Abstract

Four cases of patients with Long COVID symptoms of loss of the sense of smell and sense of taste are presented. They differ from the findings in the published case record of anosmia and loss of taste in Magoun. Osteopathic examination revealed flexion and extension of the occiput. No flexion or extension motion of the sphenoid was appreciated. A novel application of the underlying concepts of Osteopathic Cranial Manipulative Medicine is described. This approach resulted in a rapid resolution of the symptoms of loss of the senses of smell and taste, which have persisted for more than a year. An hypothesis for a possible mechanism of the pathophysiology is advanced. The olfactory nerve (CN I) lies on the cribriform plate of the ethmoid bone. When the inflamed sphenoid flexes, becoming stuck down forward on the cribriform plate of an inflamed ethmoid. This may have resulted in impingement of CN I, which then resulted further in anosmia (loss of smell) and concomitant loss of taste.

Abstract

Irritable bowel syndrome (IBS) is one of the most common disorders of the gastrointestinal system, occurring in 10-20% of the general population.^1,2,3 IBS is associated with heavy social and economic costs in the United States, as it results in the second highest cause of work absenteeism and accounts for 25-50% percent of all gastroenterology referrals.^1,4 IBS is characterized by recurrent abdominal pain or discomfort and bowel dysfunction as diarrhea, constipation or both, in the absence of any organic cause.^3,5,6,7 The pathophysiology of IBS appears multifactorial, although current focus for an understanding of the disease process is on alteration of gastrointestinal motility, visceral hypersensitivity and dysregulation of the brain-gut axis between the autonomic nervous system (ANS) and the enteric nervous system (ENS).^6,8 The lack of full understanding of the pathophysiologic processes of IBS means current management options are often ineffective and unreliable, leaving patients with frustrating and sometimes disabling symptoms.^2,7

An osteopathic approach using osteopathic manipulative treatment (OMT) to address symptoms related to IBS is an under-explored treatment option. The use of OMT within a treatment plan offers the ability to address manifestations of visceral and somatic dysfunctions unique to each patient. This case report outlines a successful osteopathic manipulative treatment course for a patient suffering from IBS symptoms. Randomized controlled trials (RCTs) for the use of OMT on patients with IBS in the current literature are also reviewed below and provide further preliminary evidence that OMT may be effective in managing IBS symptoms.^2,5,7,9,11

Abstract

Vertigo is a symptom with a wide range of etiologies as diverse as the patients it affects. The wide spectrum of etiologies can make a diagnosis difficult and therefore delay definitive treatment. The diagnosis is not commonly linked to somatic dysfunctions, however these somatic dysfunctions may be contributing to or causing a problem altogether. This case highlights the importance of investigating for somatic dysfunctions related to a patient’s presentation. A 73-year-old female presented with a history of vertigo and a current feeling of fullness and ringing in her ears. She was found to have significant Eustachian tube dysfunction related to her condition. An osteopathic approach with emphasis on the Galbreath technique was utilized to relieve her ear symptoms and decrease her ongoing episodes of vertigo.