The hiatal hernia / GERD pattern can actually be an IRT pattern that does not manifest itself unless the hiatus is challenged. It will usually not be found during the AF screening for IRT and this can present a problem. If the patient has typical HH / GERD symptoms, consider the challenge and correction with IRT earlier in the protocol – at the same time that you investigate the effects of other injury patterns. Otherwise, the HH / GERD pattern must be corrected prior to addressing any other GI tract issues. If the stomach is compromised by a HH or GERD, the rest of the GI tract will adapt. To get a clear picture of GI autonomic and enteric activity, we must resolve the HH / GERD first. In the situation where the HH / GERD pattern is identified during IRT screening in step 4, traditional concomitant findings such as the dorsolumbar fixation and psoas muscle imbalance will usually be corrected by protocol procedures performed between the IRT correction and this step. If, at this point in the protocol, asymmetrical diaphragm excursion, dorsolumbar fixation, and uneven foot turn-in (indicative of psoas imbalance) are present, they should be corrected.

22. Challenge Ileocecal Valve – Open or Closed

23.  If Digestive Problem – Rub and Pinch Visceral Referred Pain area(s)

1. If Rubbing Strengthens: Rub Chapman’s Reflex for that Organ
2. If Pinching Strengthens: Use VCT – IRT Chapman’s Reflex with Offender

Anything that affects autonomic function should be corrected prior to addressing GI issues. This includes injuries and heart-focused procedures which will correct some emotional stress related problems. The specific emotional recall techniques considered later can also affect the GI tract, and vice versa. If one checks for emotional recall weakening prior to addressing GI dysfunction and finds a GI tract acupuncture head point and/or Chapman’s reflex, correction of the GI tract involvement will often clear emotional recall weakening. This suggests that GI tract dysfunction can contribute to emotional stress. Clinical observations show that this is often the case.

Neurologically speaking, aberrant visceral sensory activity will impact the ipsilateral cerebellum (via the GI muscle imbalances) and the contralateral cortex and can contribute to right – left brain imbalances and the emotional recall weakening effects. Cerebellar adaptations to long standing GI tract related somatic muscle imbalances can also cause changes in axial (old, midline cerebellum) sensory feedback from the cerebellum into the limbic system (old, midline 28 cortex) and aggravate or enhance emotional perceptions. For this reason, the emotional recall techniques are placed after GI tract correction in the clinical protocol. This allows for correction of numerous secondary emotional recall problems during GI tract treatment.

For the purposes of the patient treatment protocol, we can consider a positive ICV open or closed challenge as just another weak digestive system muscle. (In fact, the open ICV is accompanied by a weak right iliacus and the closed ICV will usually be associated with inhibition of one or both quadriceps.) When there is an ICV open or closed, we will address other clinical factors (e.g., SYM or PS status, aggravating dietary substances, etc.) rather than treat it as a separate entity since the ICV is an integral part of, and can’t be divorced from, the rest of the GI tract. When we look at the autonomic and enteric effects on the GI tract, the ICV must be considered in this light.

Food allergies, dietary fats, and dysbiosis are common causes of digestive problems including ICV open and closed. Some of these will be corrected much earlier in our protocol. However, there may still be digestive problems present that must now be addressed.

23. If Digestive Problem – Rub and Pinch Visceral Referred Pain area(s)

    3. Challenge with Fat for Ileal Brake (Closed ICV)
    4. Challenge with Sugar for Open ICV
    5. 3-Step Challenge for Gastrocolic Reflex

There are only 200 preganglionic parasympathetic nerve fibers in the vagus nerve at the point the vagus enters the abdomen. In contrast, there are over one hundred million nerve cells in the small intestine enteric nervous system (ENS.) 19 Although these numbers might suggest otherwise, the influence of autonomic (SYM and PS) activity on the ENS function is significant and must be considered. Systemic autonomic imbalances must be corrected prior to investigating the ENS as some ENS problems will be as a result of adaptation to SYM or PS imbalances, and others may be causing the SYM or PS imbalance. In either case it is necessary to correct any SYM / PS problems in order to clearly assess the ENS picture.

ENS dysfunction is frequently at the core of recurrent ICV syndromes and other digestive problems. Left uncorrected, the ENS will create adaptations in SYM / PS autonomic function. These adaptations will often distort the clinician’s view of ENS problems, which is why they must be corrected prior to ENS assessment.

Additionally, a frequent finding is that fixing one ENS problem will reveal the presence of another, especially the ileal brake and the sugar-induced open ICV challenges. Using these challenges, there is no way to predict the order of correction. Just know that after identifying and correcting one of these ENS faults, you must check for the other.

Again, correction of digestion problems (of all types) is important prior to the emotional stress recall techniques. It has been thought by some (including this author) that the reason that seemingly equal emotional stressors sometimes result in the need for emotional recall corrections while other times they do not is related to the impact from other sensory inputs at the time of the emotional trauma.

There is a necessity of addressing psychological reversal prior to other emotional therapeutics, as discussed originally by Callahan. 20 Callahan described psychological reversal as a problem with the small intestine acupuncture meridian system and recommends tapping SI-3 bilaterally. Our observations agree with those of Callahan with the addition that normalizing the small intestine by therapies discussed above will normalize the psychological reversal just as does tapping SI-3.

When there is a psychological reversal, there is also a physiological reversal with a switching type effect on muscle testing findings. It is logical (and correct) that any type of switching should be corrected earlier in the course of treatment than at this point. The protocol addresses this by screening for allergies and bad fats very early on when screening with antihistamines and aspirin, ibuprofen, acetaminophen mix, respectively. Most of the time, there will be small intestine involvement in both allergies and bad fat ingestion and correction will eliminate both psychological and physiological reversals at this point early in the treatment. There are other cases of small intestine involvement that do not cause these reversals and these will be corrected during other GI tract treatment in this section.

Heart focused activity will clear some GI tract dysfunctions (often many) and some emotional stress disturbances (often many). It may be well noted here that the early correction of psychological and physiological reversal, prior to heart focused activity, will clear the way for more effective HF activity. In eight years of performing HF activity, there have been four negative responses noted by this author. They were all in patients who had small intestine problems that had not been corrected first.

Emotional recall patients frequently demonstrate stomach circuit involvement, but any circuit may need to be treated in emotional stress cases. Considering that the majority of patients will have some GI tract circuit needing treatment for the emotional stress correction, it is prudent to have already addressed the GI tract before embarking on emotional recall techniques. Failure to correct GI tract problems prior to assessing emotional techniques results in several undesirable patterns: 1) There is an excellent chance for recidivism of the emotional recall activity; 2) There will often be positive recall of multiple emotional recall events, all related to the same GI tract circuit misleading both the doctor and the patient to think that there are more severe emotional involvements than are truly present; and 3) Uncorrected small intestine problems will result in confusing clinical presentations and temporary results to any emotional techniques applied in its presence.