As a nutritionist specializing in gut health, I teach people how to eat to nourish their microbiomes, and how to eat to restore the intestinal barrier.  And because I’m a nutritionist, I use food and supplements as the primary tools to achieve gut health.  My goal is to give the body the tools it needs to fix itself, but sometimes a different kind of tool is required in addition to what I can offer.  This tool comes in the form of structural approaches that involve manual therapists or movement therapies.


Osteopathy is a practice that aims to enhance the body’s own ability to heal itself by addressing the state of tissues or body systems.  It is a hands-on approach where the practitioner uses palpation to sense the state of tissues, and then uses a variety of manipulation techniques to correct imbalances.

When looking at gut health, there are several conditions where osteopathy can be of benefit:

  Hiatal hernia – a hiatal hernia occurs when the upper part of the stomach protrudes through the diaphragm into the chest cavity.  A hiatal hernia can be a contributing factor to GERD (gastroesphageal reflux disease) or heartburn.  Osteopathy can help to manually bring the stomach back down to its normal position.  It can also be used to support closure of the cardioesophageal sphincter, with these same conditions to prevent continual reflux of acid into the esophagus.

IBS/SIBO – Irritable Bowel Syndrome (IBS) is characterized by alternating diarrhea and constipation, and is often a sign of SIBO (small intestinal bacterial overgrowth).  When we look at underlying factors contributing to IBS/SIBO, we see that it is a motility issue.  Motility refers to the contractions of the muscles of the gastrointestinal tract.  When motility does not get communicated correctly to the gastrointestinal tract then contractions occur too quickly, too slowly, or a combination of these, resulting in diarrhea, constipation or both.  Motility problems can stem from miscommunication from the brain, or can be the result of adhesions to fascia.  Fascia is connective tissue that attaches, stabilizes, encloses or separates muscles and internal organs.  Adhesions can occur from trauma (both physical and emotional), or from inflammation in the gut stemming from dysbiosis, infection or pharmaceutical use.  An osteopath can help to break down adhesions through gentle manipulations of the fascia.

Chronic constipation -  Like IBS, constipation can be a motility issue that has its roots in adhesions to fascia.  There are many different ways to approach constipation, but when multiple approaches have been tried with little or no lasting results, then osteopathy offers another approach that can be beneficial.


Hanna Somatics is a whole body movement approach.  Specifically it addresses muscle patterns that have developed as a result of trauma or habitual overuse. Somatic exercises reeducate the brain to unlearn trauma or overuse patterns.  A good way to start with Somatics is with a practitioner who can assess your specific imbalances and develop a program for you, but once the movements are learned it can be done at home.  In addition to assessing your imbalances and contraction patterns, a practitioner can also support your progress using hands-on techniques, which can result in more rapid changes.

Somatics will benefit gut health in individuals who have suffered physical trauma that has left impaired movement or people who have structural imbalances that have developed over time (that’s all of us!).  It allows for the retraining of all the muscles in the abdomen and pelvis to occur.  When you are able to move more freely then digestion and motility are improved.

Similarly to osteopathy, Hanna Somatics can be beneficial for:

IBS/SIBO - For the same reasons that osteopathy works (see above), this approach works, but it has the advantage of also possibly reeducating motility.

Constipation - Again we see similar reasons to the osteopathic approach (see above), with reeducation of motility.


Pelvic Floor Specialists are physiotherapists that are trained in assessing a variety of conditions and then providing modalities to re-train the muscles of the pelvic floor.  It typically involves a mixture of hands-on therapies, as well as life-style changes and techniques that are implemented at home and in daily life.

Incontinence –  When the health of the gut is compromised, it’s not just the lining of the gut that gets affected, but often other mucosal linings are affected as well, with the bladder being one of those linings.  When the bladder lining is inflamed, then the result can be frequent bladder infections or incontinence.  In addition to a dietary approach to restore the health of these mucosal barriers, physiotherapy can help to retrain pelvic floor muscles to bring back normal bladder function.

Hemorrhoids and Prolapse - When constipation, diarrhea or both are a part of your gut health picture, then hemorrhoids or prolapse can result.  These can be painful and debilitating.  Pelvic floor work can provide you with tools to help with constipation and to re-educate the pelvic floor.

Pelvic Pain – Pelvic pain can result from constipation, diarrhea, muscle imbalances, hormonal issues or adhesions to fascia.  It is important to rule out hormonal issues first.  A skilled physiotherapist may be able to help you reduce pain.


It’s no secret that diet and exercise are needed for good health.  When it comes to gut health, diet is the most important step in bringing health to the microbiome and to the intestinal barrier, but regular, gentle to moderate exercise helps to stimulate motility and helps stimulate the liver (which is an accessory organ to digestion).

Some additional forms of exercise that I like for their ability to create awareness of the gut include:

Restorative Exercise

Happy, Healthy Eating (and Moving)!