Carondelet Health Network

Carondelet Health Network

Abdominal Massage for

Increased Bowel Motility

Constipation can be defined as decreased frequency or increased difficulty of moving the bowels. Patients often complain of feeling the need to strain to move their bowels. Abdominal Massage has long been used to increase bowel motility for those with constipation. Factors that decrease bowel motility may include decreased activity levels, medications, bed rest, and the pregnancy-related hormone progesterone.

The large intestine is a tube shaped organ made of smooth muscle. The muscles contract in response to the pressure of food and move it along the tract. The muscles also contract in response to external pressure caused by daily activities (walking, bending, reaching). Decreased physical activity may increase the time that material moves through the tract resulting in constipation. Abdominal massage is a way recreating the external pressures along the tract, which stimulates intestinal contractions and helps move the food through. Daily abdominal massage helps increase frequency and ease of moving the bowels

Contraindications:

1.  Known or suspected bowel obstruction.

2.  Large abdominal mass, unless given physician approval.

3.  Abdominal radiation in past six weeks

4.  Recent abdominal surgery.

5.  If advised against massage by physician.

Technique:

Recommended you wait at least an hour after eating. Can be performed at night before bed or first thing in the morning. If you experience pain or bloating after meals, you can perform a gentler version this technique with slightly less pressure immediately after eating.

Lie on your back and place a pillow under your knees if comfortable. Or position yourself in reclined sitting or side-lying.

Massage in small circles with enough pressure to slightly indent the skin.

1.  Start just inside the RIGHT hipbone. Work your way up stopping just below the rib cage.

2.  Travel ACROSS the abdomen to the left underneath the rib cage. Avoid the xyphoid (small piece of cartilage at the bottom of the breast bone).

3.  Continue down the LEFT side staying just inside the left hipbone.

4.  Move back over to your starting position and repeat steps 1-3.

5.  Continue making circles along this horseshoe-shaped path for 5-10 min. Repeat as needed throughout the day.

Adapted from Harrington K, Haskvitz E. Managing a patient’s constipation with physical therapy. Physical Therapy. 2006;86:1151-1159.