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

Functional constipation is a common gastrointestinal disorder, particularly among obese individuals, due to factors such as reduced physical activity, altered gut motility, and increased intra-abdominal pressure. Visceral manipulation (VM), a manual therapy targeting internal organs, has emerged as a potential non-pharmacological intervention. This randomized controlled trial aimed to evaluate the efficacy of osteopathic VM in improving symptoms of functional constipation in obese adults.

A total of 102 obese adults (Body Mass Index ≥ 30 kg/m²), diagnosed with functional constipation based on the Rome IV criteria, were randomly assigned to either an intervention group receiving VM alongside standard care (n = 51) or a control group receiving standard care alone (n = 51). The intervention group underwent 20 VM sessions over four weeks. Primary outcomes included stool consistency (assessed by the Bristol Stool Scale) and defecation pain (measured by the Visual Analogue Scale). Secondary outcomes included defecation frequency and oral laxative usage. Data were analyzed using mixed-design Multivariate Analysis of Variance (MANOVA).

Compared with the control group, the VM group showed significant improvements in stool consistency (p = 0.001), increased defecation frequency (p = 0.001), reduced defecation pain (p = 0.001), and lower oral laxative intake (p < 0.01). No adverse events were reported, and the treatment was well-tolerated.

Visceral Manipulation appears to be an effective adjunctive therapy for managing functional constipation in obese adults. It offers a safe, noninvasive approach that improves gastrointestinal function and may reduce the need for pharmacological treatment. Further long-term studies are warranted to confirm these findings and assess sustained outcomes.