Inhibition of gastric motility by noxious chemical stimulation of interspinous tissues in the rat

Postural deviation patterns, trunk mobility restriction and spinal musculoskeletal dysfunctions in chronic gastritis

OBJECTIVE

This study aimed to compare posture, trunk mobility, and spinal musculoskeletal dysfunctions between adults diagnosed with chronic gastritis and healthy individuals.

STUDY DESIGN

Cross-sectional observational study.

METHODS

A total of 88 participants were included, divided into a gastritis group (GG = 41) and a comparison group (CG = 47). Posture and trunk mobility were assessed using computerized photogrammetry, while spinal musculoskeletal dysfunctions were evaluated using the tenderness, asymmetry, restriction of motion, and tissue texture change (TART) tool. Cohen's d effect sizes were calculated for the Student's t-test, and Phi coefficient (ϕ) and Cramér's V were used for Chi-square tests. Bonferroni correction was applied for multiple comparisons.

RESULTS

The GG showed a significantly higher percentage of left trunk deviation (68.3%; p = 0.005, ϕ = 0.153) and right trunk rotation (80.5%; p = 0.02, V = 0.300) compared to the CG. The GG also exhibited significantly reduced trunk flexion (mean difference = 8.79°, p = 0.013, d = 0.55) and left rotation (mean difference = 7.78°, p = 0.020, d = 0.50) compared to the CG. Additionally, the GG presented greater restrictions in passive mobility to the left for rotation and lateral glide, as well as asymmetry, pain, and increased muscle tension at multiple cervical and thoracic levels, particularly at C3, C4, T8, and T9 (ϕ ranging from 0.27 to 0.68), which remained significant after Bonferroni correction (p < 0.001).

CONCLUSION

The findings suggest that chronic gastritis is associated with compensatory postural adaptations, reduced trunk mobility, and spinal musculoskeletal dysfunctions. These results highlight the potential for visceral disturbances to contribute to biomechanical imbalances, likely due to the viscerosomatic reflex mechanism, reinforcing the need for integrative clinical approaches that address both gastrointestinal and musculoskeletal systems in the management of chronic gastritis.

Regulation of gastric motility and blood flow during acute nociceptive stimulation of the paraspinal muscles in urethane-anaesthetised rats

The aim of this study was to examine gastric motility and blood flow during nociceptive hypertonic saline injections (HS) in paraspinal muscles of urethane-anaesthetised rats. Gastric pressure was not affected by HS in intact or vagotomised conditions. After cervical spinalisation, it was decreased by injections at T13 or L6 but not T2. Moreover, HS injections at T13 produced greater gastric pressure decreases compared with L6 and T2 and increased gastric sympathetic nerve activity. Blood pressure and gastric blood flow were decreased by T13 injections in spinal cord intact but not spinalised rats. Besides, isotonic saline injections (non-nociceptive) produced non-significant or marginal effects. These results indicate that gastric motility is decreased by nociceptive input from paraspinal muscles in spinalised rats through activation of the gastric sympathetic nerve. Although gastric blood flow was also decreased by nociceptive stimulation at T13 in spinal cord intact rats, these changes seem to depend on blood pressure.

Short-term effects of manipulation to the upper thoracic spine of asymptomatic subjects on plasma concentrations of epinephrine and norepinephrine-a randomized and controlled observational study

OBJECTIVE

The purpose of this study was to investigate the short-term effects of spinal manipulation applied to a hypomobile segment of the upper thoracic spine (T1-T6), on plasma concentrations of norepinephrine (NE) and epinephrine (E) in asymptomatic subjects, under strictly controlled conditions.

METHODS

Fifty-six asymptomatic subjects were randomly assigned to receive either a chiropractic manipulative intervention or a sham intervention in the upper thoracic spine. A 20-gauge catheter fitted with a saline lock was used to sample blood before, immediately after, and 15 minutes after intervention. Plasma NE and E concentrations were determined using an enzyme-linked immunosorbent assay. Changes in plasma catecholamine concentrations were analyzed within and between groups using 1- and 2-sample t tests, respectively.

RESULTS

The plasma samples of 36 subjects (18 treatment, 18 control) were used in the analysis. Mean plasma concentrations of NE and E did not significantly differ between the 2 groups at any time point and did not change significantly after either the manipulative or sham intervention.

CONCLUSIONS

The results of this study indicate that a manipulative thrust directed to a hypomobile segment in the upper thoracic spine of asymptomatic subjects does not have a measurable effect on the plasma concentrations of NE or E. These results provide a baseline measure of the sympathetic response to spinal manipulation.

Chiropractic management of breast-feeding difficulties: a case report

OBJECTIVE

The purpose of this study is to discuss a chiropractic case of management and resolution of breast-feeding difficulties.

CLINICAL FEATURES

The case involves an 8-day-old baby unable to breast-feed since 4 days old. Initial examination revealed cervical, cranial, and sacral restrictions. She was diagnosed with craniocervical syndrome by a doctor of chiropractic.

INTERVENTION AND OUTCOME

Following history and examination, the infant received gentle chiropractic manipulation based on clinical findings. Immediate improvement and complete resolution of the nursing problems were observed after 3 treatments over 14 days.

CONCLUSION

The results of this case suggest that neuromusculoskeletal dysfunction may influence the ability of an infant to suckle successfully and that intervention via chiropractic adjustments may result in improving the infant's ability to suckle efficiently.

Capsaicin and gastric ulcers

In recent years, infection of the stomach with the organism Helicobacter Pylori has been found to be the main cause of gastric ulcers, one of the common ailments afflicting humans. Excessive acid secretion in the stomach, reduction in gastric mucosal blood flow, constant intake of non-steroid anti-inflammatory drugs (NSAIDS), ethanol, smoking, stress etc. are also considered responsible for ulcer formation. The prevalent notion among sections of population in this country and perhaps in others is that "red pepper" popularly known as "Chilli," a common spice consumed in excessive amounts leads to "gastric ulcers" in view of its irritant and likely acid secreting nature. Persons with ulcers are advised either to limit or avoid its use. However, investigations carried out in recent years have revealed that chilli or its active principle "capsaicin" is not the cause for ulcer formation but a "benefactor." Capsaicin does not stimulate but inhibits acid secretion, stimulates alkali, mucus secretions and particularly gastric mucosal blood flow which help in prevention and healing of ulcers. Capsaicin acts by stimulating afferent neurons in the stomach and signals for protection against injury causing agents. Epidemiologic surveys in Singapore have shown that gastric ulcers are three times more common in the "Chinese" than among Malaysians and Indians who are in the habit of consuming more chillis. Ulcers are common among people who are in the habit of taking NSAIDS and are infected with the organism "Helicobacter Pylori," responsible for excessive acid secretion and erosion of the mucosal layer. Eradication of the bacteria by antibiotic treatment and avoiding the NSAIDS eliminates ulcers and restores normal acid secretion.

Neurophysiological effects of spinal manipulation

BACKGROUND CONTEXT

Despite clinical evidence for the benefits of spinal manipulation and the apparent wide usage of it, the biological mechanisms underlying the effects of spinal manipulation are not known. Although this does not negate the clinical effects of spinal manipulation, it hinders acceptance by the wider scientific and health-care communities and hinders rational strategies for improving the delivery of spinal manipulation.

PURPOSE

The purpose of this review article is to examine the neurophysiological basis for the effects of spinal manipulation.

STUDY DESIGN

A review article discussing primarily basic science literature and clinically oriented basic science studies.

METHODS

This review article draws primarily from the peer-reviewed literature available on Medline. Several textbook publications and reports are referenced. A theoretical model is presented describing the relationships between spinal manipulation, segmental biomechanics, the nervous system and end-organ physiology. Experimental data for these relationships are presented.

RESULTS

Biomechanical changes caused by spinal manipulation are thought to have physiological consequences by means of their effects on the inflow of sensory information to the central nervous system. Muscle spindle afferents and Golgi tendon organ afferents are stimulated by spinal manipulation. Smaller-diameter sensory nerve fibers are likely activated, although this has not been demonstrated directly. Mechanical and chemical changes in the intervertebral foramen caused by a herniated intervertebral disc can affect the dorsal roots and dorsal root ganglia, but it is not known if spinal manipulation directly affects these changes. Individuals with herniated lumbar discs have shown clinical improvement in response to spinal manipulation. The phenomenon of central facilitation is known to increase the receptive field of central neurons, enabling either subthreshold or innocuous stimuli access to central pain pathways. Numerous studies show that spinal manipulation increases pain tolerance or its threshold. One mechanism underlying the effects of spinal manipulation may, therefore, be the manipulation's ability to alter central sensory processing by removing subthreshold mechanical or chemical stimuli from paraspinal tissues. Spinal manipulation is also thought to affect reflex neural outputs to both muscle and visceral organs. Substantial evidence demonstrates that spinal manipulation evokes paraspinal muscle reflexes and alters motoneuron excitability. The effects of spinal manipulation on these somatosomatic reflexes may be quite complex, producing excitatory and inhibitory effects. Whereas substantial information also shows that sensory input, especially noxious input, from paraspinal tissues can reflexively elicit sympathetic nerve activity, knowledge about spinal manipulation's effects on these reflexes and on end-organ function is more limited.

CONCLUSIONS

A theoretical framework exists from which hypotheses about the neurophysiological effects of spinal manipulation can be developed. An experimental body of evidence exists indicating that spinal manipulation impacts primary afferent neurons from paraspinal tissues, the motor control system and pain processing. Experimental work in this area is warranted and should be encouraged to help better understand mechanisms underlying the therapeutic scope of spinal manipulation.