|Author's note: Each patient education article in this column details research documented in Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach, co-edited by Marion Todres-Masarsky, DC.|
Today, the idea that neurological (and even psychological) factors influence digestion is a commonplace one.The Russian physiologist Pavlov largely pioneered this idea in the late 19th and early 20th centuries. This fact forms a nice background to a brief description of a more recent Russian study on the effect of spinal manipulation on duodenal ulcers, discussed in the patient education article below. Feel free to use this article for bulletin board displays, lay lectures, or your patient newsletter.
The Russian physiologist Ivan Petrovich Pavlov primarily saw himself as an investigator into the process of digestion. In the opening to his 1904 Nobel Prize address, he stated, "It is not accidental that all the phenomena of human life are dominated by the matter of daily bread - the oldest link connecting all living things, man included, with the surrounding nature."1 While there are many aspects of digestion that he could have studied, Pavlov's choice was to focus on the role of the nervous system in controlling the digestive organs. This choice had far-reaching implications in his career, and perhaps in the research activities of future generations of Russian scientists.
While his early work focused on the role of a major nerve (the vagus nerve) in stimulating the digestive secretions of the stomach and pancreas, Pavlov is best remembered for his demonstration of the "conditioned reflex." By ringing a bell prior to each feeding, Pavlov was able to condition dogs to salivate in response to the sound of the bell, even if no food were presented. This famous experiment demonstrated that the neurological circuits controlling digestion are not only those that an animal is born with, but also the ones that can be acquired as a result of conditioning.
Perhaps this long-standing interest in the relationship between the nervous system and the digestive system encouraged a Russian team of medical researchers to study the effect of spinal manipulation on duodenal ulcer.2 A group of 16 patients suffering from duodenal ulcer had spinal manipulative therapy added to the usual medical regimen. These spinal manipulations were similar to chiropractic adjustments. A second group of 40 patients received standard medical treatment only. Progress was measured by improvement in symptoms and visible remission of the ulcers under fiberoptic examination (using an endoscope).
Recovery was substantially accelerated in the group receiving spinal manipulation, with ulcer remission taking place an average of 10 days faster than in the group under traditional medical care.
The Russian study is part of a small but growing body of literature supporting the idea that vertebral misalignments or restrictions (subluxations) can disturb digestive function, and that correcting these spinal problems can help restore digestive health.3
- Nobel Prize address delivered by Ivan Petrovich Pavlov in Stockholm, Sweden on December 12, 1904. Translated in Kaplan M (editor): Essential Works of Pavlov. Bantam Books, New York, 1966.
- Pikalov AA, Kharin VV. Use of spinal manipulative therapy in the treatment of duodenal ulcer. J Manipulative Physiol Ther 1994;17:310.
- Masarsky CS, Cremata EE. The Alimentary Canal: A Current Chiropractic Perspective. In Masarsky CS, Todres-Masarsky M (editors): Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach. Churchill Livingstone, New York, 2001.
Author's note: In considering your overall approach to patient education, it is worthwhile to consider the following insight by Marshall McLuhan and Quentin Fiore (from War and Peace in the Global Village, Bantam Books, New York, 1968): "There was possibly a time when show biz was a bigger business than education. Today, education is not only by far the biggest business in the world, it is also becoming show biz."
Today, education is definitely show biz. Large audiences are tuning in to the History Channel, the Discovery Channel, and other sources of "edutainment." If you are interested in an "edutainment" approach to the material presented above, please e-mail me to request a free copy of my science fiction tale, Pavlov's Cat.
Charles Masarsky, DC
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