To evaluate the clinical effect of traditional Chinese spinal orthopedic manipulation (TCSOM) in treating irritable bowel syndrome (IBS) compared with pinaverium bromide Dicetel (PBD), and to assess a possible cause for IBS.
Two hundred ten IBS patients were randomly divided into the TCSOM group and the PBD group. All patients in the TCSOM group were treated with spinal manipulations 5 times. Pain intensity was assessed on a visual analogue scale and symptoms were evaluated based on bowel symptom scale (BSS) scores before and after treatment. A symptom improvement rating (SIR) was implemented to evaluate the effects of treatment, and to statistically compare the TCSOM and PBD groups.
Post-treatment subjective assessment for the TCSOM treatment group showed that 92 cases had excellent results, 10 cases had good results, 3 cases had fair results, and 0 cases had poor results. In the PBD group, 30 cases had excellent results, 41 cases had good results, 12 cases had fair results, and 22 cases had poor results. According to the SIR, which was based on the BSS, the TCSOM group included 92 cases with excellent results, 10 cases with good results and 3 cases with poor results. There were no adverse side effects from treatment. Based on the BSS, the PBD group had 30 cases with excellent results, 41 cases with good results, and 34 cases with poor results. We found that the symptom rating in the BSS in the TCSOM group showed a more significant improvement, such as a reduction in the severity and frequency of symptoms, compared with that in the PBD group (P < 0.001).
Displacement of intervertebral discs and/or vertebra in the thoracic or lumbar region appears to be a contributing factor in the symptoms of IBS. Correcting this displacement of intervertebral discs and/or vertebra to resolve the stimuli caused by pressure exerted on the nerves and vessels around the spine is an effective treatment for IBS.
[Show abstract][Hide abstract] ABSTRACT: The pain drawing (PD) has proven to have good inter-examiner reliability and high sensitivity in assessing neurogenic pain and dysfunction (NP) originating from the lower back. Studies on its use in the neck/shoulder region have not been found.
To investigate inter-examiner reliability of a first impression assessment of NP in the neck/shoulder region using a simplified PD made by the patient. Also, to investigate concordance between first impression assessment and a final assessment based on a complete clinical examination.
A clinical trial on 50 primary care patients with discomfort in the neck/shoulder region assessed by two independent examiners. One examiner was experienced in assessing the PD and the other was not. A first impression assessment was based solely on the PD. A final assessment was based on clinical examination also including history interviews, physical examinations, and possible radiological reports. NP was considered if at least two physical examination findings indicated neurological deficit in the area of discomfort. Concordance between the first impression assessment and the final assessment was calculated as sensitivity with the final assessment as the key.
Inter-examiner reliability based solely on the first impression assessment of the pain drawing reached 88% overall agreement and a sensitivity of 90%. Signs of NP were found in 92% of the patients according to the final assessment. Two thirds of the patients added to their pain drawing during the history interview.
First impression assessment of the PD seems to be a reliable, easily learned, and sensitive diagnostic method for assessing NP in the neck/shoulder region. NP may be greatly underestimated, especially as patients withhold symptoms of discomfort when they fill in the PD.
Pain Medicine 04/2007; 8(2):134-46. DOI:10.1111/j.1526-4637.2006.00145.x · 2.30 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Aim: To investigate if patients with Irritable bowel syndrome (IBS) have more findings in
the physical examination indicating nerve involvement from spine segments Th7-L1 than
people without gastrointestinal disorder.
Study Design: Clinical randomized blinded case-control diagnostic study.
Place and Duration of Study: Torvalla back and sports medical clinic and CeFAM at
Karolinska Institutet, Stockholm, Sweden, Mars-May 2012.
Methodology: Ten patients with IBS and six age-matched controls were randomly
scheduled to a physical examination by two independent examiners who were blinded to
the status of the person they examined. The physical examination followed a predetermined
protocol focused on neurological examination and palpation of the abdomen
and the spine. Fischer´s exact test and Cohen’s kappa (K) test were used to analyze
prevalence respectively inter-examiner reliability of examination findings.
Results: Disturbed sensibility to pain in one or more of dermatomes T7-L1 was more
prevalent in patients with IBS than controls (p=0.007 for both examiners). Tenderness on
palpation of one or more of spinal processes T7-L1 was more prevalent in patients with
Original Research Article
British Journal of Medicine & Medical Research, 4(24): 4154-4168, 2014
IBS than controls (p=0.001 for examiner 1, p=0.008 for examiner 2). Inter-examiner
reliability in the physical examination test for sensibility to pain and palpation of the
abdomen was 100% (K=1.0).
Conclusion: Patients with IBS have significantly more findings in the physical
examination indicating nerve involvement from spine segments Th7-L1 than people
without gastrointestinal disorder. Further work in larger cohorts and with added
diagnostic methods is required to confirm our findings and if confirmed may open up for
new treatment strategies of IBS.
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