Gut health has recently gained popularity in the field of medical research. We’ve known for quite some time that the gastrointestinal system contains its own complicated neural network (the enteric nervous system) and contains our microbiome. However, the importance of keeping this system healthy has only recently been brought to light.
Furthermore, many schools of thought have developed in the past decade to provide guidance on how to ensure that our complex GI systems function optimally.
- and various other techniques have all been proposed for the care of GI conditions such as irritable bowel syndrome (IBS).
Naturally, each of these interventions (or a combination) seems to work well for both the prevention and the management of IBS.
While we touch on some of the other methods for managing IBS, the focus of this piece is primarily on how massage can benefit those who suffer from the condition.
Throughout history, IBS was a somewhat elusive disorder that physicians found hard to diagnose. Luckily, in the past few decades, researchers have developed and refined a method for diagnosing the condition. One of the most widely accepted diagnostic tools for IBS is the Rome Criteria.
The Rome Criteria
The Rome Criteria is a detailed diagnostic method, and interested readers can find more information about it here. Since its inception in the 1990s, the Rome system has gone through four different iterations, with each version providing more specific criteria.
For our purposes, we can say that IBS is diagnosed by specific changes in the frequency with which a patient needs to defecate and in the appearance of their stool. Additionally, consistent abdominal pain is a hallmark sign of the condition.
In 2015, a blood test was developed for detecting IBS. The past few years of study on this blood test have been promising, but more research is still needed to better refine this tool.
Some physicians and GI specialists will use other methods to diagnose the condition. Doctors will, on occasion, even make a diagnosis based purely on patient history and their subjective reports.
In the end, as long as more serious conditions (such as cancer) are ruled out, GI specialists can often help patients find ways to safely manage their inflammatory gut condition. We will review some of these treatment and management methods in the following sections.
Surgical Treatments for IBS
In the past, surgeons would often suggest surgery for patients suffering from IBS. Surgeries could vary widely: from appendectomies to bowel resections. Fortunately, providers have largely moved away from these unnecessary surgeries. This is thanks, in large part, to a better understanding of the condition and of safer ways to manage it.
Medicinal Treatments for IBS
There are quite a few medications available for the treatment of irritable bowel syndrome. These medicines are available both over the counter and with a prescription. However, with each of these treatments come various side effects and potential complications. For this reason, many practitioners have begun to point patients toward alternative therapies, such as those indicated in the following sections of this article.
Dietary Changes for IBS
If you perform a quick Google search for “diets to help with IBS”, or a similar query, you’ll be directed to over 6 million different resources. While some of these sources may converge and offer similar recommendations, many of them will suggest diets that are completely in opposition to one another.
For instance, some sources will recommend a carnivore diet. Others will recommend a vegan diet. Still, others will point patients toward ketogenic diets, Mediterranean diets, and a plethora of others.
Unfortunately, it’s hard to give a general recommendation on what will work best for this complex condition. Perhaps the best advice is to work closely with doctors and dieticians to determine if there are any foods that cause the patient in question particular discomfort. From there, the patient can begin to eliminate these problematic foods from his or her diet.
This methodology (of eliminating groups of foods to determine what is causing the issue) is the basis of the Low-FODMAP diet. The Low-FODMAP diet has been promoted as being particularly effective for helping with symptoms of IBS.
Exercise for IBS
As is the case with nearly every condition, exercise is extremely beneficial for those who suffer from IBS. The exact dosage and mode of exercise for optimal results is still up for debate. However, a good place to start is to follow the ACSM exercise recommendations for healthy adults. For cardiovascular exercise, the ACSM recommends that patients perform moderate-intensity activity for 150 minutes a week.
From here, patients can increase their exercise volume and/or intensity as needed.
Massage Therapy for IBS
As was stated earlier in this article, there are many different proposed healthcare options for IBS. However, those that have tried exercise, dietary changes, medication, and other therapies without success may be missing a key option: massage.
Is Massage Safe for Those with GI Conditions?
When massages are performed by vetted professionals, there is very little risk of long-term (or even short-term) consequences. As compared to invasive surgeries and most medications, massage poses almost no risk to clients whatsoever.
As far as contraindications and precautions are concerned for this client population, massage therapists should follow typical guidelines and identify any potential red flags. For instance, if a client is displaying signs and symptoms of cancer (especially in the colorectal region), the massage therapist should direct the client to their physician for clearance.
Some signs that might indicate that the client is developing a more serious disease process include:
- recent weight loss
- a palpable/visible lump
- and reports of rectal bleeding.
All in all, if the client has been diagnosed with IBS and has signs and symptoms consistent with the disorder, massage can be a safe treatment method.
If the client has symptoms that seem concerning, or the massage therapist identifies any red flags, the client should be referred to his or her doctor before receiving a massage.
For massage therapists who are unfamiliar or uncomfortable with abdominal massage techniques, or don’t feel comfortable identifying red flags, there are many continuing education courses and resources available.
What Massage Techniques Work Well for IBS?
Unfortunately, there is a dearth of research pertaining to massage for IBS in particular. That being said, abdominal massages, which gently stimulate the digestive system in an anterograde direction, seem to work well for GI discomfort and disorders. Specifically, this systematic review found that abdominal massages work well for constipation, a frequent symptom associated with IBS. This is an important finding, as this type of massage can be taught to clients who can then perform self-treatments at home.
In pointing the client toward resources for self-treatment at home, those massage therapists can avoid any liability issues. Furthermore, this can be an appropriate decision for MTs who don’t feel comfortable performing this type of massage themselves.
It’s important to also note that IBS is often associated with high levels of stress. For this reason, relaxing, total-body massages may also have a positive impact on the client’s condition.
The massage therapist should carefully consider:
• client history
• treatment methods
• and goals when working with a client who suffers from IBS.
6 Steps to Performing an Abdominal Massage
Importantly, abdominal massages should always be performed in an anterograde (in this case, clockwise) direction. To properly target the colon, the massage therapist (or the client) should follow the steps listed below.
- Applying gentle, even pressure in small circles, start at the bottom right portion of the abdomen, near the pelvis (the ASIS specifically).
- Slowly and gently move upwards until encountering the ribs on the right side (it should take roughly a minute to get from the right lower abdominal area to the ribs).
- From here, begin moving left across the abdomen, all the while maintaining light pressure and creating small circles (this should take another minute to arrive at the left upper side of the abdomen).
- Continue in the same way until reaching the left lower region of the abdomen. From here, you’ll move toward the naval to complete the cycle.
- Repeat this massage process for at least ten minutes in total.
- The massage should be pain free.
In your research, you may come across different protocols which outline various amounts of time spent on the abdominal massage. You may also find slightly different techniques. Again, as long as there is no pain, no red flags, and the massage is performed in the appropriate direction, there is little risk inherent in this or any other type of massage.
Can Massage Be Used in Conjunction with Other Therapies for IBS?
IBS is a complicated condition that requires a complicated, multifactorial solution. Some people might firmly believe that there is only one way to treat IBS, but the scientific consensus refutes this claim.
• healthy diet
• stress reduction techniques
• and massage are all excellent, low-risk options for improving symptoms of IBS.
Granted, there may be medications that are appropriate for some cases of IBS, and clients should always consult with their doctor before trialing any new treatments. But in many cases, IBS responds well to a holistic approach.