# A Narrative Review on the Viability of Osteopathic Manipulative Medicine in Treating Irritable Bowel Syndrome With Constipation (IBS-C)

## TL;DR

This paper reviews how osteopathic manipulative medicine could be a new non-drug treatment for IBS with constipation by targeting inflammation and nervous system issues.

## Contribution

The paper explores the novel use of osteopathic manipulative techniques to address the underlying inflammation and autonomic dysfunction in IBS-C.

## Key findings

- Osteopathic manipulative medicine (OMM) may modulate the autonomic nervous system and reduce inflammation in IBS-C.
- Techniques like lymphatic manipulation and myofascial release are proposed as potential non-pharmacological treatments for IBS-C.
- Current therapies for IBS-C do not address autonomic dysfunction or inflammation, which OMM may target.

## Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic abdominal pain and alterations in bowel habits, with global prevalence. The etiology of the disease is likely multifactorial; however, autonomic nervous system (ANS) dysfunction and immune-mediated inflammation may contribute the most to the hallmark symptoms of abdominal pain and altered motility of the gut. Current pharmacological therapies operate to modulate intestinal transit, alter the composition of the gut flora and control pain. Non-pharmacological approaches include dietary changes, increased physical activity, or fecal microbiota transplants. None of these therapies can modulate ANS dysfunction or impact the underlying inflammation that is likely perpetuating the symptoms of IBS.

Osteopathic Manipulative Medicine (OMM) is a clinical approach focused on physical manipulation of the body’s soft tissues to correct somatic dysfunctions. OMM can directly target the pathophysiology of IBS through many approaches such as ANS modulation and lymphatic techniques to modify the inflammatory mechanisms within the body. Particular OMM techniques of use are lymphatic manipulation, myofascial release, sympathetic ganglia treatment, sacral rocking, counterstrain, and viscerosomatic treatment. The aim of this study is to identify OMM treatments that can be used to potentially reduce the inflammation and ANS dysfunction associated with IBS symptoms, thereby providing a new non-pharmacological targeted approach for treating the disease.