The AAO Journal, 2023/06, 33(2):11. doi: 10.53702/2375-5717-33.2.10, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://meridian.allenpress.com/aaoj/article/33/2/10/493538/LBORC-NUFA-Poster-Abstracts-2023-Residents)

Keywords:

case report [736]
female [655]
gastroparesis [5]
OMT [3925]
osteopathic manipulative treatment [3946]
women [608]

Abstract:

Introduction/Background: Gastroparesis is a burdensome condition affecting more women than men. In the US, up to 35% of cases are idiopathic, 29% diabetic, and other causes include cancers, post-operative changes, auto immune or connective tissue diseases. We describe a case of gastroparesis failing conventional treatment, and the approach that provided relief. Case: A 38-year-old female with anxiety/depression, headaches, previous hip fracture, and endometriosis with multiple abdominal surgeries, and a new left costal lipoma presented with persistent nausea, vomiting, and constipation since a car accident one year prior. She was diagnosed with gastroparesis, and attempted laxatives and promotility agents with no relief. Results: Screening revealed Zink compensation R/R/R/R, diminished cranial rhythmic impulse, fatty non-tender mass over L ribs 9-10, Occipito-atlantal, thoracic inlet, and abdominal diaphragm restrictions, L/L sacral torsion, R anterior innominate, R lateral tibial torsion, and flattened R arch. After two treatments, the patient had natural a bowel movement, decreased nausea, improved intake, and headache relief. On subsequent follow up, Zink compensation normalized, the lipoma shrank, and nausea resolved. Two weeks later, the lipoma was non-palpable and vomiting subsided. By the final visit, only spinal facilitation remained with improved mood and resolution of gastroparesis as a diagnosis and its presenting symptoms. Discussion: With each session of osteopathic manipulative treatment (OMT) patient symptoms improved. After five sessions over 10 weeks, complete resolution was achieved. One year later the patient remains symptom free. Using an osteopathic approach, gastroparesis can be treated economically and efficiently by addressing visceral and autonomic dysfunctions. Patients and physicians may benefit from considering OMT earlier in patient care to improve patient outcomes and reduce costs.