resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
October, 2010, Vol. 10, Issue 10
Managing Irritable Bowel Syndrome
By Leon Chaitow, ND, DO
This brief review of irritable bowel syndrome (IBS) management suggests that there are possible biomechanical, behavioural, as well as dietary strategies, that can commonly be helpful. IBS has been defined as abdominal pain, experienced more than once a month, associated with bloating and altered bowel habits.(Moore & Kennedy 2000) By definition, IBS is functional, that is, there is no infection or pathology associated with it. (Abrams et al 2002) It is more common in women than men, and is often associated with other chronic pelvic pain (CPP) symptoms. When IBS is chronic, core muscles (e.g. pelvic muscles) may become hyperalgesic with multiple trigger points. (Fall et al 2010)
Tak & Rosmalan (2010) discuss the role of the body's "stress responsive systems" in what has been termed functional somatic syndromes, such as IBS, as involving a "multifactorial interplay between psychological, biological, and social factors." Therefore, there is a need to move beyond a search for single causes of most conditions such as IBS, since, like many other complex and difficult-to-treat conditions, they commonly have multi-factorial aetiological features - possibly interacting with predispositions and altered stress-coping functions.
Beales (2004) has described a scenario that highlights multiple contributory factors to functional somatic syndromes: "Too much sustained, [stress] leads to the loss of internal balance, and results in reduced performance and a mind-body system in overdrive. In this state, the metabolism is struggling and cholesterol, blood sugar and blood pressure are often raised, resulting in ill health ... for instance, sufferers from irritable bowel syndrome may also commonly experience back pain, fatigue and loss of libido. Negative emotions, such as frustration and despair, can trigger exhaustion, which in turn can trigger breathing pattern disorders, as a consequence of the perceived threat to survival eliciting fight, flight or freeze reactions."
Massage offers a highly suitable stress modulating approach. (Moraska et al 2008)
Overbreathing & Colon Constriction
Ford et al (1995) have reported on the high incidence of increased colonic tone and dysfunction in hyperventilating individuals. Hypocapnic hyperventilation (low CO2 blood levels) produces an increase in colonic tone, and phasic contractility in the transverse and sigmoid regions. These findings are consistent with either inhibition of sympathetic innervation to the colon, or the direct effects of over-breathing on colonic smooth muscle contractility, or both.(Chaitow 2007)
Prather et al (2009) expand on these relationships, in review of the anatomy, evaluation, and treatment of musculoskeletal pelvic floor muscle (PFM) pain in women.
They note that persistent muscle contraction of the pelvic floor, related to noxious visceral stimulation, such as that deriving from endometriosis or irritable bowel syndrome, can lead to splinting and pain, with reduction of normal PFM function. Specifically, they report that viscerosomatic reflex activity may be responsible for increased resting tone of the pelvic floor with reduced ability to fully relax the muscle group as a whole. As a result, they suggest, adaptation occurs via recruitment of global muscles in the region (e.g. psoas and iliacus) leading to symptoms such as posterior pelvic and low back pain. Prather et al also point out that: "Proper breathing techniques, while performing exercises and activities, are essential for pelvic floor relaxation ... pelvic floor contraction during exhalation allows for synergy between the pelvic and respiratory diaphragms."
This is also a key to assisting IBS dysfunction.
In a comprehensive review of the subject Heizer et al (2009) suggest that dietary changes are worth attempting in an effort to relieve irritable bowel syndrome (IBS) symptoms. It is recommended that dietary restrictions should be introduced one at a time, beginning with any food or food group that appears to cause symptoms based on a careful patient history or review of a patient's food diary. The most effective duration for dietary trials has not been well studied, however 2 to 3 weeks is commonly suggested. A modified exclusion diet, followed by stepwise reintroduction of foods is likely to be more effective in finding problem foods, but it is more time-consuming.
General dietary recommendations for patients with IBS, based on clinical experience and anecdotal reports (Heizer et al 2009) include:
Research suggests that use of peppermint oil, particularly in cases of relatively mild IBS is likely to be of benefit in symptomatic treatment of IBS. (Capello et al 2007)
While some studies have shown potential benefit for use of turmeric (curcumin) in treatment of IBS (a member of the ginger family of plants), no placebo-controlled studies have been conducted. (Heizer et al 2009)
The conclusion of a review of the evidence for use of probiotics in both IBS and inflammatory bowel disease are cautiously positive.(Iannitti & Palmieri 2010) Two meta-analyses (Nifkar et al 2008, McFarland & Dublin 2008)) and two comprehensive narrative reviews (Wilhelm et al 2008, Spiller 2008) on the use of probiotics in the treatment of IBS. All concluded that probiotics may be useful but there are many variables affecting the results such as the type, dose, and formulation of bacteria comprising the probiotic preparation, the outcome measured, as well as size and characteristics of the IBS population studied.
IBS is common. Patients with this condition may respond well to stress reduction, better breathing patterns, biomechanical normalisation (pelvic structures) and trigger point deactivation. For more on the topic of pelvic pain in general, enhanced breathing strategies, and manual therapy, go to: www.leonchaitow.com, or blog: http://chaitowschat-leon.blogspot.com.
Click here for more information about Leon Chaitow, ND, DO.
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