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Visceral massage reduces postoperative ileus in a rat model

PainSci » bibliography » Chapelle et al 2013
Tags: massage, fascia, surgery, odd, inflammation, manual therapy, treatment, controversy, debunkery, etiology, pro, pain problems

One article on PainSci cites Chapelle 2013: Does Fascia Matter?

PainSci notes on Chapelle 2013:

In this odd rat study, rat guts were massaged after an emulation of surgical “running of the bowel” (examining the entire bowel for abnormalities). The point of this was to see if the massage would prevent post-surgical “stickyness” (adhesions, postoperative ileus). Apparently it did: the treatment “reduced experimental postoperative ileus,” possibly through reducing inflammation.

Fascia enthusiasts have often used this study as a basis for speculation that massage can have a measurable effect on connective tissue, and as justification for visceral manipulation. That’s a big leap with many problems.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: Abdominal surgery invariably causes a temporary reduction of normal intestinal motility, called postoperative ileus. Postoperative ileus extends hospital stays, increases the costs of hospitalization, and may contribute to the formation of postoperative adhesions. We designed experiments to determine if visceral massage affects postoperative ileus in a rat model.

MATERIAL AND METHODS: Forty female Long Evans rats were assigned to 4 groups in a 2 (surgery) × 2 (treatment) factorial design. Twenty rats were subjected to a small intestinal manipulation designed to emulate "running of the bowel." Transabdominal massage was performed upon 10 operated and 10 control rats in the first 12 h following surgery. Ileus was assayed after 24 h using fecal pellet discharge and gastrointestinal transit. Intraperitoneal inflammation was assayed using total intraperitoneal protein and inflammatory cell concentrations.

RESULTS: The surgery consistently caused ileus. Compared to the operated group with no treatment, the operated with treatment group showed increased gastrointestinal transit and reduced time to first fecal pellet discharge. Similar group comparisons revealed that the treatment decreased total intraperitoneal protein and numbers of intraperitoneal inflammatory cells.

CONCLUSIONS: In this rat model, visceral massage reduced experimental postoperative ileus. The data suggest that the effect was through the attenuation of inflammation. A similar study could be designed and performed in a hospital setting to assess the potential role of visceral massage as part of the integrated care for postoperative ileus.

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