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Osteopathy decreases the severity of IBS-like symptoms associated with Crohn’s disease in patients in remission

Piche, Thierrya,b; Pishvaie, Dorsaa; Tirouvaziam, Dianec; Filippi, Jeromea; Dainese, Raffaellaa; Tonohouhan, Mariea; DeGalleani, Lauriannea; Nébot-Vivinus, Marie-Hélèneb; Payrouse, Jean-Lucc; Hébuterne, Xaviera

European Journal of Gastroenterology & Hepatology: December 2014 - Volume 26 - Issue 12 - p 1392–1398
doi: 10.1097/MEG.0000000000000219
Original Articles: Inflammatory Bowel Disease

Background Osteopathy may decrease the severity of irritable bowel syndrome (IBS). About 35% of patients with quiescent Crohn’s disease (CD) continue to suffer from IBS-like symptoms with impaired quality of life (Qol). We aimed to evaluate the effect of osteopathy on the severity of IBS-like symptoms in quiescent CD patients.

Methods We prospectively included 38 patients with CD on remission over 12 months while receiving infliximab every 8 weeks. Patients were randomized 2/ 1 to receive three sessions of standardized osteopathy (n=25) at 15, 30, and 45 days after the last infusion of infliximab or simple follow-up. The severity of IBS-like symptoms, psychological factors, and its impact on Qol were assessed using questionnaires.

Main results Compared with baseline, the severity of IBS-like symptoms was significantly reduced in patients receiving osteopathy. The decrease was significantly more pronounced in patients receiving osteopathy at day 30 [−38.4 (−76.1 to 10.2) vs. 32.2 (−16.6 to 41.6), P=0.01], day 45 [−36.7 (−74.4 to 25.3) vs. 32.2 (−16.6 to 41.6), P=0.04], and day 60 [−39.5 (−60.9 to −9.2) vs. 6.1 (−38.7 to 28.5), P=0.05] with a concomitant increase in Qol (P=0.09 at day 30, P=0.02 at day 45, P=0.3 at day 60). Compared with baseline, the severity of fatigue was significantly reduced in patients receiving osteopathy, whereas depression and anxiety remained unchanged.

Conclusion Three sessions of osteopathy reduced the severity of IBS-like symptoms associated with CD in remission. Osteopathy should be viewed as a helpful therapeutic option to reduce the severity of abdominal pain and discomfort in patients with CD but in remission with IBS-like symptoms.

aDepartment of Hepato-Gastroenterology and Oncology. Archet 2 Hospital, CHU of Nice, University of Nice Sophia Antipolis, 06202 Nice Cedex 03

bDepartment of Immunology and Biology, EA 6302 Immune Tolerance, Archet 1 Hospital, Univesrity of Nice Sophia Antipolis

cATMAN Osteopathy Center, Sophia Antipolis, France

Correspondence to Thierry Piche, MD, PhD, Department of Hepato-Gastroenterology and Oncology, Archet 2 Hospital, CHU of Nice, 06202 Nice Cedex 03, France Tel: +33 492 036 399; fax: +33 492 036 575; e-mail:

Received July 4, 2014

Accepted September 3, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins