the natural pathway of the large intestine has shown to effectively relieve stomach pains. Patients can perform this massage on themselves as well to help relieve acute symptoms. Ulcerative colitis Ulcerative colitis is a disease that causes inflammation and sores (ulcers) in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells that usually line the colon, which then bleeds and produces pus. Inflammation in the colon also causes the colon to empty frequently, causing diarrhea. It can be difficult to distinguish between ulcerative colitis and Crohn’s disease. Crohn’s disease differs because it causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system including the small intestine, mouth, esophagus, and stomach (Mayo Clinic, 2022). Ulcers associated with NSAID use can be effectively healed by proton pump inhibitors. In cases where NSAID use is discontinued, more effective ulcer healing occurs. While continued use of NSAID reduces the amount of healing, some positive effects are still seen. Proton pump inhibitors are used among some populations daily to prevent potential complications from NSAID use, like bleeding or perforation. Proton pump inhibitors administered orally once or twice daily for a period of up to five days significantly reduces ulcer re-bleeding (the recurrence of bleeding from peptic ulcers) (Gwee et al., 2018). Manual therapy of the abdomen for someone who is experiencing acute ulcerative colitis is contraindicated. This is especially true if there is fever present from this condition. When someone is a subacute phase of this condition it is possible receive gentle relaxation manual therapy if it is comfortable, but it is also recommended to avoid abdominal massage altogether. Be sure to check in with the patient more often than normal about positioning and pressure throughout the session. 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, and so on (Salisbury & Terrell, 2023). There are three main types of antacid preparations: sodium bicarbonate, calcium carbonate, and magnesium or aluminum hydroxide. Common names with the preparations of antacids are aluminum hydroxide gel* (Amphojel), calcium carbonate* (Tums), combination aluminum hydroxide and magnesium hydroxide preparations* (Maalox, Mylanta, Gaviscon), or sodium bicarbonate* (baking soda, Alka Seltzer) (Pope, 2023) 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 may exacerbate fluid retention, particularly in patients with hypertension, heart failure, and renal dysfunction (Shaw, 2017). Calcium carbonate is less soluble and reacts more slowly with hydrochloric acid than sodium bicarbonate, with a
Side effects of the medications used to treat motion sickness include sleepiness, dizziness, dry mouth, or urinary retention. Diphenhydramine and dimenhydrinate are histamine H1 antagonists with both antiemetic and sedating effects. Meclizine is less sedating and may be used for prevention of motion sickness and cases of vertigo. Hyocine (scopolamine) is one of the most effective treatments for the prevention of motion sickness. Side effects from oral administration are reduced significantly by administration in the form of a transdermal patch (Takov & Tadi, 2023). Massaging the pressure point of pericardium has been studied to significantly help nausea and in particular motion sickness symptoms. The point is found on the wrist in- between the major tendons. Applying repeating pulsing pressure and small circular movements directly to the point for a couple minutes is the most effective way to massage this point for individuals that suffer from motion sickness. Motion sickness bracelets use pressure of a button directly on this point to relieve symptoms (Memorial Sloan Kettering Cancer Center, 2022). Inflammatory bowel disease (IBD) Inflammatory bowel disease (IBD) is the general name for diseases that cause inflammation in the small intestine and colon. Inflammatory bowel disease (IBD) refers to two distinct disorders: Crohn’s disease and ulcerative colitis. The cause and progression of both is still largely unknown. Crohn’s disease (regional enteritis) is a condition of inflammation of the mucosa in the large intestine, and more commonly, the ileum of the small intestine. Accumulation of scar tissue may lead to poor absorption of nutrients, with symptoms including abdominal pain, diarrhea, nausea, and fever. The cause is unknown, but there may be a genetic component or predisposition (CDC, 2022). Abdominal massage has given many sufferers from IBD both immediate and long-term relief from symptoms. Working the abdomen with small circular pressures following Gastrointestinal medications According to Almario et al. (2018), approximately 61% of people experience regular GI symptoms. Gastrointestinal medications are widely used and available over the counter and by prescription, and most patients wouldn’t think twice about omitting their use of a common antacid on their intake form when coming to receive therapy. Educating them on the interactions between manual therapy and certain medications, as well as specific benefits of manual therapy for certain GI conditions, is an integral part of a treatment plan to accommodate and aid your patients. There are several categories of hyperacidity medications. Hyperacidity conditions are caused by an overproduction and stimulation of stomach acids that results in the destruction of the epithelial cells that line the stomach and intestine. Antacids, H-2 receptor antagonists, mucosal protectants, antiflatulants, and proton pump inhibitors are all examples of commonly used hyperacidity medications. These categories make up a large portion of medications to treat GI disorders. Antacids Antacids neutralize stomach acids and are used to treat heartburn. Calcium carbonate is a common example of an antacid that is widely available over the counter, and safe to use for almost every population who is suffering from heartburn, indigestion, or upset stomach. Side effects are minimal, but constipation can occur. There are no known interactions between manual therapy and antacids (Cleveland Clinic, 2022). Antacids have a long history of nonprescription use in individuals with acid-peptic disorders and were the primary
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