BodyWork: Case Studies
Constipation
Patient: 5 year old male seen in the Pediatric Emergency Room (“Jorge”)
History of Present Issue (HPI): This child first came to the emergency room a couple weeks before due to abdominal pain. He was diagnosed with constipation and discharged with a prescription of Miralax. Jorge became very distressed after having some laxative-related diarrhea and the Miralax was stopped by his parents. He has come back to the emergency room today with similar abdominal pain and nausea, and has refusing to eat or drink for 2 days. Jorge also has fears of going to the bathroom or taking additional medications that might cause more diarrhea— he has not had a bowel movement in 5 days.
Signs and Symptoms (S/S):
Distended abdomen with discomfort on palpation, significant stool felt in all abdominal quadrants
Refusing to eat or drink for 2 days due to nausea and abdominal pain
Has not had a bowel movement in 5 days
Plan & Outcome:
Provider ordered an enema
Jorge is already fearful of medical procedures and taking additional medications, it is likely that that an enema would be both invasive and emotionally traumatic for him.
Jorge and his father agree to abdominal bodywork treatments before attempting an enema
Treatment included:
Jorge was given Zofran to address nausea
2 sessions (~15 minutes) of abdominal bodywork, followed by drinking approximately 500 mL water, parent was then advised to take child to the bathroom to attempt a bowel movement
Whilst in the bathroom patient was audibly distressed due to fears of diarrhea, he did not have a bowel movement
An additional 15 minute of abdominal work was applied
Shortly after Jorge defecated successfully and was able to discharge without enema
Parent was instructed on how to apply additional bodywork treatments at home
Acid Reflux
Patient: 7 year old female seen in the Pediatric Emergency Room (“Brea”)
HPI: Brea came in with chest pain and nausea. She was seen by her pediatrician 2 weeks ago and diagnosed with acid reflux, with recommendations for dietary changes and medications to take at home which did not help her pain. Mom brought Brea to the emergency room concerned about her chest pain because it was more intense than usual and was not getting relief since it started the night before. Mom had become concerned that her daughter may have a problem with her heart.
S/S:
Brea’s EKG was normal and there were no concerns for heart-related chest pain
Her chest pain was on the left and right side and Brea stated that it feels the same as the pain she usually gets, but said that it feels worse. Brea and her mom stated that this pain is typical for her after eating or while laying down, but was different that day because it was more constant.
Brea states that the night before she had thrown up a little, “spitting up” vomit has been usual for her since she was a baby. Mom states when Brea was a newborn she used to worry about her having choking episodes after eating.
On assessment it was found that Brea often has hiccups
Before the treatment, Brea was completely unable to tolerate laying flat on the bed at all due to intense chest pain
No abdominal distention was found, mom reports Brea has normal bowel movements
Tension is noted in Brea’s upper abdomen below her sternum
Plan & Outcome:
One 20 minute abdominal treatment was applied including some lower abdominal work. During the treatment Brea experienced some pain in the area of tension below her sternum and to the left side under her rib cage. Diaphragmatic release work was applied. Gradually, Brea was able to tolerate lowering the head of the bed until she was completely flat and not experiencing any more pain. Education and a treatment plan was provided to mom so they can continue the therapy at home.