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What is the Gut? Part 2

This is part 2 of my series on the abdominal organs - better known as our guts. This article will discuss what manual therapy can do in this area of the body. The main tenet here is that many of the same physiological effects of manual therapy applied to muscles, joints, tendons, and ligaments are also at play when applied to abdominal structures. This is excellent news for manual therapists, and gives us a whole new "playground" for our work!


Skeletal muscles are primarily controlled by the peripheral nervous system - motor and sensory pathways to and from the spinal cord. The abdominal organs and the metabolic systems that support these organs are managed by a branch of the autonomic nervous system called the enteric nervous system (ENS). All tissues in the body (including the guts) need an arterial blood supply, access to the venous system to return blood to the heart, access to the lymph system to clean and detoxify, and a connection to some aspect of the nervous system.

Additionally, all of our abdominal organs have a fascial support system called peritoneum - a wrapping suspensory structure - that holds each organ and its commensurate blood, lymph, and nerve supply in place. This set up is much like the walls of our home which hold onto utility wires and plumbing pipes.

What does manual therapy do for the organs?

Relaxes the NS

Skillful manual therapy in the belly helps transition the autonomic nervous system from a stressed and contracted state (sympathetic) to a more relaxed and dilated state (parasympathetic). This transition is critical for proper digestion and transit of material through the GI tract. The transition to parasympathetic also helps improve overall blood circulation, decreases fluid stagnation and pooling, and decreases the feeling of bloat and fullness in the belly.

Enhances blood supply

Better blood circulation to our organs in general means we digest and absorb our food more efficiently, transport macronutrients from our small intestine into blood and lymph vessels more effectively, and balance fluid dynamics in the peritoneum and portal system. Improved blood supply to the liver helps with detoxification pathways. Improved blood supply to the kidneys and spleen helps clean blood more efficiently. More blood to the large intestine assists with peristalsis and the elimination of food waste. Blood is our life fluid, and all of our tissues are dependent on it.

Improves the function of our reproductive system

The male and female reproductive systems are complex, and many of the functions of these systems can be optimized with manual therapy including fertility, prostate gland swelling, erectile dysfunction, dysmenorrhea, and pelvic organ prolapse, to name a few.

De-laminates adhesion / improves mobility

All of our organs move and slide against each other in response to the movement of the diaphragm with each breath cycle, while walking and moving, and while under the force of gravity. Sometimes these sliding surfaces stick together because of inflammation, post-surgical adhesion syndromes, a general lack of movement, or poor fluid circulation.

Manual therapy can find these sticking points are located, and actually de-laminate hypo-mobile areas. Belly gurgles (borborygmus), changes in breathing pattern, changes in contour, temperature, and texture of the belly wall are all working signs that the nervous system is relaxing and the organs are moving better. All good things!

Improves immune function

70% of our immune response happens in tissue called gut associated lymphoid tissue or GALT. This tissue is located in the lumen of the small intestine. Although little is known about manual therapy and GALT function presently, it stands to reason that if fluid circulation and mobility of the small intestine improves, then the function of our GALT will also improve. This will be a fabulous manual therapy research project for down the road. You read it here first!

Improves affect / mood

Since 95% of serotonin (a neurotransmitter) is made in the small intestine, it only follows that optimizing the function of the small intestine will also improve mood and affect. This is certainly my experience when I receive this work. I also see this in my professional practice and in the classroom setting.

Improves energy flow

Energy, chi, prana, and life force are all names that various health systems use to explain how we function, what drives our vitality, and what predicts disease. All of these systems recognize that many pathways of chi flow through the belly.

My clinical experience indicates that working in the belly often creates a flush in the face and chest, a sense of well being and ease, and interesting sensations emanating from the belly to various parts of the body along established energy lines. These chi responses are good working signs that the body is responding to this work.


One of manual therapy's oldest mantras is that "we are all connected." This phrase is generally used to describe our complex skeletal muscle, fascia, and bony matrix. Sadly, we often forget that this also means the belly. The axial skeleton, core musculature, and fascial pathways (superficial and deep) all connect our center to our appendages. The ubiquitous nervous system and fluid pathways in the belly and trunk also connect the center to the periphery.

Touching the belly also means touching the place where we hold emotion. Many researchers, manual therapy practitioners, and non-professionals agree that our belly holds some aspect of unfinished business and "undigested" feelings. This is one of many things I love about this work - touching the belly not only gives one the opportunity to touch important metabolic structures that do not reside in the periphery; we also touch the emotional body at the same time.

Creating connection means touching the body in all of these ways with all of these intentions. Missing the belly means missing an opportunity to connect the whole body and the whole person!

Marty is in private practice in Seattle, WA.  He is the director of Love Your Guts Seminars, and teaches internationally throughout North America and the UK. Additional Contact info:,


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