OMT for Cancer Patients After Bowel Resection
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Nicole Peña
OMT Minute: OMT After Bowel Resection
eVideo. In patients with colon cancer, OMT after bowel resection can reduce musculoskeletal symptoms, complications, and pain.
Patients with cancer typically have substantial somatic dysfunction that results from surgical procedures and treatment regimens, including radiation therapy and chemotherapy. Osteopathic manipulative treatment (OMT) can help reduce musculoskeletal symptoms, complications from treatment, and pain, and thus lead to earlier ambulation, shorter time to flatus, and shortened hospital stays.
In the video, we describe the application of 2 techniques for patients with colon cancer after bowel resection: release of the 12th rib via balanced ligamentous tension (BLT) and lumbosacral decompression with BLT. These OMT techniques, which should be applied to a patient in the supine position, may be safely and effectively used to improve respiration and postoperative ileus.
Postoperative patients may splint their breath or breathe in a shallow manner, limiting the motion of the diaphragm. However, diaphragm motion is important not only for aeration and prevention of atelectasis, but also for the movement of venous and lymphatic return from the abdomen and pelvis, including the colon. The diaphragm attaches anteriorly and laterally to the lower ribs at the costal margin and posteriorly attaches to the 12th rib as the lateral and medial lumbocostal arches or arcuate ligaments, covering the quadratus lumborum and the psoas muscles, respectively. By releasing the 12th rib via BLT, the operator can affect tension in the diaphragm via its posterior attachments and increase its overall excursion, helping to optimize intrathoracic and intraabdominal pressure gradients.
The parasympathetic innervation for the large intestine from the transverse colon onward travels via pelvic splanchnic nerves arising from the S2 through S4 ventral rami and enters the pelvic or inferior hypogastric plexus. In patients who have undergone bowel resection, lumbosacral decompression with BLT may assist the relief of viscerosomatic reflexes and improve parasympathetic outflow, improving postoperative bowel function.
Acknowledgment
We thank Jeffery Reedy for filming and video editing.
Resources
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Articles in the same Issue
- THE SOMATIC CONNECTION
- Stand Up and Climb Out of Ankle Spasticity
- OMT MINUTE
- OMT for Cancer Patients After Bowel Resection
- STILL RELEVANT
- Discovering Osteopathic Antiquity in Historical Osteopathic Pamphlets
- LETTERS TO THE EDITOR
- Chronic Pain Management: Perspective of an Osteopathic Medical Student in New Mexico
- ORIGINAL CONTRIBUTION
- Variations in Progression and Regression of Precancerous Lesions of the Uterine Cervix on Cytology Testing Among Women of Different Races
- Medical Student Decision-Making: Standard Surgical Excision or Mohs Micrographic Surgery to Manage Basal Cell Carcinoma
- BRIEF REPORT
- Evaluating the Effectiveness of One-on-One Conversations to Increase Colorectal Cancer Screening in a Community-Based Clinical Setting
- JAOA/AACOM MEDICAL EDUCATION
- Effect of Ultrasonography on Student Learning of Shoulder Anatomy and Landmarks
- CASE REPORT
- Toxic Injury to the Gastrointestinal Tract After Ipilimumab Therapy for Advanced Melanoma
- Nephroblastoma Arising in a Primary Testicular Teratoma in a Nonatrophic Testis of a 50-Year-Old Man
- THE SOMATIC CONNECTION
- It Makes a Difference What You Are Thinking When You Touch Someone Clinically
- OMT May Be Helpful in the Management of Benign Paroxysmal Positional Vertigo
- CSF Flow Has a Significant Respiratory Component
- Lymphatic Vessels Found in the Brain—Osteopathic Considerations, Part 2: Now in Humans and Monkeys
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