Osteopathic Visceral Manipulation on Functional Constipation in Obese Adults: A Randomized Controlled Clinical Trial

Area of Science:

• Gastroenterology
• Manual Therapy
• Obesity Medicine

Background:

• Functional constipation is prevalent in obese individuals, linked to lifestyle and physiological factors.
• Visceral manipulation (VM) is a manual therapy targeting internal organs, showing potential for non-pharmacological treatment.
• Obesity can exacerbate functional constipation symptoms through reduced activity, altered motility, and increased abdominal pressure.

Purpose of the Study:

• To evaluate the efficacy of osteopathic visceral manipulation (VM) as an adjunctive therapy for functional constipation in obese adults.
• To assess the impact of VM on key symptoms including stool consistency, defecation pain, frequency, and laxative use.
• To determine if VM offers a safe and effective alternative or supplement to standard care for this patient population.

Main Methods:

• A randomized controlled trial involving 102 obese adults diagnosed with functional constipation (Rome IV criteria).
• Participants were randomized to receive either VM plus standard care (intervention group, n=51) or standard care alone (control group, n=51).
• The intervention group received 20 VM sessions over four weeks, with outcomes assessed using the Bristol Stool Scale, Visual Analogue Scale for pain, defecation frequency, and laxative intake.

Main Results:

• The VM group demonstrated statistically significant improvements in stool consistency (p=0.001) compared to the control group.
• Significant reductions in defecation pain (p=0.001) and oral laxative usage (p<0.01) were observed in the VM group.
• The VM intervention led to a significant increase in defecation frequency (p=0.001) with no reported adverse events.

Conclusions:

• Visceral manipulation is an effective adjunctive therapy for managing functional constipation in obese adults.
• VM provides a safe, non-invasive method to improve gastrointestinal function and potentially reduce reliance on pharmacological treatments.
• Further research is recommended to validate long-term outcomes and sustained efficacy of VM for functional constipation.