

Editor-in-Chief: Lui, Edmund

Ed. by Ko, Robert / Leung, Kelvin Sze-Yin / Saunders, Paul / Suntres, PH. D., Zacharias

CiteScore 2017: 1.41

SCImago Journal Rank (SJR) 2017: 0.472
Source Normalized Impact per Paper (SNIP) 2017: 0.564

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Managing irritable bowel syndrome: The impact of micro-physiotherapy

Daniel Grosjean / Patrice Benini
  • Corresponding author
  • Association Centre de Diffusion de la Microkinésitherapie ACDM, 78 Rue de Pont à Mousson 57950 Montigny les Metz, France
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Pierre Carayon
  • Services de Gastroentérologie, d’Oncologie et d’Endocrinologie Moléculaires, de Chirurgie Viscérale et Vasculaire, CHU Besançon, Besançon, France
  • Other articles by this author:
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Published Online: 2017-03-17 | DOI: https://doi.org/10.1515/jcim-2015-0044



Irritable bowel syndrome (IBS) has a complex pathology, high prevalence and large impact on patients’ quality of life. As conventional therapy may yield unsatisfactory results, a more holistic approach may be desirable. The current study assessed the effect of micro-physiotherapy on the severity of IBS symptoms.


In a double-blind study, 61 recurrent IBS patients were randomised to two sessions of micro-physiotherapy or sham micro-physiotherapy. Inclusion criteria were the presence of ≥1 IBS symptom from abdominal pain, constipation, diarrhoea or bloating. Exclusion criteria were previous major intestinal surgery and the presence of chronic diseases. The mean patient age was 53.5±15.3 years. Micro-physiotherapy consisted of micro-palpatory examination to identify osteopathic lesions, followed by micro-massage to stimulate self-healing. The control group underwent a sham procedure. The presence and severity of symptoms was assessed at baseline and at 1-month follow-up by the same gastroenterologist.


Two patients did not complete the study. There was a significant difference in percentage of patients that improved after the first session, at 74 % for the micro-physiotherapy group and 38 % for the sham group, respectively (p=0.005). After the second session, the initial improvement was maintained in both groups, although with no further gains, and the differences between the study groups remained significant (p=0.007).


Micro-physiotherapy significantly improves IBS symptoms and should be explored further for use in mainstream healthcare.

Keywords: integrative medicine; irritable bowel syndrome; randomised controlled trial


  • 1.

    Brun-Strang C, Dapoigny M, Lafuma A, Wainsten JP, Fagnani F. Irritable bowel syndrome in France: Quality of life, medical management, and costs: The Encoli study. Eur J Gastroenterol Hepatol. 2007;19:1097–1103.CrossrefWeb of ScienceGoogle Scholar

  • 2.

    Jones R, Lydeard S. Irritable bowel syndrome in the general population. Bmj. 1992;304:87–90.CrossrefGoogle Scholar

  • 3.

    Saito YA, Schoenfeld P, Locke GR. The epidemiology of irritable bowel syndrome in North America: A systematic review. Am J Gastroenterol. 2002;97:1910–1915.Google Scholar

  • 4.

    Lee OY, Mayer EA, Schmulson M, Chang L, Naliboff B. Gender-related differences in IBS symptoms. Am J Gastroenterol. 2001;96:2184–2193.CrossrefGoogle Scholar

  • 5.

    Wilson S, Roberts L, Roalfe A, Bridge P, Singh S. Prevalence of irritable bowel syndrome: A community survey. Br J Gen Pract. 2004;54:495–502.Google Scholar

  • 6.

    Spiller RC. Irritable bowel syndrome. Br Med Bull. 2004;72:15–29.Web of ScienceCrossrefGoogle Scholar

  • 7.

    Amouretti M, Le Pen C, Gaudin AF, Bommelaer G, Frexinos J, Ruszniewski P,et al. Impact of irritable bowel syndrome (IBS) on health-related quality of life (HRQOL). Gastroenterol Clin Biol. 2006;30:241–246.CrossrefGoogle Scholar

  • 8.

    Camilleri M, Choi MG. Review article: Irritable bowel syndrome. Aliment Pharmacol Ther. 1997;11:3–15.CrossrefGoogle Scholar

  • 9.

    Collins SM. Peripheral mechanisms of symptom generation in irritable bowel syndrome. Can J Gastroenterol. 2001;15 Suppl B 14B–16B.CrossrefGoogle Scholar

  • 10.

    Collins SM, Piche T, Rampal P. The putative role of inflammation in the irritable bowel syndrome. Gut. 2001;49:743–745.CrossrefGoogle Scholar

  • 11.

    Buckley MM, O’Mahony SM, O’Malley D. Convergence of neuro-endocrine-immune pathways in the pathophysiology of irritable bowel syndrome. World J Gastroenterol. 2014;20:8846–8858.Web of ScienceGoogle Scholar

  • 12.

    Mulak A, Bonaz B. Irritable bowel syndrome: A model of the brain-gut interactions. Med Sci Monit. 2004;10:55–62.Google Scholar

  • 13.

    Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. 2006;130:1480–1491.CrossrefGoogle Scholar

  • 14.

    Chang FY. Irritable bowel syndrome: The evolution of multi-dimensional looking and multidisciplinary treatments. World J Gastroenterol. 2014;20:2499–2514.Web of ScienceCrossrefGoogle Scholar

  • 15.

    Wu JC. Complementary and alternative medicine modalities for the treatment of irritable bowel syndrome: Facts or myths?. Gastroenterol Hepatol (N Y). 2010;6:705–711.Google Scholar

  • 16.

    Hayee B, Forgacs I. Psychological approach to managing irritable bowel syndrome. Bmj. 2007;334:1105–1109.CrossrefWeb of ScienceGoogle Scholar

  • 17.

    Cahn AM, Carayon P, Hill C, Flamant R. Acupuncture in gastroscopy. Lancet. 1978;1:182–183.CrossrefGoogle Scholar

  • 18.

    Hagege H. Alternative treatments in irritable bowel syndrome. Gastroenterol Clin Biol. 2009;33(Suppl 1):79–83.CrossrefWeb of ScienceGoogle Scholar

  • 19.

    Shen YH, Nahas R. Complementary and alternative medicine for treatment of irritable bowel syndrome. Can Fam Physician. 2009;55:143–148.Google Scholar

  • 20.

    Spanier JA, Howden CW, Jones MP. A systematic review of alternative therapies in the irritable bowel syndrome. Arch Intern Med. 2003;163:265–274.CrossrefGoogle Scholar

  • 21.

    Van Tilburg MA, Palsson OS, Levy RL, Feld AD, Turner MJ, Drossman DA,et al. Complementary and alternative medicine use and cost in functional bowel disorders: A six month prospective study in a large HMO. BMC Complement Altern Med. 2008;8:46.CrossrefWeb of ScienceGoogle Scholar

  • 22.

    Tanaka Y, Kanazawa M, Fukudo S, Drossman DA. Biopsychosocial model of irritable bowel syndrome. J Neurogastroenterol Motil. 2011;17:131–139.Google Scholar

  • 23.

    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;22:1394–1398.Web of ScienceCrossrefGoogle Scholar

  • 24.

    Piche T, Pishvaie D, Tirouvaziam D, Filippi J, Dainese R, Tonohouhan M,et al. Osteopathy decreases the severity of IBS-like symptoms associated with Crohn’s disease in patients in remission. Eur J Gastroenterol Hepatol. 2014;26:1392–1398.Web of ScienceCrossrefGoogle Scholar

  • 25.

    Florance BM, Frin G, Dainese R, Nebot-Vivinus MH, Marine Barjoan E, Marjoux S,et al. Osteopathy improves the severity of irritable bowel syndrome: A pilot randomized sham-controlled study. Eur J Gastroenterol Hepatol. 2012;24:944–949.CrossrefWeb of ScienceGoogle Scholar

  • 26.

    Muller A, Franke H, Resch KL, Fryer G. Effectiveness of osteopathic manipulative therapy for managing symptoms of irritable bowel syndrome: A systematic review. J Am Osteopath Assoc. 2014;114:470–479.CrossrefGoogle Scholar

  • 27.

    Grosjean D, Benini P. La micropalpation, base de la microkinésithérapie. 1990.

  • 28.

    Grosjean D. La microkinésithérapie, une thérapie complémentaire?. Profession Kinésithérapeute. 2006;11:14–16.Google Scholar

  • 29.

    Grosjean D, Benini P. Approche du syndrome algoneurodystrophique du membre supérieur par la microkinésithérapie. Ann Kinésithér. 1990;17:301–304.Google Scholar

  • 30.

    Grosjean D, Poquin D. Assessment of a microkinesitherapie treatment on 300 low back pain sufferers. Medycyna Manualna. 2006;10:35–46.Google Scholar

  • 31.

    Pinto Pereira A, Dos Santos Carvalho EM, Ii K, Furman M, Wosh PJA, Gulogurski RL,et al. Assessment of heart rate variability in fibromyalgia after micro-physiotherapy. MTP Rehabil J. 2014;12:191–195 .Google Scholar

  • 32.

    Henley CE, Ivins D, Mills M, Wen FK, Benjamin BA. Osteopathic manipulative treatment and its relationship to autonomic nervous system activity as demonstrated by heart rate variability: A repeated measures study. Osteopath Med Prim Care. 2008;2:7.Google Scholar

  • 33.

    Manabe N, Tanaka T, Hata J, Kusunoki H, Haruma K. Pathophysiology underlying irritable bowel syndrome–from the viewpoint of dysfunction of autonomic nervous system activity. J Smooth Muscle Res. 2009;45:15–23.Google Scholar

  • 34.

    Gaynes BN, Drossman DA. The role of psychosocial factors in irritable bowel syndrome. Baillieres Best Pract Res Clin Gastroenterol. 1999;13:437–452.CrossrefGoogle Scholar

  • 35.

    Bonaz BL, Bernstein CN. Brain-gut interactions in inflammatory bowel disease. Gastroenterology. 2013;144:36–49.Web of ScienceCrossrefGoogle Scholar

  • 36.

    Koloski NA, Jones M, Kalantar J, Weltman M, Zaguirre J, Talley NJ. The brain–gut pathway in functional gastrointestinal disorders is bidirectional: A 12-year prospective population-based study. Gut. 2012;61:1284–1290.Web of ScienceCrossrefGoogle Scholar

  • 37.

    Koloski NA, Jones M, Talley NJ. Investigating the directionality of the brain-gut mechanism in functional gastrointestinal disorders. Gut. 2012;61:1776–1777.Google Scholar

  • 38.

    Mach T. The brain-gut axis in irritable bowel syndrome–clinical aspects. Med Sci Monit. 2004;10:125–31.Google Scholar

  • 39.

    Bonaz B. Inflammatory bowel diseases: A dysfunction of brain-gut interactions?. Minerva Gastroenterol Dietol. 2013;59:241–259.Google Scholar

  • 40.

    Enck P, Martens U, Klosterhalfen S. The psyche and the gut. World J Gastroenterol. 2007;13:3405–3408.Web of ScienceCrossrefGoogle Scholar

  • 41.

    Tack J, Fried M, Houghton LA, Spicak J, Fisher G. Systematic review: The efficacy of treatments for irritable bowel syndrome–a European perspective. Aliment Pharmacol Ther. 2006;24:183–205.CrossrefGoogle Scholar

  • 42.

    Wu JC, Ziea ET, Lao L, Lam EF, Chan CS, Liang AY, et al. Effect of electroacupuncture on visceral hyperalgesia, serotonin and fos expression in an animal model of irritable bowel syndrome. J Neurogastroenterol Motil. 2010;16:306–314.Google Scholar

  • 43.

    Herman PM, Craig BM, Caspi O. Is complementary and alternative medicine (CAM) cost-effective? A systematic review. BMC Complement Altern Med. 2005;5:11.CrossrefGoogle Scholar

  • 44.

    Kaptchuk TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE,et al. Components of placebo effect: Randomised controlled trial in patients with irritable bowel syndrome. Bmj. 2008;336:999–1003.CrossrefGoogle Scholar

  • 45.

    Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, Singer JP,et al. Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. Plos ONE. 2010;5:15591.Google Scholar

  • 46.

    Spiller RC. Problems and challenges in the design of irritable bowel syndrome clinical trials: Experience from published trials. Am J Med. 1999;107 91S–97S.CrossrefGoogle Scholar

About the article

Received: 2015-06-22

Accepted: 2017-02-24

Published Online: 2017-03-17

Published in Print: 2017-03-16

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Complementary and Integrative Medicine, Volume 14, Issue 2, 20150044, ISSN (Online) 1553-3840, DOI: https://doi.org/10.1515/jcim-2015-0044.

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