Digestive disorders

CHAPTER 12 Digestive disorders

Common digestive disorders

Many patients who come for Tui na treatment have digestive problems as part of their presentation. Common complaints include:

• Irritable bowel syndrome (IBS)

• Constipation

• Epigastric pain

• Abdominal pain

• Acid reflux

• Belching and flatulence

• Hypochondriac pain

• Poor appetite

Factors in common digestive disorders

The causes of these ailments are generally a combination of factors such as dietary inadequacies and excesses, irregular eating patterns, overwork and stress. Any combination of these lifestyle factors can lead to deficiency of Qi, Blood, Yin and Yang and to stagnation of Qi and accumulation of Heat, Cold and Damp.

Other factors in common digestive disorders

The small intestine

Sometimes known as the abdominal brain, the small intestine sits at the foot of the heart, sifting and sorting, absorbing what is useful, and passing on what is not to the large intestine and bladder to be excreted. This applies to thoughts and emotions as well as to nutrients. If you practice in a big city as I do, patients often report feeling overwhelmed, having too much to do, too much work, not enough time to reflect; they feel pushed by the general energy around them and find it very difficult to relax. Generally, there is a feeling of being hyper-stimulated. In attempting to deal with all of this mental and emotional energy information, the small intestine, and consequently the large intestine, can become tense, tight and knotted, much in the same way as our shoulders develop tension and congestion when we are stressed and pushing our Qi too hard.

On palpation, the small intestine should feel soft and move easily and painlessly; often however, it feels tight, knotty and uncomfortable on palpation. As well as affecting the digestion, knotted and compromised intestines can lead to various problems such as menstrual disorders, emotional problems and back pain. Tui na is very effective for releasing these areas of stagnation and accumulation.

Suggested methods for releasing stagnation of Qi manifesting as accumulation, adhesion and knotting in the abdomen

The abdomen is a sensitive area and this work can get quite deep and be a bit uncomfortable both physically and emotionally. Always start by working initially on the patient’s back and chest. Old traumas can be held in the small intestine, particularly around the navel, and powerful release work can be done by freeing up the accumulated and stagnant emotional Qi. The following method is suggested:

• Start with Mo fa using the pads of your index, middle and ring fingers. Work from the navel out in small anti-clockwise circles.

• Moving slightly deeper, work in the same manner as above using Rou fa, feeling for areas of knotting, tightness and congestion and asking your patient to let you know of any tender or painful areas. Apply this three times.

• Go back to the knotted areas that you found and begin to disperse them with fast anti-clockwise Rou fa, Zhen fa and Ji dian fa.

• With both palms over the area of the small intestine, apply Rou fa in a wave-like motion, as if rolling a ball that is inside the patient’s belly, between your hands.

• Bring the ulnar edge of your palms to beneath the patient’s ribcage, fingers just below the sternum, and use Rou fa to release the diaphragm, thinking of drawing it down towards the navel.

The navel

Ren8 – ‘spirit door’ – is a place that can provide an exit for stagnant accumulated pathogenic Qi. Releasing the area around the navel will help to release both physical and emotional traumas. The suggested method is as follows:

• Apply Ji dian fa and Zhen fa to the area all around the navel.

• Imagine eight doorways around Ren8, all 0.5 cun away. Think of them as representing the eight directions of a compass. Starting from the east at the doorway that corresponds to KD16 on the right, work around these points using An fa and Rou fa. Work with your patient’s breath, applying pressure with their exhalation to take you to the Ying Qi level, maintain the pressure at that level and apply anti-clockwise Rou fa, gradually kneading up to the Wei Qi level at the surface. Your intention is to draw the pathogenic Qi up and out of the body through the navel. Apply this method three times, dispersing with Zhen fa, Ji dian fa and Pai fa in between. The third time when you have pressed down into the Ying Qi level, maintain the pressure and stretch the underlying tissue slightly by pushing your thumb away from the navel. Ask your patient to breathe into the pressure then, as before, use anti-clockwise Rou fa to draw up to the Wei Qi level.

Working under the ribs

To help release the diaphragm, move stagnation in the Middle Jiao, and improve the functions of the lungs, liver, gallbladder, stomach and spleen, the suggested method is as follows:

• Work under the ribs, moving gradually from the area of Liv13 on the right to Liv13 on the left using An fa and Rou fa with both thumbs. Work with your patient’s breath, applying pressure with their exhalation. To provide deeper stimulation, ask your patient to breathe deeply into your pressure a few times.

General tips for treating digestive problems

• Work on the back first, the Governing Vessel, Bladder channel, sacrum and hips, any relevant Back Shu points, Governing Vessel or Huatuojiaji points.

• Work distally on the appropriate leg, and sometimes the arm channels, stimulating your chosen distal points as you work.

• Work the chest and ribs to soothe and disperse Qi using the basis of the area foundation routine.

• Work the abdomen last.

• Use the simple abdominal routine as a basis for your local work.

• If on palpation of the abdomen you found knots, adhesion and accumulation, consider using some of the abdominal release work.

To help you plan a Tui na treatment for digestive ailments, see Table 12.1 for some suggestions of useful techniques to consider including in the treatment of common patterns of disharmony.

Table 12.1 Suggestions for the treatment of digestive ailments

Presenting disharmony	Useful treatment techniques
Spleen-Qi Xu Spleen- and Kidney-Yang Xu	Lifting–grasping from the sacrum to the nape about 10 times Palm Ya fa plus Rou fa up the spine and over points on the abdomen Clockwise palm and forearm Rou fa over Back Shu points and Front Mu points Clockwise Mo fa along Yin channels of the legs Tai chi Mo fa on the abdomen Ca fa along the Bladder channel of the back and across Back Shu points Ca fa at KD1, Du14 and Du4 for Yang Xu Palm Zhen fa over points on the abdomen and back Direct and indirect moxa of points
Liver-Qi stagnation Qi stagnation in the intestines	Pinching–grasping and kneading–grasping along the leg channels Gun fa on the back, hips and the sacrum area Rou fa hips and the sacrum Tan bo fa over the Bladder channel Back Shu points Ya fa at GB30 Tui fa, Zhen fa and Ji dian fa to the chest Lifting–grasping the abdomen Striking techniques on the back and limbs Cuo fa to the ribs Abdominal release work Cupping on the back and abdomen Gua sha on the back channels
Accumulation of Damp	Pai fa and joined palm Ji fa to the limbs and back Pai fa to the abdomen Pinching–grasping leg Yin channels Dredging Tui fa along the leg channels Indirect moxa over the abdominal area and points < div class='tao-gold-member'> Only gold members can continue reading. Log In or Register to continue Share this: Click to share on Twitter (Opens in new window) Click to share on Facebook (Opens in new window) Related Related posts: Area foundation routines Muscular skeletal ailments External herbs Introduction to Section Three Ancillary therapies Basic techniques Stay updated, free articles. Join our Telegram channel Tags: Tui Na A manual of Chinese massage therapy Jun 22, 2016 \| Posted by admin in MANUAL THERAPIST \| Comments Off on Digestive disorders Full access? Get Clinical Tree Get Clinical Tree app for offline access Get Clinical Tree app for offline access