Osteopathic Manipulative Treatment for the Management of Irritable Bowel Syndrome: A Case Report

Irritable bowel syndrome (IBS) is one of the most common disorders of the gastrointestinal system, occurring in 10-20% of the general population.1,2,3 IBS is associated with heavy social and economic costs in the United States, as it results in the second highest cause of work absenteeism and accounts for 25-50% percent of all gastroenterology referrals.1,4 IBS is characterized by recurrent abdominal pain or discomfort and bowel dysfunction as diarrhea, constipation or both, in the absence of any organic cause.3,5,6,7 The pathophysiology of IBS appears multifactorial, although current focus for an understanding of the disease process is on alteration of gastrointestinal motility, visceral hypersensitivity and dysregulation of the brain-gut axis between the autonomic nervous system (ANS) and the enteric nervous system (ENS).6,8 The lack of full understanding of the pathophysiologic processes of IBS means current management options are often ineffective and unreliable, leaving patients with frustrating and sometimes disabling symptoms.2,7 An osteopathic approach using osteopathic manipulative treatment (OMT) to address symptoms related to IBS is an under-explored treatment option. The use of OMT within a treatment plan offers the ability to address manifestations of visceral and somatic dysfunctions unique to each patient. This case report outlines a successful osteopathic manipulative treatment course for a patient suffering from IBS symptoms. Randomized controlled trials (RCTs) for the use of OMT on patients with IBS in the current literature are also reviewed below and provide further preliminary evidence that OMT may be effective in managing IBS symptoms.2,5,7,9,11