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Abstract:
Objective:
To investigate the question: is it justified to use osteopathy in the treatment of gastroesophageal reflux (GERD)?
Design:
A clinical, non-randomized study consisting of a "waiting phase" of four weeks without treatment, followed by a treatment phase of eight osteopathic treatments ("Waiting-List-Design").
Setting:
The study was performed by three trained osteopaths in their private practices. The patients were either recruited with the help of internal specialists or came from the osteopaths' own patient lists.
Patients:
In this study, 25 patients aged between 30 and 73 (median 51), who had a history of gastroesophageal reflux diagnosed by an allopathic physician, took part. The patients were required to have been suffering from reflux for at least 6 months with a minimum of one attack per week, and were being treated with drugs to alleviate the symptoms. An endoscopic examination within the last 12 months to eliminate any serious pathological condition was also a prerequisite to being included in the study.
Intervention:
After the waiting phase of four weeks, the patients received eight osteopathic treatments at weekly intervals. During these treatments osteopathic dysfunctions in the cranio-sacral, visceral and parietal systems were detected according to the "Black-Box-Principle". The individually discovered osteopathic dysfunctions were treated according to the principles of osteopathy.
Main outcome parameters:
Improvement of the gastrointestinal symptoms, as evaluated by the questionnaire GSRS (gastrointestinal symptom rating scale), as well as an improvement in the quality of life, as evaluated by the questionnaire SF-36. Further parameters included the frequency and intensity of the gastro-oesophageal reflux, changes in the use of medication and the influence of food and stress. These were measured using questionnaires developed by the authors.
Results:
During the treatment phase, the gastrointestinal symptoms decreased by 35 % (p<0.001, 95% CI = 2.3 to 6.5), as opposed to the waiting time, in which no significant improvement of the symptoms was detected. Regarding the quality of life, the bodily feeling improved by 11 % (p<0.001), the psychological feeling by 9 % (p=0.044). A direct comparison between the waiting phase and treatment phase using the physical scale of SF-36 resulted in a statistically significant improvement with the osteopathic treatment (p=0.014, 95% CI = -7.7 to -1.0). This level of significance was not reached with the gastrointestinal symptoms. During the treatment phase the frequency and intensity of the reflux each decreased by 26 %; the use of drugs was reduced by 18 %. The eating behaviour improved during the waiting phase by appox. 7 % and remained almost constant until the end of the study.
Conclusion:
Eight osteopathic treatments within a time period of eight weeks showed a positive influence on the gastro-oesophageal reflux. These positive results make further studies on this disease pattern desirable. They should be randomized controlled trials in which the sustainability of the results needs to be checked by a follow up.
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