SİRİNGOMYELİ VE ARNOLD-CHİARİ MALFORMASYONU OLAN BİR OLGUDA KABIZLIK TEDAVİSİNE İLİŞKİN BİR OLGU SUNUMU

Abstract

Öz Amaç: Bu çalışmada, Arnold-Chiari malformasyonu ve siringomyeli tanısı olan bir olguda kronik konstipasyon tedavisinde osteopatik manipülatif tedavi (OMT) teknikleriyle vagus sinirinin uyarılmasının etkinliğini değerlendirmek amaçlanmıştır. Yöntem: Siringomyeli ve Arnold-Chiari malformasyonu tanısı olan 34 yaşındaki kadın hasta, kabızlık şikâyetiyle fizyoterapi kliniğine başvurmuştur. Hasta, Roma III kriterleri ve Konstipasyon Ciddiyet Ölçeği (KCÖ) ile değerlendirilmiştir. Ardından, tek seanslık osteopatik vagal sinir uyarımı uygulanmıştır. Uygulama sonrası bir ay süresince hasta haftalık takiplerle izlenmiş ve tedavi sonunda aynı ölçüm araçlarıyla yeniden değerlendirilmiştir. Sonuçlar: Tedavi öncesinde KCÖ toplam puanı 46 olarak belirlenirken, birinci ay sonunda bu değer 6’ya düşmüştür. Hasta, tedavi öncesinde ayda en fazla beş kez dışkılama yaptığını belirtirken, tedavi sonrası dönemde her gün dışkılama gerçekleştiğini ifade etmiştir. Dışkı kıvamında yumuşama ve dışkılama sırasında zorlukta belirgin azalma bildirilmiştir. Tartışma: Osteopatik manipülatif tedavi yoluyla yapılan vagal sinir uyarımı, invaziv olmayan, kolay uygulanabilir ve düşük maliyetli bir yöntem olarak kabızlık tedavisinde etkili olabilir. Bu vaka, Arnold-Chiari malformasyonu ve siringomyeli birlikteliğinde ortaya çıkan konstipasyonun yönetiminde OMT’nin potansiyelini ortaya koymakta olup, daha geniş örneklem gruplarıyla yapılacak çalışmalara öncülük edebilir.

Keywords

• Arnold-Chiari Malformasyonu
• Kabızlık
• Osteopatik Tedavi
• Siringomyeli
• Vagus Siniri

A CASE REPORT ON THE TREATMENT OF CONSTIPATION IN A PATIENT WITH SYRINGOMYELIA AND ARNOLD-CHIARI MALFORMATION

Abstract

Abstract Objective: This study aimed to evaluate the effectiveness of vagus nerve stimulation via osteopathic manipulative treatment (OMT) techniques in the management of chronic constipation in a patient diagnosed with Arnold-Chiari malformation and syringomyelia. Methods: A 34-year-old female patient with a history of syringomyelia and Arnold-Chiari malformation presented with chronic constipation. She was assessed using the Rome III criteria and the Constipation Severity Instrument (CSI). A single session of osteopathic vagal stimulation was administered. The patient was monitored weekly for one month and re-evaluated at the end of the intervention using the same scales. Results: The total CSI score decreased from 46 at baseline to 6 at the end of the first month. The patient reported defecating a maximum of five times per month prior to treatment, while achieving daily bowel movements after the intervention. A notable softening in stool consistency and reduction in straining were observed. Discussion: Vagus nerve stimulation through OMT appears to be an effective, non-invasive, and cost-efficient method in the treatment of constipation. This case highlights the therapeutic potential of OMT in managing constipation associated with syringomyelia and Arnold-Chiari malformation, encouraging further studies with larger sample sizes.

Keywords

• Arnold-Chiari Malformation
• Constipation
• Osteopathic Treatment
• Syringomyelia
• Vagus Nerve

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