Visceral Manipulation

Posted on June 2, 2019

By Dr. Alexandra Shustina, DO

Visceral manipulation (VM) is a type of Osteopthic Manipulative Therapy (OMT) targeting the internal organs of the body.  It is a gentle manual therapy to realign the body and restore normal motion to the internal organs.  VM was developed by a world renowned French physician and osteopath, Dr. Jean-Pierrre Barral.  Using the VM techniques a physician can evaluate the structure of the internal organs in relation to each other, to their fascial attachments. 

All structures in the body are attached to other structures.  Nothing is free floating with no adjacent attachments.  All body structures have an inherent and subtle motion called motility.  This applies to the internal organs from the brain to the lungs to the gut.  It is important that this motion is optimized.  It needs to be the right range, symmetry, speed, and amplitude.  Any kind of fascial restrictions can have an effect on the motility of the organ.  What is fascia?  Fascia is a connective tissue which attaches on organ to another or to another structure, as sort of “internal skin.”  If this fascia is inflamed, restricted, or in any way affected this can negatively affect the motility of the structure. 

Three of the main principles of Osteopathic Medicine are: (1) Any dysfunction in one part of the body can affect another part since we are one whole unit.  Nothing in the body functions independently without being affected and affecting other parts.  (2) The body has the ability to maintain and create health by itself as long as it is optimized.  As long as there is proper circulation and nervous innervation, the body has the potential to heal itself.  A properly functioning immune system can fight off even the worst infections and destroy abnormal cells which can become cancer.  (3) Structure and function are intimately related.  Any structural abnormality such restricted fascia or impaired motility can affect the function of an organ.  We see that slow moving gut can cause anything from gastroparesis to constipation.  A fast moving gut can cause diarrhea and decreased absorption of nutrients.  This principle applies to all structures and organs.

Emotional health is a vital part of total body health. This very clearly seen in digestive illnesses. as there are more connections from the digestive system to the nervous system and the brain than any other system.  We know patients with Irritable Bowel Syndrome, Crohn’s Disease, and Ulcerative colitis have increased rates of depression, anxiety, or history of sexual and physical abuse (1,2,3).  According to the principles of Traditional Chinese Medicine, we store our emotions in the tissues of our organs.  Visceral manipulation can help break the mind body stress pattern for total body and emotional health and vitality.


  1. Simon P Dunlop, David Jenkins, Keith R Neal, Robin C Spiller, “Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS,” Gastroenterology,Vol 125, 6, (2003), 1651-1659.
  2. Ananthakrishnan, Ashwin N et al. “Similar risk of depression and anxiety following surgery or hospitalization for Crohn’s disease and ulcerative colitis.” The American journal of gastroenterology vol. 108,4 (2013): 594-601.
  3. Kanuri N, Cassell B, Bruce SE, et al. The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS). Neurogastroenterol Motil. 2016;28(10):1508–1517.

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