MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Chiropractors are back pain specialists, they say. They do not pretend to treat non-spinal conditions, they claim.

If such notions were true, why are so many of them still misleading the public? Why do many chiropractors pretend to be primary care physicians who can take care of most illnesses regardless of any connection with the spine? Why do they continue to happily promote bogus treatments? Why do chiropractors, for instance, claim they can treat gastrointestinal diseases?

This recent narrative review of the literature, for example, was aimed at summarising studies describing the management of disorders of the gastrointestinal (GI) tract using ‘chiropractic therapy’ broadly defined here as spinal manipulation therapy, mobilizations, soft tissue therapy, modalities and stretches.

Twenty-one articles were found through searching the published literature to meet the authors’ inclusion criteria. The retrieved articles included case reports to clinical trials to review articles. The majority of articles chronicling patient experiences under chiropractic care reported that they experienced mild to moderate improvements in GI symptoms. No adverse effects were reported.

From this, the authors concluded that chiropractic care can be considered as an adjunctive therapy for patients with various GI conditions providing there are no co-morbidities.

I think, we would need to look for a long time to find an article with conclusions that are more ridiculous, false and unethical than these.

The old adage applies: rubbish in, rubbish out. If we include unreliable reports such as anecdotes, our finding will be unreliable as well. If we do not make this mistake and conduct a proper systematic review, we will arrive at very different conclusions. My own systematic review, for instance, of controlled clinical trials drew the following conclusion: There is no supportive evidence that chiropractic is an effective treatment for gastrointestinal disorders.

That probably says it all. I only want to add a short question: SHOULD THIS LATEST CHIROPRACTIC ATTEMPT TO MISLEAD THE PUBLIC BE CONSIDERED ‘SCIENTIFIC MISCONDUCT’ OR ‘FRAUD’?

25 Responses to Chiropractic therapy for gastrointestinal diseases. Evidence of scientific misconduct?

  • Both.
    Scientific misconduct is fraud.
    (Seeking to gain advatage by falsehoods. ‘Deliberate deception to secure unfair or unlawful gain.’ (Wikipedia)

  • EE, it is now your responsibility to explain in anatomical and neurophysiological terms why it is impossible for Spinal Manual Therapy to affect gastro-intestinal complaints. Is there a plausible reason why SMT may help GIT complaints, if not, why not? Please do not weasel of the explanation. After all, you made the statement, now back it up with scientific plausibility.

    • That is not how science works. It is not up to EE to disprove the null hypothesis. That’s like asking someone to prove that god doesn’t exist. It is up to the believer to prove the existence of god. In this case it is up to the chiropractors to prove their case, for instance using a randomized controlled trial.

      • it is also not how common sense works: if I claim I can fly, foretell the future or make gold out of dog poo, it is I who has to prove it and not someone who doubts my claims to disprove it.

    • @GibleyGibley,
      “Is there a plausible reason why SMT may help GIT complaints, if not, why not?”

      Is there any reason why SMT would have anything to do with GIT matters? Apart from the implausibility of “innate energy flow”, harking directly back to D.D. Palmer, is there ANY mechanism that might link them?

      GG, you made the claim by implicitly supporting the assertion, so please provide an explanation?

  • I guess fraud is a relative term in some parts of the world.

    One has been led to believe that in the US, fraud, swindle and similar immoral activities against fellow human beings are generally frowned upon and oftentimes result in rather heavy-handed judicial retribution. But it appears that there are a few magic terms that confer complete protection against such liability. The main preventative term is “health” especially if used as a prefix. Another strong shield seems to be “chiropractic”.

    As a blatant example, have a look at this vacuous idiot who advertises world wide on the internet that he can fix hiatal hernia by external manipulation:

    https://youtu.be/8dg0xEU8A44

    • At 53 seconds, the clown says, “His ribs are lined up much better”, as distinct from the many other absurd observations verbalised.

      The poor b@stard, oops patient, has on a T shirt and, what looks like, a bit of body fat, so how can the ribs be discerned? This whole video is a sad joke. Chiropractors love clicky things, whether they are the magic table or that strange hand-held device. I was also unaware orbital sanders, which I use for their intended purpose (sanding objects, such as wood), had made their way into use by chiropractors, for the purpose of stimulating blood flow.

      Thanks Björn, this chiropractic stuff just gets weirder and weirder.

  • The full conclusion!
    “The number and quality of research papers found for this narrative review were not high enough, and the studies that did exist were often not robust enough with respect to their design, in order to draw any concrete conclusions regarding the effectiveness of chiropractic treatment on gastrointestinal disorders. There were no reports of either worsening of symptoms or other adverse reactions by patients receiving various types of chiropractic therapy. Therefore, it would be fair to state that chiropractic therapy can be used as an adjunct to other forms of conventional treatment of GI disorders.

    It is quite evident that there is a significant gap in the evidence base regarding chiropractic therapy for GI disorders, especially evidence coming from well-controlled clinical trials. Bearing that in mind, there is not currently any defensible treatment protocols or guideline that can be provided to practitioners to assist them in making reasonable choices with respect to chiropractic care planning decisions for patients with GI disorders.”

  • So, after all it’s EE who doesn’t have ‘time’ to read full paper.

  • I don’t trust the abstract from any paper no matter who wrote it or the journal its published in, be it chiropractic or medical!
    To just quote a select sentence of the abstract is poor form!

    • @”Thinking” Chiro,
      “It is quite evident that there is a significant gap in the evidence base regarding chiropractic therapy for GI disorders, especially evidence coming from well-controlled clinical trials. Bearing that in mind, there is not currently any defensible treatment protocols or guideline that can be provided to practitioners to assist them in making reasonable choices with respect to chiropractic care planning decisions for patients with GI disorders.”

      If this isn’t a complete put down of the notion (couched in language of abstracts), I can’t think what else would be. This alone, “there is a significant gap in the evidence base” is enough.

      “I don’t trust the abstract from any paper no matter who wrote it or the journal its published in, be it chiropractic or medical!”, yet you became a chiropractor, based on what evidence?

      • Trusting an abstract alone and not reading the full article before commenting? Facepalm!
        I went to SOT, activator etc seminars 25+ and asked one question “Why”. I did not get a satisfactory answer and never went down that path. You are making assumptions! Questioning what you do, looking for best evidence and applying it in practice is at the heart of progress and reform!
        The critics are very good at pointing out the BS and this is an important part of the reform process. The next step is supporting the reformers and not making blanket statements and assumptions. This second step is lacking!

        • “Trusting an abstract alone and not reading the full article before commenting? Facepalm!”
          The quotes from the abstract are enough to determine there is no link. Even the idea of treating GIT disease by spinal manipulation flies in the face of sense. It is not as if one has to look too far to find the notion is past ridiculous; what next, treating fungal conditions of the feet?

          And you can shove your facepalm put-down too, while I’m at it. Rightful exasperation can be expressed by those who wonder at those who would consider the idea has merit.

          “I went to SOT, activator etc seminars 25+ and asked one question “Why”. I did not get a satisfactory answer and never went down that path. You are making assumptions! Questioning what you do, looking for best evidence and applying it in practice is at the heart of progress and reform!”

          Reform what? A wanna be profession that makes absurd claims with no evidence, treats conditions that do not exist, and treats those who are not ill? http://www.abc.net.au/pm/content/2015/s4281643.htm In Australia, the head of the chiropractic association snuck into maternity to “manipulate” the spines of newborns. While she has been strongly criticised, I believe she should be charged with numerous cases of assault. While some might think she should face action for medical malpractice, as chiropractic is not medical, this may not be possible. The idea a newborn needs spinal adjustment is one of the many ridiculous ideas propagated by chiropractic. Again, reform what?

          “The critics are very good at pointing out the BS and this is an important part of the reform process. The next step is supporting the reformers and not making blanket statements and assumptions. This second step is lacking!”
          And why do you think the critics are good at pointing out the BS? Because chiropractic is largely BS, founded on the supernatural, based on a single principle, and full of absurd quackery.

          I ask again; reform what?

  • Typo – 25+ years ago.

  • @Frank Collins
    She was diciplined as were 6 others featured on Reasonable Hanks blog and it was a good result.
    As for adjusting babies an Australian chiropractor, Doug Scown (Chiropractic Trojan Horse) has answered that well here
    http://chiropractictrojanhorse.blogspot.com.au/2014/09/vitalistic-chiropractic-awareness-art.html
    The rest of his blog is equally as good and he recently took up a academic position at Central Queensland University. Another good result!
    Reform is there, you just have to look for it, and support it. Additionally, I am a long term member of the professional association COCA/CA that is different to CAA/Helen Alevaki that you cited above! They are the voice of reason within the profession within Australia and they are growing rapidly and garnering a lot of good press recently for actively promoting reform. Check them out:
    http://www.abc.net.au/news/2015-07-27/peak-chiropractic-body-to-review-membership-obligations/6651994
    http://chiropracticaustralia.org.au/
    http://www.smh.com.au/nsw/chiropractic-fraternity-splits-over-allegations-of-mismanagement-20150710-gi7qxd.html

  • Reform what?
    Never adopted that BS, Was never taught except in historical context, moved on 25+ years ago! Been progessing and changing ever since!

    • “The critics are very good at pointing out the BS and this is an important part of the reform process. The next step is supporting the reformers and not making blanket statements and assumptions.”
      Reform what?

  • Exactly FrankO! The reform is already happening and the fringe either change or go the way of the dinosaurs! Help and support the reform process, not take a wrecking ball to it with assumptions and generalities!

  • @Thinking_Chiro
    Tropical astrologers think they reform astrology by pushing sidereal astrology to the fringe. But astrology still remains bunk. The same applies to your daft views of the unproven ‘art’ of spinal manipulation. It’s all BS. The real reform is for you to learn medicine and stop imagining you have something to offer.

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