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.
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.
Jones R, Lydeard S. Irritable bowel syndrome in the general population. Bmj. 1992;304:87–90.
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.
Lee OY, Mayer EA, Schmulson M, Chang L, Naliboff B. Gender-related differences in IBS symptoms. Am J Gastroenterol. 2001;96:2184–2193.
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.
Spiller RC. Irritable bowel syndrome. Br Med Bull. 2004;72:15–29.
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.
Chang FY. Irritable bowel syndrome: The evolution of multi-dimensional looking and multidisciplinary treatments. World J Gastroenterol. 2014;20:2499–2514.
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.
Hayee B, Forgacs I. Psychological approach to managing irritable bowel syndrome. Bmj. 2007;334:1105–1109.
Cahn AM, Carayon P, Hill C, Flamant R. Acupuncture in gastroscopy. Lancet. 1978;1:182–183.
Hagege H. Alternative treatments in irritable bowel syndrome. Gastroenterol Clin Biol. 2009;33(Suppl 1):79–83.
Shen YH, Nahas R. Complementary and alternative medicine for treatment of irritable bowel syndrome. Can Fam Physician. 2009;55:143–148.
Spanier JA, Howden CW, Jones MP. A systematic review of alternative therapies in the irritable bowel syndrome. Arch Intern Med. 2003;163:265–274.
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.
Tanaka Y, Kanazawa M, Fukudo S, Drossman DA. Biopsychosocial model of irritable bowel syndrome. J Neurogastroenterol Motil. 2011;17:131–139.
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.
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.
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.
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.
Grosjean D, Benini P. La micropalpation, base de la microkinésithérapie. 1990.
Grosjean D. La microkinésithérapie, une thérapie complémentaire?. Profession Kinésithérapeute. 2006;11:14–16.
Grosjean D, Benini P. Approche du syndrome algoneurodystrophique du membre supérieur par la microkinésithérapie. Ann Kinésithér. 1990;17:301–304.
Grosjean D, Poquin D. Assessment of a microkinesitherapie treatment on 300 low back pain sufferers. Medycyna Manualna. 2006;10:35–46.
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 .
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.
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.
Gaynes BN, Drossman DA. The role of psychosocial factors in irritable bowel syndrome. Baillieres Best Pract Res Clin Gastroenterol. 1999;13:437–452.
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.
Koloski NA, Jones M, Talley NJ. Investigating the directionality of the brain-gut mechanism in functional gastrointestinal disorders. Gut. 2012;61:1776–1777.
Mach T. The brain-gut axis in irritable bowel syndrome–clinical aspects. Med Sci Monit. 2004;10:125–31.
Bonaz B. Inflammatory bowel diseases: A dysfunction of brain-gut interactions?. Minerva Gastroenterol Dietol. 2013;59:241–259.
Enck P, Martens U, Klosterhalfen S. The psyche and the gut. World J Gastroenterol. 2007;13:3405–3408.
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.
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.
Herman PM, Craig BM, Caspi O. Is complementary and alternative medicine (CAM) cost-effective? A systematic review. BMC Complement Altern Med. 2005;5:11.
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.
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.
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.
The Journal of Complementary and Integrative Medicine focuses on evidence concerning the efficacy and safety of complementary and alternative medical (CAM) whole systems, practices, interventions and natural health products, including herbal medicines.
01 Jan 2004
Robert Ko, Kelvin Sze-Yin Leung, Paul Saunders and Zacharias Suntres, PH. D.