Análise dos efeitos da terapia manipulativa osteopática como tratamento em pacientes com síndrome do intestino irritável: uma revisão sistemática

Abstract

Irritable bowel syndrome (IBS) is a common and frequent life-long functional gastrointestinal disorder. According to the low efficiency of the drugs available for IBS, there is a growing interest in alternative therapies. Therefore, this systematic review aimed to evaluate the effectiveness of osteopathic manipulative therapy (BMT) for the management of IBS symptoms. Articles were selected in Portuguese and English in the following databases: PubMed, Embase, Cochrane Library and OSTMED.DR. Research terms included irritable bowel syndrome, IBS, functional colonic disease, irritable bowel, osteopathy, osteopathic manipulation, clinical trial, and randomized clinical trial. Citation identification, study selection, and data extraction were performed independently by two reviewers with a Cochrane data extraction form. A consensus method was used to resolve disagreements on the methodological quality assessment of the RCTs that were reviewed. As a result, the research identified 12 studies that examined the use of BMT for IBS patients, but only 3 studies (97 patients) met the inclusion criteria. All studies were assessed as having low risk of bias according to Cochrane Collaboration criteria, although there were heterogeneity in outcome measures and control interventions. All studies reported more pronounced short-term improvements with the use of BMT compared with placebo or standard treatment alone. These differences remained statistically significant after different post-treatment follow-up times. The present systematic review allows us to conclude that there is preliminary evidence that BMT may be beneficial in the treatment of patients with IBS. However, caution is required in the interpretation of these findings, owing to the limited number of studies available and the small sample size.