Gastrointestinal Conditions

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How can the massage therapist assist the client with gastrointestinal discomfort? The massage therapist can use pillows or bolsters to increase the client’s comfort. The therapist can also ensure that the client’s body position is comfortable. The therapist might even need to avoid massaging the client’s abdomen. *— If the client has a colostomy or ileostomy, the therapist should advise the client not to eat for the 2 hours prior to the client’s massage appointment. Using the side-lying position and placing an extra pad under the massage linens can also help accommodate these clients. When should the massage therapist proceed after the palpation of a hard abdominal mass? The massage therapist can proceed with the massage, avoiding the abdominal region until the source of the mass is determined by the client’s health care provider. A mass in the descending or sigmoid colon region is probably a stool, but it could be an indicator of something more serious. *— The images on this slide demonstrate how to test for rebound tenderness, which can indicate the presence of appendicitis or peritonitis, both of which require immediate medical attention. Is a colostomy necessarily permanent? No, it is sometimes a temporary bypass method used in conjunction with other surgeries. *— What should the massage therapist do if a spill occurs? The massage therapist should remain calm, assure the client that these things sometimes happen, and offer to assist the client in cleaning up the spill. *— Massage therapists should avoid getting lubricant on or near the bag opening. What are the differences among the three main body types? Ectomorphs tend to be long and lean, with little body fat or muscle. Endomorphs tend to have more adipose tissue and gain weight easily. Mesomorphs tend to be athletic and have a good balance between adipose and muscle tissue. Massage therapists should be able to effectively massage clients with any body type. How should the massage therapist approach working with skin folds on clients who have experienced recent weight loss? The massage therapist should avoid pinching these areas or working them deeply. Folds can be moved to the side or flattened out during work on adjacent muscle. *— The massage therapist needs to be aware of mechanics and efficiency when working on larger clients. It can help to lower the table height or stand on a small platform in order to gain leverage. If the client has any of these disease manifestations, the client should be referred to a health care provider for diagnosis and treatment. Rebound tenderness is the discomfort felt as the fingertips are lifted off the abdomen rather than during application of pressure. How is massage helpful for clients with anorexia nervosa? The massage therapist needs to obtain clearance from the client’s health care provider first, especially for clients with severe symptoms, but a gentle nurturing massage can be a helpful adjunct to psychological counseling. Massage can also help to improve the client’s self-image and decrease anxiety. What causes appendicitis? Appendicitis is caused by an obstruction of the hollow center of the appendix or an abnormal narrowing or kinking of the organ. *— Why is massage contraindicated? Massage is contraindicated because clients with appendicitis require immediate medical attention. Bulimia is classified as both an eating and an emotional disorder, and it is generally treated by psychological counseling. *— Massage can help decrease the client’s anxiety. *— Is massage indicated if the client has chronic cholecystitis? If the client has chronic cholecystitis and the pain is not severe, then general massage can be performed. However, the massage therapist should avoid the abdominal region. Why is massage contraindicated in clients with cirrhosis of the liver? Massage is contraindicated because it increases the fluid returned to the blood from edema and/or ascites, which would further tax an already debilitated liver. An impaired liver also increases the chance of bruising, since the liver synthesizes many clotting factors. The massage therapist should ascertain the cause of constipation before proceeding with massage therapy. If the constipation is not due to diverticulitis, then abdominal massage can help relieve constipation by stimulating the forward movement of intestinal contents using gliding strokes, kneading, and vibration. What are some massage considerations in clients with Crohn’s disease? Because symptoms can vary, the massage therapist should ask the client about current symptoms before beginning massage. The abdomen should be avoided, a side-lying position might be required, and an ileostomy could be involved. The massage therapist should ascertain the cause of diarrhea before proceeding with massage therapy. If clearance has been obtained from the client’s health care provider, then general massage can be performed, avoiding the abdominal region. Is massage indicated if the client has chronic gallstones? If the client has chronic gallstones and the pain is not severe, then general massage can be performed. However, the massage therapist should avoid the abdominal region. Chronic gastritis is generally an indication of an underlying illness, such as an ulcer. Therefore massage can be performed on clients who have chronic gastritis. However, the therapist should do the following: avoid the client’s abdomen if it is sensitive and elevate the client’s head slightly to aid in digestion. If gastroenteritis is caused by psychological factors or by eating food that is irritating, then massage can be performed. The massage therapist should help the client find a comfortable position to lie on the table, perhaps elevating the head, and avoid the client’s abdomen if it is sensitive. How can the massage therapist assist a client with GERD? The client should be urged not to eat a large meal in the hour before the massage appointment; the head of the massage table should be elevated to aid digestion; a side-lying position can be used to help the client feel comfortable; and the abdomen should be avoided if it is sensitive. Can massage be performed if the client has chronic hepatitis? If a client has chronic hepatitis, massage can be performed if clearance is obtained from the client’s health care provider. However, even with clearance from the client’s health care provider, abdominal massage is contraindicated because it can put undue pressure on the liver. HAV can have complete recovery, and infection provides lifelong immunity. HBV can cause rapid death or chronic disease. HCV can lead to liver cirrhosis or failure. HBV and HCV can both lead to cancer. HDV occurs as a coinfection with HBV and is responsible for half of all total liver failure cases. HEV resembles HAV and usually occurs in epidemics in the Middle East or Asia; it can be fatal in pregnant women. What types of hernias are pictured on this slide? The hernia on the left is a hiatal hernia. The hernia on the right is an inguinal hernia. General massage can be performed, but only if the client is not in pain. However, local massage is contraindicated. Intestinal obstructions can be caused by adhesions from past surgeries, impacted feces, or tumors, but most are due to mechanical reasons. *— Why is massage contraindicated? Massage is contraindicated because intestinal obstruction is a serious condition that requires medical attention. How can massage therapy help clients with irritable bowel syndrome? Massage can help reduce stress, but it should be undertaken carefully. The massage therapist should ascertain the current severity of symptoms, propose a side-lying position, and avoid the abdomen. Where can the distinctive yellow discoloration of jaundice appear on the client? The yellow discoloration of jaundice can appear in the skin, mucous membranes, and sclera of the eyes. *— Why is massage contraindicated? Massage is contraindicated for clients with jaundice because of the potential negative impact on the already debilitated liver. What are the symptoms for mumps? The symptoms for mumps include the following: enlargement of the parotid salivary glands, fever, and extreme pain during swallowing. *— Why is massage contraindicated? Massage is contraindicated in cases of mumps because it is contagious. If massage is not contraindicated for other reasons, it can be performed on the obese client. *— What are some important massage considerations for obese clients? A nonjudgmental attitude is important. The therapist needs to distinguish between adipose and muscle tissue to avoid causing bruises. The therapist will also need to do extra work on muscles that have become overdeveloped to support the client’s weight. Larger draping is required, and the massage therapist should consider lowering the table or standing on a small platform for better leverage. Is massage contraindicated for clients with chronic pancreatitis? For clients with chronic pancreatitis, the massage therapist needs to obtain clearance from the client’s health care provider. If clearance is obtained, massage is permitted, but abdominal massage should be avoided. What are some of the ways that bacteria and other irritating substances can gain access to the peritoneum? Bacteria and irritating substances can be introduced into the abdominal cavity by a ruptured organ, penetrating wound, perforation of the gastrointestinal or urogenital tract, or a ruptured appendix. *— When might massage be indicated? If clearance is obtained from the client’s health care provider, massage can be performed in a hospital to reduce stress and pain. If the cause of pharyngitis is not an infection, can massage be performed? Yes, massage can be performed if the pharyngitis is not due to an infection. If the polyps are noncancerous, is massage permitted? If the polyps are noncancerous, massage can be performed, but the affected area should be avoided. What are some massage considerations in clients with ulcerative colitis? The symptoms can vary, so the massage therapist needs to ask the client about current severity of pain and other symptoms before proceeding with massage. It is also important to help the client find a comfortable position to lie on the table and to avoid abdominal massage.

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3 Responses to “Gastrointestinal Conditions”

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