Case Study on the Effect of Osteopathic Manipulation on Gallbladder Ejection Fraction




Lin, Emily
Montalvo, Emily
Adams, Natalie
Garcia Garcia, Diana
Sparks, Clarence


0000-0002-9385-048X (Lin, Emily)

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There is minimal research regarding the effects of osteopathic manipulative treatment (OMT) upon biliary emptying. Despite the limited research, OMT has been used to treat gallbladder dysfunctions in clinical practice.

Case Information:

The purpose of this case study was to examine the effects of OMT on gallbladder ejection fraction (EF) as measured by ultrasound and to determine if there was sufficient evidence of OMT-influenced biliary emptying to base a larger study. OMT was performed by a neuromusculoskeletal medicine board certified osteopathic physician on a medical student, who was acalculous and asymptomatic of any biliary disorder. Interventions included OMT targeting sympathetic and parasympathetic innervation levels, Chapman points, visceral myofascial release, and Sphincter of Oddi release. Results included gallbladder EF as measured by ultrasound. Blinded analysis demonstrated a 8.88% increase in average gallbladder EF following OMT, with a statistically significant difference in mean ejection fraction between OMT (M=46.95, SD=19.83) and no OMT (M=38.07, SD=19.13) conditions (paired t(4)=2.828, p=0.047).


A limitation in the design of this study is that the comparison EF was measured 15 days after the OMT intervention. In future studies, we would first measure the EF and then perform OMT and measure the EF at least 4 weeks later. The results of this case study provide an enhanced understanding of OMT’s effect on gallbladder EF. Future studies should apply the biliary OMT protocol to a diverse clinical population with and without functional gallbladder disorder to determine if OMT could be used as an alternative treatment.


Research Appreciation Day Award Winner - Texas College of Osteopathic Medicine, 2023 OMM-I.M. Korr, Ph.D. Memorial Research Award