Corticosteroids also impair the body’s ability to repair body tissues normally, resulting in longer healing periods and fragile tissue after any injury. Corticosteroids also have immunosuppressant effects that make an individual more susceptible to infection, so hand washing and being in good health are important to the client’s health and safety. Individuals taking corticosteroids for long periods may notice changes in skin sensitivity and altered reactions to heat and cold. Normal function and sensitivity of the skin are compromised to the extent that skin rolling, friction, and wringing techniques can result in bruising and inflammation of the tissues. Any massage strokes that involve placing direct pressure or stress on tissue structures will need to be reviewed. Avoid heavy tapotement, passive forced stretching, muscle stripping, deep kneading, frictions or joint mobilization. For tissues affected by topical steroid applications, exercise caution and modify the depth of pressure when working on tissues. digestion. Extreme caution is necessary in performing infant massage. Anyone unfamiliar with handling a baby must receive appropriate instruction before massaging. Infants are fragile and strokes must be very delicate. 30 percent of cases, while infection with Helicobacter pylori (H pylori) accounts for about 70-80 percent of the cases. Acid-peptic diseases include gastroesophageal reflux, peptic ulcer (gastric and duodenal), and stress-related mucosal injury. Ulceration or mucosal erosion occurs when caustic substances (like acid, bile, and pepsin) in the gastrointestinal tract overpower the defenses of gastrointestinal mucosa (mucus and bicarbonate secretions, blood flow, prostaglandins, and cellular regeneration after injury). Drugs used in acid-peptic disorder treatment typically do one of two things: reduce intragastric acidity or promote mucosal defense. Anti-ulcer medications reduce symptoms and encourage healing of gastrointestinal ulcers, while antisecretory ulcer medications suppress excess stomach acid production. In some cases, a material like sucralfate forms a chemical barrier over the ulcerated area, protecting it from stomach acid. may exacerbate fluid retention, particularly in patients with hypertension, heart failure, and renal dysfunction. Calcium carbonate is less soluble and reacts more slowly with hydrochloric acid than sodium bicarbonate, with a reaction producing carbon dioxide and calcium chloride. Use of calcium carbonate may cause gastric distention, belching, and the potential for metabolic alkalosis. Excessive doses of sodium bicarbonate or calcium carbonate with a calcium-rich diet can cause hypercalcemia, renal insufficiency and metabolic alkalosis. Magnesium hydroxide or aluminum hydroxide react more slowly with hydrochloric acid to form magnesium chloride or aluminum chloride and water. Distension and belching do not occur, as no gas is generated by this process. Potential for metabolic alkalosis is also avoided. As unabsorbed magnesium salts may produce osmotic diarrhea and aluminum salts may produce constipation, these two items are used together in a number of proprietary medications to minimize effects on bowel movements. Because both magnesium and aluminum are absorbed and excreted by the kidneys, any individuals with renal dysfunction should not take either formulation for any length of time. All types of antacids affect the absorption of other medications, so special care should be taken in timing medications around the use of antacids. Antacids should not be taken within two hours of tetracyclines, itraconazole, iron, and fluoroquinolones.
side effects of constipation (and rarely, diarrhea). Constipation may be alleviated by working on the abdomen, in a clockwise pattern, to help stimulate peristalsis. Any time that constipation is an issue, encourage drinking water to assist intestinal motility. Side effects including diarrhea, dizziness, nausea, headache, rash, or itching should be referred to a physician. Antiflatulent drugs like Mylanta, as well as fiber laxatives, facilitate the release of gas pockets in the abdominal tract. Gentle abdominal massage can facilitate the process. Gentle abdominal massage can also relieve mild side effects of cramping and diarrhea from stimulant and lubricant laxatives. Any significant abdominal pain and distention, constipation, or diarrhea should be referred to a physician. Corticosteroids cause atrophy and weaken connective tissues, including skin, fascia, ligaments, and muscle, joint capsules, bones, and tendons. When injected into joints for arthritis, steroids can induce breakdown of articular cartilage. Colic and constipation in infants Results from a number of recent studies 1 suggest that in infants with colic, massage is beneficial in dispersing gas, easing muscle spasms, and returning the digestive system to normal. Stimulation may also relieve constipation and assist Common gastrointestinal conditions Gastrointestinal medications are used to treat a variety of disorders of the esophagus, stomach, and intestines. Disorders of the esophagus include esophagitis, an inflammation of the esophagus that may be accompanied by heartburn. Esophagitis may be caused by infection, trauma, irritation or from the ingestion of certain foods and/or acid reflux. Disorders of the stomach and intestines include gastroenteritis, an inflammation of the intestines and stomach that may cause nausea, diarrhea, and abdominal pain. Possible causes of gastroenteritis include a viral or bacterial infection, allergic response, or exposure to irritating particles. Peptic ulcers are ulceration of the mucosa lining of the stomach and, more commonly, the duodenum affecting about 1/10th of the U.S. population. The cause may be attributed to use of NSAIDS (nonsteroidal anti-inflammatory drugs) that include aspirin, ibuprofen, and naproxen, which account for about 20- Agents that reduce intragastric acidity Antacids Aluminum hydroxide gel*(Amphojel), calcium carbonate* (Tums), combination aluminum hydroxide and magnesium hydroxide preparations*(Maalox, Mylanta, Gaviscon), sodium bicarbonate* (baking soda, Alka Seltzer). Antacids have a long history of nonprescription use in individuals with acid-peptic disorders, and were the primary treatment strategy until the development of H2 receptor antagonists and proton pump inhibitors. Antacids are weak bases that react with hydrochloric acid in the gut to form saltwater. Their primary function is the reduction of intragastric acidity, but they may also enhance mucosal defense through increased mucosal prostaglandin production. The acid- neutralization capacity among different antacid formulas varies widely, depending on a range of factors including rate of dissolution (pill vs. liquid, for example), gastric contents and emptying, etc. There are three main types of antacid preparations: sodium bicarbonate, calcium carbonate, and magnesium or aluminum hydroxide. Sodium bicarbonate reacts quickly with hydrochloric acid, producing carbon dioxide and sodium chloride, which may cause gastric distention and belching. When sodium bicarbonate is taken in high doses or by individuals with renal dysfunction, there is a potential for metabolic alkalosis due to absorption of unreacted alkali. Absorption of sodium chloride
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