Interview with Torsten Liem about osteopathy for digestive problems
Mr. Liem, what does an osteopath actually do?
Torsten Liem: Osteopaths work with a therapeutic touch called palpation. On the basis of well-founded and detailed knowledge of the entire living anatomy and physiology of humans, we treat the respective structures and organs and, above all, their relationships such as joints, ligaments, muscles, fascial sliding surfaces, nerves and vessels. All of this always takes place with holistic consideration of the patient’s life situation .
Osteopathy is philosophy, science and art at the same time . As a philosophy, the treatment is based on different principles, perspectives and models, which understand the patient on the one hand as a whole and at the same time in the context of all his life influences. As a science, teaching is constantly being adapted to new findings and, if necessary, outdated perspectives are relativized. An almost infinite variety of approaches and techniques are used as an art, depending on the patient and the time of treatment.
The sensitivity of the hands, the anatomical-physiological and medical knowledge, life experience, intuition and empathy of the osteopath, the patient and his individual life situation, the timing and the interaction between therapist and patient during the treatment – all these aspects influence the treatment result.
Accordingly, the art of osteopathy is a lifelong learning process . For example, I started my osteopathic studies in 1989 and am still a student, deepening my understanding and craft with each patient and have still fared from perfection.
How can osteopathy help with intestinal problems?
Liem: Osteopathy is characterized by a very individualized approach to the patient . So we treat less of a disease – rather, the treatment is completely tailored to the patient’s characteristics and the context in which they live. This means, for example, that ten patients with apparently the same irritable bowel symptoms may experience ten completely different treatments . While in one patient the focus is on the nervous supply of the intestine, in the other the body posture, the immune system, the jaw or the motor functions of the intestine could be the focus.
The aim of treatment is to interact and improve adaptability with the help of the five models of osteopathy. These are:
- the biomechanics of posture and movement,
- the respiratory and cardiovascular system,
- the system of metabolism, the immune and hormonal systems,
- the nervous system with the brain, the peripheral and autonomic nervous system
- and biopsychosocial adaptations.
In osteopathy, not only the affected region is treated, but also often distant regions , precisely because they may impair the bowel function.
For example, a more upright posture or stimulation of the vagus nerve could improve nerve supply to the intestine. Deeper breathing can also have a positive effect on the digestive tract. Improved posture, breathing, and vagus nerve stimulation could also work together to reduce the experience of high stressful emotions, which in turn could affect the bowel.
So there are no linear causal chains that are in the foreground here. Osteopaths carry out a multitude of interventions , each of which may have barely noticeable effects on its own, but in their interactions and interactions may, in a seemingly miraculous way, possibly bring about a clearly noticeable improvement in symptoms .
For which types of intestinal complaints do you think osteopathy is particularly recommended?
Liem: Osteopathy is particularly recommended for functional diseases and chronic disorders that are not life-threatening and in which no pathological tissue changes have taken place and which cannot be traced back to a single cause such as a bacterium.
In the case of many functional intestinal diseases in which many factors interact and no tissue pathology could be found, osteopathic treatment – possibly in combination with other methods – can help, such as irritable bowel syndrome, functional abdominal pain, feeling of pressure, constipation, diarrhea, vomiting, childlike Abdominal colic and breastfeeding problems in newborns.
Can osteopathy relieve irritable bowel symptoms? How would you treat someone with irritable bowel syndrome?
Liem: Some studies suggest that osteopathy could help with irritable bowel symptoms. A study by Florance et al. that osteopathic treatment of the organs compared to massage therapy had significantly more positive effects on irritable bowel symptoms .
Likewise, a randomized crossover study by Attali and colleagues from 2013 showed that global and local vibration techniques of the organs could improve irritable bowel symptoms such as constipation, diarrhea, diarrhea, abdominal bloating, abdominal pain and rectal pain sensitivity and that these improvements continued even a year later.
My treatment is based on the aspects already mentioned. A very precise anamnesis gives me information about possible risk factors that may have added up in the course of life until the patient finally shows symptoms of irritable bowel syndrome. This individual risk analysis is indispensable because they are stored differently for each disease.
This can sometimes go all the way back to birth or even pregnancy . We now know that certain circumstances during pregnancy greatly increase the risk of developing certain diseases. Medical history information is essential as lifestyle changes eliminating these risk factors will enable healing.
During the entire consultation, my attention is also focused on the patient’s posture, gestures and facial expressions , as these provide a great deal of information about possible influencing factors for the respective complaints. This is followed by the investigation.
Before starting treatment with osteopathic touch, I explain to the patient in great detail what factors may have caused their symptoms so that they understand that they can regain control over the symptoms . If he is really aware of this, the healing has already started and he will mostly be motivated to do his part.
Finally, the treatment begins through the art of osteopathic touch . Here I use different local treatment approaches and techniques. For example, I can set the entire body in a healing vibration and then again precisely support an artery, nerve or organ connection and thus improve its gliding ability, elasticity, density, tension or mobility.
If I notice a pull in a certain direction with my hands, for example from the transverse colon to the stomach, I check: the position of the stomach, its shape, tension, volume, density, mobility and its arteries, veins, lymph vessels and nerve innervations, its relationships to the spine and muscles, to statics and of course the suspensions and sliding surfaces, for example from the stomach to the large intestine.
If a certain emotional or neurovegetative excitement occurs in the patient when the tissue tension is sensed, I would also include this in the treatment. As I said, it is a very individual treatment. I am treating less of the IBS than the patient who is showing IBS symptoms.
However, other findings are also important and therefore interdisciplinary cooperation is essential for the success of the treatment. For example, a deficiency in beta-glucuronidase or an overgrowth in the small intestine (SIBO) in irritable bowel syndrome can also be involved. These cannot be changed by osteopathic treatment alone. In the case of irritable bowel syndrome, it should also be investigated whether oral supplementation of pancreatic enzymes is recommended.
Babies in particular often have digestive problems. Are the osteopathic therapy methods also suitable for children and babies?
Liem: A review by Dobson et al. concludes that parentsnoticedsignificantly less crying in their children when they were treated with osteopathic treatment. Even if there are too few well-done studies to be able to clearly assess the extent to which osteopathy helps.
My personal experience is that manual osteopathic treatment alone or in combination with other methods such as microbiome support very often reduces or relieves digestive problems and crying in babies. However, if there is no improvement after three or at the latest four applications, I would not recommend further treatment.
Osteopathic treatments also showed an improvement in childhood defecation and constipation . The osteopathic treatment of premature infants also appears to reduce the high incidence of gastrointestinal symptoms and prolonged stays in the premature infant intensive care unit, as well as to improve nutrition .
What exercises can you do yourself to calm your digestion?
Liem: A lot of exercise, free breathing and a balanced diet rich in vegetables help digestion in general. The abdominal cavity can also be relaxed by forming the tone O with exhalation and paying attention to the space in the abdominal region.
To calm the bowel, both hands can be placed on both sides of the abdomen around the navel so that the thumbs touch and the hands form a triangle pointing downwards. You can breathe gently into your hands three to six times. Perhaps the movement of the intestines can also be felt through the hands while breathing.
This is felt like a lowering and forward movement during inhalation and an upward and backward movement during exhalation. Ultimately, the hands can direct heat and energy into the bowel by following the minimal bowel movements with the hands.
I have also described many other exercises in my book ” Osteopathy – the targeted solution of blockages ” and in my health blog.
What are the limits of osteopathy? For which complaints should one go to a doctor?
Liem: Osteopathy should not be used in diseases that are characterized by pathological tissue changes, such as colon carcinoma or duodenal ulcer .
Also acute bacterial intestinal diseases or life-threatening bowel diseases such as intestinal obstruction, intestinal bleeding or appendicitis should not be treated with osteopathy. Immediate medical treatment is essential in these cases .