The escalating prevalence of diabetes mellitus globally poses significant challenges, not only due to the disease itself but also because of its numerous complications. One such complication, diabetic gastroparesis, severely impacts patients’ quality of life by disrupting normal gastric motility and digestion, leading to symptoms like nausea, vomiting, and abdominal pain. While conventional treatments focus primarily on medications, there’s growing evidence that osteopathic manipulative treatment (OMT) can provide significant relief, particularly for symptoms associated with gastroparesis in diabetic patients.
Understanding Diabetic Gastroparesis
Diabetic gastroparesis is a chronic condition characterized by delayed gastric emptying in the absence of any mechanical obstruction. The condition is believed to be caused by vagus nerve damage, which is responsible for controlling the stomach muscles. This impairment affects stomach motility, leading to the typical symptoms of gastroparesis.
Role of OMT in Managing Diabetic Gastroparesis
OMT involves the use of hands-on techniques by trained osteopathic practitioners to diagnose, treat, and prevent illness or injury. Using OMT, physicians aim to enhance the body’s natural ability to heal by affecting the body’s structure (joints, muscles and fascia) and function.
A recent case study sheds light on the potential benefits of OMT for patients suffering from diabetic gastroparesis. The study focused on a patient with type 1 diabetes who had significant symptoms of gastroparesis. The intervention consisted of a series of OMT sessions targeting the areas around the vagus nerve and other related structures to alleviate the mechanical restrictions potentially impeding its function.
Case Study Insights
The patient underwent six OMT sessions over several weeks. Notably, there was a marked improvement in the patient’s Gastroparesis Cardinal Symptom Index (GCSI) score, which measures the severity of gastroparesis symptoms. The score improved from 13 to 8, indicating significant symptom relief. Furthermore, the frequency of the patient’s hospital admissions due to severe symptoms reduced drastically, from once every 6-8 weeks to once in six months.
Physiological Rationale for OMT in Gastroparesis
The physiological basis for using OMT in the treatment of diabetic gastroparesis hinges on its potential to restore normal function through improved nerve function, enhanced circulatory and lymphatic health, and the stimulation of reflexive bodily mechanisms that govern digestion:
- Enhancing Nerve Function: OMT techniques aimed at the cervical spine and cranial areas could potentially improve the neural output and blood flow to the vagus nerve. Manual therapy might reduce local mechanical restrictions and enhance nerve conductivity, indirectly facilitating better control of gastric motility.
- Improving Lymphatic Circulation: OMT can aid in optimizing lymphatic flow, which helps in reducing local inflammation. By enhancing lymphatic drainage in areas around the pancreas and stomach, OMT might contribute to better local control of inflammation and possibly lessen neuropathic degeneration over time.
- Increasing Blood Flow: Techniques that improve circulation could help in mitigating ischemia and supporting nerve and muscle function in the gastrointestinal tract. Enhanced blood flow can provide better oxygenation and nutrient supply, crucial for the healing and function of the nervous system and digestive tract muscles.
- Stimulating Reflexive Responses: OMT can stimulate certain reflexes that influence the gastrointestinal system. Manual manipulation of the abdominal and spinal areas could activate parasympathetic responses, which are essential for digestive processes.
Why Consider OMT?
OMT offers a non-pharmacological approach that might reduce the need for medications and their associated side effects. It provides a holistic treatment option that addresses not just the symptoms but the underlying structural issues that may contribute to the disease’s severity.
While more extensive research is needed to generalize these findings, the current evidence suggests that OMT could serve as an effective adjunctive treatment for managing symptoms of diabetic gastroparesis. It underscores the importance of a comprehensive treatment plan that includes both conventional medical therapies and osteopathic manipulative interventions to enhance patient outcomes in diabetes care.
This integrative approach to diabetic complications highlights the potential of osteopathic medicine to contribute significantly to the holistic management of chronic conditions, offering a promising avenue for enhancing the quality of life for many patients.
References
Valerie, J., Van, Ravenswaay., Simeon, J., Hain., Sierra, Grasso., Jay, H., Shubrook. (2015). Effects of Osteopathic Manipulative Treatment on Diabetic Gastroparesis.. The Journal of the American Osteopathic Association, 115(7):452-458. doi: 10.7556/JAOA.2015.091
Crux Performance Therapy 