Inflammatory Bowel Disease (Gastrointestinal Pathologies)

Question 1

What is Inflammatory Bowel Disease?

Answer 1

It is used to identify two conditions:
1. Ulcerative colitis

2. Crohn’s disease

These diseases commonly begin to affect people between the ages of 15-20 and other people in their mid 50’s-60’s

Both diseases can affect multiple systems in the body and cause peripheral arthritis, arthralgia, myalgia and obstructive pulmonary disease

Question 2

Cause

Answer 2

The cause of these conditions is unknown, although there is a familial tendency (family member)

Question 3

Ulcerative Colitis

Answer 3

1. Results in a broad area of ulceration in the mucosa of the left colon and rectum
2. Periods of pain and bloody diarrhea, up to 20-30 times/day, alternating with remission
3. Other symptoms include nausea, vomiting, anorexia and weight loss
4. There are varying degrees of severity from mild to severe
5. The majority of people have the mild form
6. Serious complications such as toxic megacolon which is dilation of the colon that leads to systemic toxicity can occur
7. Over the long term, there is increased risk of colon cancer
8. Medically it is managed with medication and possibly surgery to remove ulcerated areas

Question 4

Crohn’s Disease

Answer 4

1. Results in multiple, patchy ulcerative lesions which may affect any part of the GI tract
2. These cause scarring and thickening of the bowel
3. If the lesion penetrates the bowel, abscesses result
4. The ileum of the small intestine and the ileocecal area of the colon are most commonly affected
5. All layers of the intestinal wall may be affected
6. The recurrent inflammation results in scarring and thickening of the affected areas
7. Rectal bleeding is less common initially
8. Symptoms are more painful compared to ulcerative colitis
9. Pain may diminish after a bowel movement or release of gas
10. Intermittent diarrhea, weight loss, malaise, low-grade fever and nutritional deficiencies occur
11. Complications include intestinal obstruction and abdominal abscesses
12. Eventually, the majority of those with Crohn’s disease require surgical intervention to address complications
13. Medically, management is through nutritional supplements, diet modification stress management and medication

Question 5

Contraindications

Answer 5

1. During a flare-up, any treatment of the abdomen or low back is CI’d
2. Vigorous or deep work to the abdomen or low back is generally
3. CI’d due to the ulcerative and inflammatory nature of these diseases
4. Arthralgia and myalgia may be more severe if medication to control intestinal inflammation is suddenly reduced. Modification of pressure and vigour of techniques may be necessary

Question 6

Health History Questions

Answer 6

Has the condition been diagnosed by a physician?

How long have you had the condition?

Are there any complications or are other areas of the body affected?

What treatment has been received?

Are you on any medications?

Have you had surgery for this condition?

What symptoms are you experiencing?

What exacerbates your symptoms?

What relieves your symptoms?

Question 7

Testing

Answer 7

Performance of the rebound test will be negative for irritable bowel syndrome

Question 8

Massage

Answer 8

The focus of the massage treatment is on stress reduction and relaxation

Gentle vibrations and rocking to the sacrum will help to decrease SNS firing

If the client is not experiencing a flare-up, gently and soothing abdominal techniques are performed

Question 9

Self-Care

Answer 9

The client may be referred to a bowel disease specialist

A nutritionist or naturopath can assist in dietary modifications

Encourage stress reduction techniques