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“Get That Poo Out of You!” – Part 3

“I Love You” Belly Massage

stomach with arrows going in circleThere are many manual techniques physical therapists can use to assist with clearance and movement of stool through a child’s colon. Say “I Love You” to a full and upset colon with an ILU massage. The ILU massage follows the path of stool through the colon from the lower right side of their abdomen (enters the colon from the small intestine about where brown circle is on picture to the right), up to the right lower ribs, across top of abdomen to the left lower ribs, and down the left side of the abdomen, ending at top of hip bone.

To begin, have the child lie down with feet and knees slightly elevated on pillows for a neutral spine and pelvis. Place some lotion on child’s belly to reduce friction between your fingers and the child’s skin. Using forefinger and middle finger, apply firm, but comfortable pressure throughout (should not be painful!!!). For ticklish children, try adding a little more pressure, or have them take a few deep breaths once you have placed your hands. Pressure should be kept consistent throughout massage.

circle drawn around belly button to show direction1. Start with big clockwise circles 2-3” out from belly button to stimulate the small intestine.

2. The “I”—Start at the child’s left side in the lower abdomen. With forefinger and middle finger, make 2-3 clockwise circle at each stop. Lift fingers and move along path indicated by light blue arrows. In order to move the backed up poo through the descending colon, we need to make space before we fill space, therefore we start at the bottom (#1) and move up to lower ribs with 2-3 clockwise circles at each stop. Next, follow same path back down to hip bone on left side (#2). Repeat 5-10 times depending on child’s tolerance.

3. The “L”—starting at left lower ribs, perform clockwise circles moving horizontally across upper abdomen to the right lower ribs along transverse colon (#3). Then, move back horizontally from right lower ribs to left lower ribs and down descending colon to left hip bone (#4). Repeat 5-10 times depending on child’s tolerance.


4. The “U”—Starting at right lower ribs, move down to right hip bone with clockwise circles (#5). Then, begin the full U from right lower abdomen, along the ascending colon to right lower ribs, across transverse colon to left lower ribs, and down descending colon to left hip bone (#6). Repeat 5-10 times, depending on child’s tolerance.

5. Finish with 5-10 more clockwise circles 2-3” out from belly button to stimulate small intestine again.


– Recommendations from APT Physical Therapist, ​Lauren Hirsch, PT, DPT