The AAO Journal, 2026/09, 36(3):18–24. doi: 10.53702/i2375-5717-36.3.18, type of study: ,cr,,,,

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/36/3/article-p18.xml)

Keywords:

bile acid diarrhea [1]
case report [736]
male [860]
mind-body approach [1]
OMT [3924]
osteopathic manipulative treatment [3945]

Abstract:

The following case involves a 31-year-old male from Yucatan, Mexico suffering from five years of idiopathic bile acid diarrhea in which he had difficulty tolerating bile acid sequestrants and subsequently discontinued use. He was found to have key somatic dysfunctions of the root of the tongue, mandible, anterior neck, respiratory diaphragm and thoracolumbar region. These findings and his overall body structure were consistent with what is known in the field of somatic psychology as the “oral character,” in which the body is generally tall and slender with a swayback posture with slumped/hunched shoulders and considerable tension in the mandible and anterior strap muscles. These somatic findings are believed to be owed to a mind-body connection exhibiting excessive dependence and originating from perceived lack of connection with mother and/or suboptimal breastfeeding during the first 18 months of life. Mostly indirect manual techniques including counterstrain, indirect myofascial release and balanced ligamentous tension were applied to resolve significant somatic dysfunctions in three visits during a period of one month. Since the conclusion of the third visit, the patient has experienced ongoing relief of his diarrhea for more than six months. The resolution of diarrhea symptoms coincided with a breakthrough in the previously troubled relationship between the patient and his mother as he reported suddenly being able to forgive her and heal their relationship shortly after the third treatment. The physical findings and outcome appear to coincide with the ideas of Wilhelm Reich, MD, who initially described the oral character as a clinical pattern arising from strife between mother and child beginning in infancy and reflected both emotionally and structurally in the patient. This case study proposes a retained suckle reflex and its potential effects on the enteric nervous system as a likely neurological explanation to this mind-body phenomenon. The clinical case sheds light on some of the anatomic, physiological, and psychodevelopmental connections under which the mind and body may work as one.