Clinico-functional assessment of the effectiveness of osteopathic correction of biliary disorders in patients with celiac disease

Abstract

Ntroduction. Celiac disease is a genetically determined disease, which is often associated with the dysplasia of the connective tissue, and may be considered as one of the causes of the secondary biliary dysfunction. Functional alterations play a signifi cant role in the formation of chronic pathology. The basis for osteopathic treatment is the correction of functional alterations, aimed at amelioration of work of the basic elements of the biliary system.Goals of research - to evaluate the clinical effectiveness of osteopathic correction in treatment of biliary dysfunction in patients with celiac disease.Materials and methods. 48 patients (23 men and 25 women) diagnosed with celiac disease aged from 18 to 35 took part in the research. Their average age was 26,5±2,1 years old. All the patients underwent clinical and osteopathic examination, I. A. Alexeev-Berkman coprological examination, ultrasound examination «SonolinePrima LC» («Siemens», Germany) performed according to the standard methodology with the determination of the fraction and the coeffi cient of the evacuation. Patients received osteopathic treatment during two months. Results. The assessment of the diagnostic fi ndings showed that among 48 patients with biliary disorders with a background of different anomalies of the gall bladder 41 (85,4 %) patients suffered from clinical manifestations of the disease. During the osteopathic examination of patients typical somatic dysfunctions were found: regional biomechanical disorders (cervical, thoracic, lumbar and pelvic regions) and local biomechanical disordes (cupula of the diaphragm on the right, lower ribs on the right, ligamentous apparatus of the liver, gall bladder, duodenum). The ultrasound examination of the abdominal organs revealed different anomalies of gall bladder in combination with the alteration of the colloidness of the content of the gall bladder. Statistically signifi cant contingency between the presence of the biliary sludge and the type of anomalies of the gall bladder was determined (χ2=8,12; р=0,017; С=0,55). After the course of osteopathic treatment the main clinical manifestations signifi cantly reduced, the mobility improved in all the regions of the spine, and in the thoracic diaphragm, the importance and the manifestation of somatic dysfunctions decreased in the liver, in the bile ducts, in the stomach, in the duodenum, and in the bone structures of the pelvis (р<0,01). Also the process of digestion improved: creatorrhoea, steatorrhoea, amylorrhea were less expressed (p<0,05), the contractile function of the gall bladder improved (emptying coeffi cient 59,8±1,84 %) and the anechogenic effect was achieved.Conclusion. The use of osteopathic methods showed high effectiveness in treatment of biliary pathologies in patients with celiac disease.