system infection or imbalance; peritonitis; disorders of the liver, bile ducts, or gall bladder; adverse effects from radiation and chemotherapy; obstruction of gastrointestinal tract; and delayed colonic transit. Vomiting is the result of afferent input from a range of sources within the body. Nausea is an uneasiness of the stomach that often accompanies the urge to vomit but doesn’t always lead to vomiting. Vomiting is the forcible voluntary or involuntary emptying (“throwing up”) of stomach contents through the mouth. Some triggers that may result in vomiting can come from the stomach and intestines (infection, injury, and food irritation), the inner ear (dizziness and motion sickness), and the brain (head injury, brain infections, tumors, and migraine headaches). Various stimuli that affect nausea and vomiting come together in an area in the brain known as the vomit (or emetic) center in the medulla. This “center” is not a discrete nucleus but a complex array of coordinated neurons. The vomit center receives input from four major areas: the GI tract, the chemoreceptor trigger zone, the vestibular apparatus, and the cerebral cortex. Each of these four areas responds to certain types of stimuli, modulated by specific neurotransmitters that bind specific receptors. Identification of increasing numbers of neurotransmitters has been associated with the development of antiemetic agents that have affinity for specific receptors, with combinations causing a variety of different mechanisms and effects. Ondansetron, granisetron, and dolasetron are 5-HT3 antagonists approved for prevention and treatment of nausea and vomiting. Each has powerful antiemetic properties mediated primarily through peripheral 5-HT3 receptor blockade on intestinal vagal afferents, in the vomiting center, and chemoreceptor trigger zone. Ondansetron, granisetron, and dolasetron have a half- life from 4 to 9 hours and undergo substantial hepatic metabolism. While all are excreted by renal and hepatic elimination, dose reduction for elderly individuals or those with renal insufficiency is generally not necessary. People with liver dysfunction may require dose reduction in the case of ondansetron. All agents tend to slow esophageal and gastric motility and increase colonic transit time. 5-HT3 receptor antagonists are increasingly being used to prevent and treat postoperative nausea and vomiting as well as nausea and vomiting in patients treated with radiation therapy due to their relative lack of serious adverse side effects (Zhong et al., 2021). Manual techniques should be used very cautiously on someone who is experiencing nausea or vomiting. Vigorous or circulatory abdominal massage can actually provoke symptoms. Acupressure and reflexology are the most effective modalities of manual therapy to treat nausea and vomiting. Working directly on the abdomen when someone is experiencing nausea and vomiting is particularly unadvised. Motion sickness Motion sickness is caused when the brain is processing too many movement signals from the eyes, ears, and body at once. Symptoms can include cold sweats, nausea, increased salivation, pale skin, dizziness, and headache. Women and children are generally more prone to experience motion sickness, but there are other factors that may trigger someone to experience it more than the general population. If you experience migraines, are on hormonal birth control, are pregnant, or have Parkinson’s disease, then you may be more prone to experience motion sickness.
There are many tests to diagnosis Crohn’s disease, including blood tests, stool samples, biopsies and colonoscopies. When diagnosed, people who suffer from Crohn’s disease can implement diet changes, lifestyle/stress management, introduce medications, or even undergo surgery to help reduce and control the symptoms from this condition. Unfortunately, there is no current cure (Crohn’s and Colitis Foundation, 2023). Gentle manual techniques can help with stress management for individuals with Crohn’s disease, and abdominal massage can help relieve stomach pains. Colic and constipation in infants Recent studies suggest that in infants with colic, abdominal massage is beneficial in dispersing gas, easing muscle spasms, and returning the digestive system to normal. Stimulation may also relieve constipation and assist digestion. Studies have shown that additional benefits of infantile massage include weight gain, and pain relief (Mrljak et al., 2022). Additionally, the benefits of a mother or father giving infantile massage to their child are not exclusive to the infant. Parents who regularly massaged their infant showed significant reductions in stress and anxiety, leading to a greater bond with the child, and reduction in post- partum depression (Dixon, 2023). As a manual therapist performing massage on an infant requires caution. Infants are fragile and strokes must be very delicate. It is highly recommended that before working with infant massage in a professional capacity that you receive a certification or training course in infantile massage. However, many parents and guardians can be instructed with basic techniques and educated about the cautions to take when performing massage on their own children experiencing colic or constipation at home. It is also helpful to have the parent in the room with you during the treatment, so they can observe and learn how to massage their infant at home. This participation during treatment sessions empowers parents by assisting to help keep the baby calm and be available to help with positioning and feeding if necessary. Constipation At some point in their lives, most people will experience constipation, but chronic constipation can be categorized as a GI disorder. Chronic constipation is characterized by slow moving stool through the colon. The difficulty or inability to pass stool can result in anal fissure, hemorrhoids, stomach discomfort, or rectal prolapse. General blood work can be done to look for systemic disease as the cause for constipation, but the impacted fecal matter will be determined by a doctor’s palpation of the abdomen. Warning signs for severe cases that require immediate medical attention would be a distended abdomen, blood in the stool, weight loss, and vomiting. Treatment of constipation will most often include a diet change. Eating enough fiber, fresh fruits and vegetables, and certain supplements are the most common approaches recommended by doctors to manage constipation. Laxatives for immediate relief will also be prescribed in more severe cases (Diaz et al., 2023). Manual therapy is an excellent way to give relief to someone who is experiencing constipation. Abdominal massage with small circular movements clockwise to the colon can be applied. Combining abdominal massage with vibration techniques can help mimic the body’s natural peristaltic movement. This can trigger the body’s parasympathetic nervous system to evacuate the stool from the body. Vomiting and nausea Vomiting/nausea are common symptoms associated with a wide range of conditions, including medicinal side effects; systemic infections or disorders; pregnancy; central nervous
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