VISCERAL HYPERSENSITIVITY IN IRRITABLE BOWEL SYNDROME. A NEW WAY OF PHYSIOTHERAPEUTIC TREATMENT THROUGH VISCERATE CHAINS?

Abstract

 The Irritable Bowel Syndrome (IBS) is a multifactorial disorder of the bowel affecting an increasing proportion of adult population. The morbidity derived from the IBS generates high economic and social costs. Dietary habits, unhealthy lifestyles, the possible somatization of traumatic events, the emotional condition of the person... are different elements that may explain a disfunction of the gastrointestinal tract even when there is no organic or physiological concrete disorder. Nowadays, all the treatments that are carried out just try to solve the different factors that are prone to cause the syndrome. Visceral hypersensitivity, understood as an abnormal perception of visceral pain, plays a key role in the physiopathology of the IBS. As a consequence, the bowel remains with hypersensitivity and a «permanent defense scenario» so the visceral system and consequently the muscle chains are affected. The objective of this study is to propose a theoretical new treatment based on solving the visceral disorder that exist in the IBS using as a method the visceral chains reeducation proposed by Leopold Busquet. Material and method: a bibliographic review in several databases (pubmed, Elsevier, Cochrane,) using irritable bowel syndrome (IBS), physiopathology and visceral as key words have been carried out. Results: the «feeling» of having bowel inflammation appears in almost 95 % of pepple with a gastrointestinal disorder. However, this «feeling» is not always accompanied by a real increase of the abdominal perimeter; in fact, in nearly 50 % of the cases, the abdominal diameter is reduced due to the necessity of «visceral defense» because of the permanent hyperexcitability scenario. According to what has been exposed by Busquet, the augment or reduction of the abdominal size produces what is called as «visceral unfoldment or visceral withdrawal*. Depending on the selected visceral adaptation takes place a group of several postural changes establishing a new postural pattern in the subject. Conclusions: postural analysis of each subject with IBS will allow to establish precisely the abdominal visceral adaptation that has taken place in each single case so it will be possible to organize the required physiotherapeutic program.