Studying the effect of abdominal massage on the gastric residual volume in patients

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Gastric residual refers to the volume of fluid that remains in the stomach every time during an enternal nutrition feeding (direct to the stomach). Nurses can withdraw the fluid through a feeding tube by pulling back on a plugger of a large syringe (usually a 60 Ml) at intervals at intervals ranging from 4-8 hours. The nurses or someone in the team that is taking care of the critically ill patient should ensure that they replace the residual fluid into the stomach of a patient to prevent loss of electrolyte, fluid and nutrients.

Gastric abdominal massage is one of the ways to decrease gastric residual volumes. It is an external practice that aims at shifting internal organs that could have changed the location to restrict blood flow, body chi and lymphs .it help to release more than the physical tension by also one that occurs because of spiritual and mental strain. Releasing the tension opens up the energy pathways and flow of chi in the body.

Critically ill patients cannot eat sufficient quantities of food to satisfy the nutritional needs. The doctors at this time may decide that feeding should take place through a tube that is inserted into the stomach or small bowel to provide enough nutrients.

There is various tube feeding formulas in the market made by different companies with ingredients that meet 100 per cent of the nutritional needs by the patient. This feeding can go on continually for some hours at any time of the day at a specific rate. The delivery is by a pump or sometimes several times of measured amounts within the day. Adequate nutrition depends on right amount and type of formula.

Sickness or injury might cause an increase in the need for energy, protein and metabolic rate to promote healing by providing more nutrients. Muscle damage is also common at this stage because there is a limitation to mobility at this time. Many people with severe injuries such as those of the spinal cord lose a significant amount of muscle when they first get an injury. The body needs for protein and calories will decrease in a few months after the injury and care providers should adjust the tube feedings to prevent unwanted weight gains.

It is important to monitor the body weight and know the weight goals. It is essential for a doctor or registered dietician to provide the tube feeding adjustment instructions after significant weight changes which are a loss or gain of over two pounds in a week. It is also essential to seek the counsel of adjusting the tube feeding after clearance to eat by a specialist.

A healthcare provider has the responsibility to prescribe the feeding schedule, formula and the amount of water necessary for optimal hydration and nutrition.

How Widespread Is Abdominal Massage Practice

It is not many people who know about abdominal massage compared to other types of massage. It is a restorative and healing process that has shown to have many benefits for individuals in need of a holistic approach to the wellbeing.

Role of Abdominal Massage In Decreasing Gastric Residual Volumes In Critically Ill Patients

Gastrointestinal dysfunction is one of the problems that affect critically ill patients during their hospitalization in the intensive care units. Some of them even get constipation that affects their bowel movement.

The increase of bowel dysfunction among the critically ill has become common to the point of reaching up to 50%. Enternal feeding is a primary recommendation for the critically ill and mechanically ventilated patients but still can be a risk factor for aspiration.

More caregivers and health institutions are becoming aware that abdominal massage has the power to reverse such GI issues. The simple technique of massaging the stomach in a clockwise motion is proving to be very useful in helping to relieve the issues. It works better with incorporation of some reflexology point work on the abdomen, intestines and bladder.

Currently, abdominal massage is one of the non-medicinal methods that one can apply with or without therapeutic methods that have much acceptance. To prove the efficiency of abdominal massage on gastrointestinal functions, a clinical trial on 70 patients in intensive care and with an endotracheal tube.

The researchers used a convenience sampling method for random allocation to a control or an intervention group. The intervention group got 15 minutes of abdominal massage two times a day for three days, but the control group only got routine cares. The study team took records of the abdominal circumference, times of bowel movements, the frequency of constipation and gastric residual volume.

The results show that gastric residual volume had a significant decrease in the intervention group that got an abdominal massage. The control group that was receiving support care showed a significant increase in gastric residual volume. The intervention group also had more benefits in the form of an increase in defecation times and a decrease in the prevalence of constipation. The abdominal circumference in the intervention group also reduced more than those in the control group.

The findings show that the abdominal massage helps to improve gastrointestinal functions among the enternally fed patients with endotracheal tubes. The suggestion to those taking care of critically ill patients is that they should consider using abdominal massage as an adjunct therapy to improve gastrointestinal functions in intensive care patients.

Importance of Decreasing Gastric Residual Volumes with Abdominal Massage

Experts in critical patient care recommend early enternal nutrition (EN) as the first line of nutrition therapy in critically ill patients because it alters the outcome in the favor providing the nutritional and even non-nutritional benefits. However, the critically ill patients who are receiving mechanical ventilation are a high risk of pulmonary aspiration, regurgitation, and ventilator-associated pneumonia (VAP) if they stay long in this environment. EN can increase these risks when gastrointestinal dysfunction is present. It has a surrogate parameter in the Gastric residual volume (GRV) as the enternal feeding progresses in the early phase of the critical illness and even beyond. Clinicians who monitor GRV might detect patients with a delayed gastric emptying much earlier and intervene with strategies that will prevent or minimize VAP one of the most significant risks of EN.

The value of periodic GRV measurements regarding reducing VAP incidents is a frequent cause of debate in the past years. An increase of GRV threshold before interrupting the results of gastric feeding will cause marginal increases in the EN delivery.

Benefits of Abdominal Massage To Critically Ill Patients

Abdominal massage plays a significant part in reducing abdominal massage. The abdomen is a critical part of the body as it houses many vital organs including most of the digestive system. The digestive system can develop weaknesses as a result of illness. Living a sedentary lifestyle and failing to exercise enough can also contribute to weakness in the abdomen. Abdominal massage practice helps in toning and strengthening the muscles in the abdomen, and it helps to improve the digestive system tremendously. An abdominal massage helps in detoxification of the body. It is one of the recommendations for the success of a colon cleansing program.

Additionally, it also provides these other benefits.

1.The holistic and complete attention of the organs

Most people have never got an opportunity to receive abdominal or anterior chest work. Abdominal massage is an opportunity for the huge sections of the body that have not got attention to get of addressing their problems through touch. Clients who get the massage even at the commercial outlet when they are not ill say they feel lighter, calmer, more energized and with more integration. Patients get more benefits because their movement at the time is restricted.

2.Enhances intestinal functional

Some studies show that massage promotes peristalsis, helps to improve or prevent symptoms of constipation and soothes the minor intestinal discomforts. The partly mechanical effects help in moving intestinal contents for those people with various conditions including:

  • Parkinsonism
  • Neurological gut control
  • Spinal cord injury
  • High-stress level
  • Anxiety proneness

It also has neurologically and reflex-mediated effects to support simplicity and efficiency of the intestinal function.

3.Helps with other physical, mental and spiritual conditions

Abdominal massage provides benefits that go beyond the abdomen because the effect of massage reaches another region of the body to help with reducing anxiety, depression as well as eating disorders. Some of those who went for abdomen therapy due to GI issues also report that it reliefs lower back pain, post-childbirth syndromes and posture abnormalities showing that abdomen work has therapeutic qualities.

It is important to consider then contradictions and cautions of abdominal therapy. It is essential to do a study about the appropriateness of the massage therapy by examining the scope of practice and collaboration with other health practitioners as well as using the correct techniques for the practice.

More focus on the fact is essential considering the effects in the previous points which show strong indications that abdominal massage helps to manage and overcome various disorders above decreasing gastric residual volumes.

The Connection between Abdominal Massage, Gastric Residual Volumes And Wellbeing

The abdominal massage was until recently a new thing but fascination new information is now filtering through, and scientists are taking more time to learn about an enteric nervous system that is drawing a lot more interest due to connection and role. There might not much reach data massage connection with abdominal organs, but there is enough information to stimulate the thought process.

The enteric nervous system predates much development and independent features with some connection to the brain.

Limitations of Abdominal Massage Techniques

Although abdominal massage has numerous benefits for the critically ill patients who need everything that can reduce their gastric residual volumes, it is not everyone.

i.Inflammations

People with certain gastrointestinal tract disorders should not get an abdominal massage. It should also not take place in the presence of inflammatory intestinal conditions such as celiac disease, ulcerative colitis and celiac disease during the flare-ups.

Light, soothing abdominal massage helps but it should be without pressure to the abdomen if the recipient is hypersensitive. The touch should be lighter on someone who is in the first trimester of pregnancy. Some pregnancies are a no-go zone if they have elements such as placenta précis or anything that makes it high-risk pregnancy.

ii.Reproductive and high risk conditions

Some of the reproductive conditions including severe endometriosis and unstable ovarian cysts do not permit abdominal massages. It is always essential to consider if a medical condition is too risky for other procedures including the non-invasive massage.

Presence of less acute reproductive or gastrointestinal disorders such as abdominal surgeries, high –risk pregnancies or aortic complications require consultation and working in collaboration with a physician. Abdominal massage in such instances involves input by a massage practitioner who understands the medical repercussions and the necessary care but not someone who has primary massage education.

iii.Emotional and psychological factors

Some people have reservations about massage on their belly for other non-medical reasons. For instance, some people feel that it is undesirable or uncomfortable for someone to touch their abdomen because they consider it to be more of a private body part. Such arguments might seem weak in the face of the benefits that abdominal therapy can bring, but massage therapists have to respect these stances.

This list might not exhaust everything about the use of abdominal massage to decrease gastric residual volumes but with a little research and common sense will decide on the suitability of the procedure to be straightforward.

If a client who should benefit from the abdominal massage techniques or the family sets any boundary, the first step should be to provide information about the pros. The details and answers to questions might change the attitude after an increase of awareness and trust for the therapist. However, it would be unethical to pressurize the patient or family into accepting abdominal massage by portraying like it is the only way to promote healing.

Lessons about Abdominal Massage and GRV

Abdominal massage can decrease gastric residual volumes (GRVs) and abdominal circumference over time in select population in the critical care unit. Research and standardization for abdominal massage practice might provide clinicians with some additional tools to improve gastrointestinal (GI) functions and feeding among the critically ill.

It is a fair rating that many of the persons who have not got an abdominal massage during a critical illness that compels doctors to feed them via a tube is because the therapist s did not suggest the option. It could also be that their physicians were uncomfortable with the procedure due to real or overblown safety worries.

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