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Why Is The Stomach Massage So Controversial?

Written by: Sam Mishra, Executive Contributor

Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.

 
Executive Contributor Sam Mishra

The number of people that walk through my door having never had a stomach massage astounds me, since it is so good for both physical and emotional wellness. Most of my first-time stomach massage clients have said that it was more enjoyable than they had expected, even though a few may not have found it to be as relaxing as other areas of the massage. Although it is assumed that feeling someone's hands pushing on your stomach would be awkward and painful, many people actually find that it is soothing and restorative, releasing tension that frequently results from stress, worry, and negative emotions. This may occur from both a more focused deep colon massage or from just five minutes of an hour-long Swedish massage.

Woman and therapist massaging her stomach

Why is stomach massage still seen as a contentious topic?

 

Many massage courses instruct therapists to enquire before treating the abdomen because it can be sensitive for many patients. Another area to exercise caution with abdominal massages is that they may trigger an emotional response from the client, especially in those who have experienced trauma. When we consider the chakras, our stomach represents our power; it is the core of who we are and the place where we "digest" our feelings and ideas. Tapping into this can be unsettling for both the client and the therapist.

 

The client's self-consciousness about their stomach and desire for no attention to be paid to it could be another reason they choose not to have a massage. I frequently observe this in people who are overweight or who have numerous stretch marks. But, by demonstrating that other people aren't horrified by their perceived problem, individuals with these kinds of issues can significantly benefit from the physical touch in this area, which can boost self-esteem and help to reverse any negative body image.

 

Therapists have even been known to claim that the stomach region is too personal. However, I always tell my customers that it's already quite personal if I ask them to undress when we've just met so I can give them an oil massage. Whether it's medically, psychologically, or emotionally, the client has improved, and stomach massages are frequently a part of that recovery.

 

The diaphragm is one of the muscles that is most often neglected in massage therapy, and I can attest from my own experience with irritable bowel syndrome that it may be greatly impacted by bloating. Insufficient diaphragm function prevents us from breathing deeply or adequately oxygenating our tissues, both of which are essential for healing.

 

Naturally, there's a good likelihood that the client's discomfort during a stomach massage is caused by some sort of faecal impaction or faeces being forced through the colon if none of these problems apply to them.

 

Abdominal massage has historical records dating back to Ancient Egypt. Like many other complementary therapies, it also has Chinese medical roots. Taoist monks used abdominal massage to help detoxify and strengthen their bodies, utilising the energy of the internal organs to enhance both physical and mental well-being. This was predicated on the idea that emotional problems that have not been resolved are retained in the digestive system and, if untreated, can result in illness and disease. We now understand that this massage has other health benefits beyond improved digestion.

 

The impact of postural alignment on the abdominal organs

 

Keeping your posture straight is crucial to maximising your health. The ground reaction force pushes us upward against the gravitational force, while gravity pulls us downward towards the centre of the earth. Allostasis, or homeostasis, is the state in which our bodies are able to maintain an upright posture without much effort due to the balance of these opposing forces. This state is referred to as physiological efficient posture, or PEP. In order to regain equilibrium and keep the posture straight, the body must exert far more effort. For example, a sports therapist may use imaginary lines to measure a client's PEP while searching for different anatomical abnormalities. that the head, shoulders, and hips are parallel, or that the body appears balanced on both sides.

 

How posture affects detoxification

 

Toxins are expelled from cells by a specific pathway that avoids some of the abdominal organs (cells, lymph, blood, liver, gall bladder, bile bowel, and rectum). However, if there is a problem at any one of these steps. Toxins will build up as a result of postural misalignment and become unable to exit the cells. Large abdominal muscles, the lats, the psoas (hip flexor), and the diaphragm will begin to compensate for the lack of PEP if this imbalance is not fixed. This compensation then puts more strain on the detoxification system as a whole and on posture, which can lead to neurological as well as myofascial dysfunctions. Because of the variations in the ribcage angle, this affects not only the muscles and joints but also the diaphragm and abdominal organs' location and function. Because the pelvis supports the internal viscera, pelvic tilt will also have an impact on the location of the abdominal organs. We refer to this as visceroptosis. The process of detoxification is impacted when the viscera are misaligned because it makes it harder for them to function as a system.

 

Aortic hiatus constriction brought on by visceroptosis limits the function of the thoracic lymphatic duct, which is in charge of delivering lymph fluid to the heart for blood-to-lymph mixing. This thoracic lymphatic duct moves the lymph fluid during breathing because of diaphragmatic movement. As a result, if PEP is not maintained and visceroptosis prevents deep, diaphragmatic breathing, lymph flow—the first step in the detoxification process—will be restricted.

 

Visceroptosis also affects the diaphragm's carval hiatus and the inferior vena cava. This implies that when we breathe in, the inferior vena cava narrows less, allowing less blood to flow into the atrium and negatively affecting venous return. Blood pooling in the lower extremities and persistent venous congestion may arise from this.

 

The liver and gallbladder will work differently as a result of visceroptosis and any nerve abnormalities, possibly also brought on by pelvic tilt. Peristalsis may also be restricted, which raises the risk of constipation. Even if the peristaltic action is still quite efficient, visceroptosis may also impair the tone and angle of the puborectalis muscle, which may lead to difficulties with defecation.

 

How can massage help to restore the PEP and aid in detoxification?

 

By reducing myofascial tension and strengthening the tone of weaker muscles, massage can aid in the restoration of PEP by enhancing joint flexibility. Massage can also relieve strain on the nerves and relax the nervous system by adjusting any pelvic tilt. Additionally, the stimulation of blood and lymph circulation will aid in the release of toxins from cells.

 

The diaphragm and abdominal organs can operate more effectively when PEP is restored because they are in their natural positions. Additionally, better peristaltic movement of the intestines will help with the elimination process. When the PEP is restored, any additional compensatory actions by the muscles and joints will also be avoided. Additionally, massage can help to improve deep breathing patterns by realigning the diaphragm and the ribs, which will enhance oxygen intake and benefit all of the body's systems and tissues.


Muscular causes of abdominal pain

 

In addition to several medical conditions (e.g., diverticular disease, pancreatitis, appendicitis, kidney stones, hernias, stomach ulcers, gallstones, and irritable bowel syndrome), abdominal pain can also be brought on by trigger points in the muscles that surround the stomach, just like menstrual pain does. The problem with trigger points is that they can cause intense pain in a specific location, or they can be diffuse and difficult to locate. If the pain in the abdomen seems to be related to certain movements or postures, then the cause is most likely tight muscles that contain trigger points. These muscles can cause other symptoms like bloating, gas, heartburn, acid reflux, nausea, vomiting, loss of appetite, fullness, diarrhoea, cramping in the stomach and bladder, referred pain in the back, groin or thighs, scoliosis, or a tilted pelvis.

 

Stomach massage benefits

 

Having a stomach massage has several advantages, which should demonstrate its worth and the reason it ought to be a part of full body treatments.

 

Enhances posture

 

The effects of bad posture on the abdominal organs have already been covered in this article. Your core muscle group consists of your abdominal muscles; thus any weakness or stress there can result in poor posture, which can cause injuries and impair the operation of your organs. We can sit or stand taller and more aligned if our abdominal muscles are relaxed. Increased muscle suppleness from abdominal massage can lead to an improved range of motion.

 

Our posture can occasionally be affected by stomach disorders, and if we are in pain, we often hunch forward. Using abdominal massage to ease any cramping or other discomforts in the abdomen may help release tension, which in turn may aid with misalignment correction.

 

Reducing tiredness and low energy

 

Increased vasodilation in muscles that fatigue more easily from malnutrition is one way that abdominal massage aids in improving circulation. By lessening bloating and easing a sluggish colon, it also boosts energy levels, which might hinder the detoxification process.

 

Reducing stress

 

Stress relief is one of the key reasons we receive massages. The application of abdominal massage provides the same advantage. Allowing a massage therapist to work on our stomachs or taking some time to massage our own midsections can give our bodies—which we've been made to feel self-conscious about—the much-needed attention and self-care they deserve, especially in light of the social pressures surrounding the stomach. Taking care of our bodies by letting go of our own fears and judgements can be just as purifying as the physical advantages of our jobs.

 

Anxiety can cause a queasy feeling in the stomach, which can be followed by muscle spasms and trapped gas. These conditions can impair digestion and cause bad posture. In addition to promoting relaxation by balancing the nerve system, abdominal massage also affects the solar plexus chakra, which is linked to feelings of optimism and hope, promoting mental clarity and serenity.

 

Boosts the immune system

 

Since the gut contains a substantial portion of our immune system, intestinal health naturally influences immunity and general health, assisting our systems in fending off infections and viruses. The lymphatic system is stimulated by abdominal massage, which enhances cleansing and strengthens the body's defence mechanisms. According to studies, it may help boost white blood cell activity, which aids in the body's defence against illness. Furthermore, it can aid in the reduction of inflammation and promote the release of endorphins, which are feel-good hormones that help to control your mood.

 

Reducing pelvic pain

 

Massage therapy is a natural alternative for people with PMS, ovulation pain, PCOS, and endometriosis due to its ability to reduce pain, cramping, bloating, gas, and indigestion. It is well known that during women's menstruation, the abdominal region becomes stiff in the muscles. By using massage techniques, you can ease the tension in this area and lessen the pain related to the menstrual period. It occasionally helps with period regulation and enhances menstrual health in general. Work on the ankles and thighs in addition to the abdomen may help alleviate additional PMS symptoms, including water retention.

 

The abdomen and pelvis are sensitive and prone to pain in women's bodies. The pelvic floor, which is also regarded as a diaphragm and cooperates with the abdominal diaphragm while breathing, is impacted by the reduction of muscular spasms and the release of the diaphragm.

 

Clients with a stoma

 

In the United Kingdom, 120,000 or so people have a stoma of some form. Most stomas are temporary, giving the bladder or bowel time to heal; around 6,500 of the 21,000 stoma procedures performed each year result in permanent stomas. Living with a stoma can be quite challenging. It not only affects a person physically but can also lead to issues with self-esteem. As a result, many people may avoid certain activities because they are afraid that their stoma may burst. One of these pastimes is massage, although having a stoma shouldn't prevent someone from relaxing on their own time.

 

Clients with stomas can benefit most from massage therapy because it can help with bowel movements, break down scar tissue during the healing process, and lower the risk of adhesions after surgery. Additionally, massage can help with wind relief, which can lessen pain. People who have stomas can also benefit from improved lymphatic circulation because oedema can be a problem. Massage therapy that promotes skin integrity can also be beneficial, especially for people who are still learning how to take care of their stomas or who have only recently acquired one. Laying face down is probably the biggest obstacle that people feel stands in the way of getting a massage, but since we, as therapists, adapt treatments and positioning for other reasons, like pregnancy or Down's syndrome, there is no reason why the same accommodation can't be given to a stoma. Additionally, abdominal massage may help clients who are still coming to terms with having a stoma or who have anxiety surrounding it. Although the body and a stoma can tolerate pressure, it can be emotionally reassuring to position carefully, especially for clients who have recently acquired their stoma. It can take some time for them to accept that this is the reality.

 

Better digestive function

 

The obvious advantage of abdominal massage is that it facilitates better digestion. In addition to being the body's detoxification and metabolic centre, the digestive tract is also where we store most of our emotional stress, which can lead to digestive issues. We experience reduced stomach problems like gas, bloating, and cramping when the abdominal muscles relax and digestion and peristalsis are stimulated.

 

Research has indicated that individuals with more severe digestion problems may benefit from abdominal massages. It achieves this by assisting in the relaxation of your abdominal core muscles and tissues, which promotes more effective food digestion and waste product elimination. Additionally, it can aid in reducing gastrointestinal tract inflammation, which can be brought on by stress or bad posture. Additionally, as you massage your abdomen, digestive enzymes are released, aiding in the breakdown of food and the absorption of nutrients.


Reduces diarrhoea, constipation, and other irritable bowel syndrome symptoms

 

By increasing the frequency and type of bowel movements and, consequently, peristalsis, stomach massages can help alleviate constipation. Aromatherapy can enhance the effect of gentle, continuous pressure on the stomach muscles, which causes the digestive system to awaken and begin moving. In addition to creating mild tension in the bowel to relieve discomfort, control the ileocaecal valve, and calm the intestines, massage can also accelerate peristalsis, reduce colonic transit time, and improve the frequency of bowel movements, all of which can help ease constipation. Children with disabilities like cerebral palsy benefit greatly from massage therapy due to its benefits for constipation.

 

Abdominal massage is particularly helpful for those with irritable bowel syndrome (IBS) or persistent constipation since it helps to improve the digestive system's performance and transport food through the intestines more efficiently.

 

Massage therapy can provide relief from irritable bowel syndrome, a fairly common condition that affects the colon (large intestine). While it does not cause lasting damage to the large intestine, it can severely limit a person's lifestyle. Finding a therapist who performs this type of massage could be difficult because, as we all know, a full body massage doesn't often involve abdominal work, and you need to be sure the therapist is trained and knowledgeable in handling this issue.

 

The wonderful thing about massage is that its focus can be readily changed by applying and selecting different techniques. For example, abdominal massage can be tailored to help with constipation by regulating peristalsis, reducing colonic transit time, and increasing the frequency of bowel movements, which will lessen pain and discomfort, or diarrhoea by almost creating mild tension in the intestines to relieve pain and soothe the intestines. An abnormal ileocecal valve can result in both diarrhoea and constipation; this will be covered later. Improved peristalsis and a shorter colonic transit time will lower intestinal pressure, which will soothe gas and bloating and ultimately relieve cramping in the abdomen.

 

Food moves through the colon too slowly, leading to constipation, or too quickly, causing diarrhoea or gas, because the muscles lining the walls of the intestines contract more in an IBS patient than in a healthy individual. Massage can also assist in lessening overstimulation brought on by stress and certain meals by lessening the frequency and urgency of bowel and bladder movements, which will make the client feel less exhausted. Regular massage therapy can help alleviate symptoms of irritable bowel syndrome (IBS) by alleviating stress, which is known to increase the frequency and intensity of symptoms.

 

I've worked with children with cerebral palsy for many years, and I've found that using pressure points and specific massage techniques can help improve slow digestion, relieve bloating and flatulence, relax abdominal muscles, and help establish a more regular pattern of bowel movements. It is simple for a skilled practitioner to palpate the belly, feel faeces in the bowel, and then massage the excrement progressively along the intestine. But receiving too much massage in one session might result in intestinal irritation, which can lead to further issues (which is why it's crucial to consult a therapist skilled in this kind of therapy). Enhancing peristalsis and removing any obstruction in the descending colon will increase the likelihood that the treatment will be effective. After that, certain methods can be employed to dissolve any obstruction and then gradually push it through the colon. However, as several contributing medical disorders are contraindicated, the causes of any obstruction must be identified before therapy can begin.

 

Ileocaecal valve function, gastroparesis, and small intestine bacterial overgrowth (SIBO).

 

Constipation or diarrhoea may result from the ileocaecal valve, which is located between the small and large intestines, occasionally being open or closed, especially in circumstances like SIBO. It is possible to open or seal the ileocaecal valve to stop colon contents from returning to the small intestine. Symptoms can be effectively treated by treating the valve in conjunction with a deep colon massage to support the maintenance of the bowel's tone and peristaltic function.

 

When bacteria from the remainder of the digestive system proliferate in the small intestine (ileum), a condition known as small intestinal bacterial overgrowth (SIBO) takes place. The bacteria deplete the body's nutrition supply, causing discomfort, diarrhoea, and malnutrition. Malnutrition and dehydration may result from SIBO if treatment is not received. It is frequently observed in patients with ileocaecal valve impairment, Crohn's and coeliac disease, diabetes, gastroparesis, bowel surgery, and chronic gastrointestinal problems. However, some drugs, such as opioids, may also be contributory factors if they compromise intestinal function. HIV, cirrhosis, Parkinson's disease, hypothyroidism, and other illnesses have also been connected to SIBO. Nerve injury can occasionally also be a factor.

 

As was previously stated, SIBO symptoms include discomfort, bloating, diarrhoea, constipation, gas, lethargy, and joint pain, all of which can be relieved with massage therapy.

 

Gastroparesis, or delayed gastric emptying, is a condition in which food stays in the stomach for extended periods of time due to difficulty passing readily into the small intestine. It can also result in SIBO and ileocaecal valve dysfunction. This occurs when a damaged vagus nerve prevents the stomach from contracting regularly, pushing partially digested food into the intestine and preventing further digestion and nutritional absorption. Intestinal and stomach muscles that aren't working properly can totally block movement.

 

6.2% of diabetics develop gastroparesis as a result of delayed stomach emptying, dysrhythmia, pylorus spasm, non-synchronized gastroduodenal motility, and the neurological effects of diabetes. A history of certain gastric surgeries, infections, or tumours affecting the oesophagus, stomach, or small intestine that may impact the vagus nerve, neurological problems, metabolic disorders, or gastroesophageal reflux disease (GERD) might also cause it to arise. Gastroparesis can potentially be brought on by a variety of medical conditions, including trauma and psychological illnesses that impair vagus nerve function due to nervous system instability, as well as drugs like anticholinergics that block nerve impulses and opioids that impede bowel movements. 

 

Infections, intestinal blockages, oesophageal rips and inflammation, malnourishment and dehydration, blood sugar abnormalities, and extreme cases of undigested food forming a solid mass can all be consequences of gastroparesis.

 

Therefore, using a natural therapy like massage to help prevent such consequences and reduce symptoms makes sense. Peristalsis can be aided by visceral manipulation and massage, which help relieve pressure and stress from the abdominal organs. Studies have indicated that acupressure can help with anorexia, bloating, and epigastric pain in diabetic gastroparesis. It can also help lower blood sugar levels and promote easier stomach emptying. Although studies on belching, nausea, or vomiting haven't shown any discernible improvements, it's possible that adding aromatherapy to a colonic massage will help with these symptoms. Additionally, abdominal massages in general can help reduce nausea and ease pressure under the ribs.

 

Improved respiratory function

 

Bloating and taut abdominal muscles raise internal pressure in the belly, which limits the diaphragm's normal movement and prevents deep breathing. I frequently discuss how, in order to truly make a difference, soft tissue treatment must address the underlying cause of an issue rather than just treating its symptoms. But this isn't always the case, and the diaphragm is one of the most often neglected regions.

 

A few years ago, my IBS caused me to experience increasing bloating and, for the first time, shortness of breath after only a very short walking distance. I realised that the tightness in my abdomen, extending to my rib cage, was probably the cause of my breathing difficulties, as the diaphragm was being pulled taut.

 

The skeletal muscle known as the diaphragm is involved in ribcage movement because it attaches to the ribs and divides the thoracic and abdominal chambers. It functions in tandem with the pelvic floor diaphragm, a hammock that divides the abdominal and pelvic chambers and includes the levator ani and coccygeus muscles. The rectus abdominis and transverse abdominis flex during exhalation, causing the diaphragm to stretch into its natural dome form and the ribcage to descend beneath it. The ribcage retracts as the obliques contract.

 

Considering that the rib cage must retract and descend, i.e. The diaphragm must stretch in order for the obliques to contract, a tight diaphragm will not accomplish this as well. Anterior pelvic tilt is encouraged when the rib cage is kept high and extended, and this might affect the hamstrings by altering the length of the muscles during rest.

 

When bending forward, the diaphragm must be mobilised to its maximum extent; hip flexion and posterior pelvic tilt are required, as well as the pelvic floor and rib cage to be depressed and retracted. Other movements will be inefficient if the diaphragm and pelvic floor cannot move in this manner, affecting the balance of muscle length and tension.

 

Therefore, the diaphragm needs to be allowed to move to its fullest extent while breathing in order to support the greatest possible effectiveness of the abdominal muscles and glutes. Thus, in addition to helping with respiratory function, abdominal and diaphragmatic massage may also encourage flexibility and effective movement in other areas.


Why does the diaphragm become tight?

 

Many events can cause tension in the diaphragm and the pelvic floor, but trauma, long-term stress, bloating in the abdomen from bowel issues, and irregular breathing patterns are prominent factors impacting both diaphragms. Breathing disorders or sympathetic dominance of the nervous system can cause changes in breathing patterns and respiratory drive (hyperventilation, or quick, rapid breathing out of breaths that keep the diaphragm contracted for extended periods of time). Once breathing patterns are changed, the scalenes and serratus, two accessory respiratory muscles, contract to maintain adequate respiration, which can lead to more compensatory issues.

 

Certain bodily systems, like the respiratory system, adjust to meet the needs of the body when long-term stress, discomfort, and hyperarousal increase wear and tear on the body and impair its ability to maintain homeostasis. Even the anticipation of imagined threats will have an effect on the respiratory system in clients with PTSD, decreasing exhalation and lengthening the diaphragm's contraction time.

 

Because the respiratory and neurological systems react to emotions rather than chemoreceptors, illnesses like PTSD, depression, sorrow, and other similar ones may also affect metabolic activities, potentially changing homeostasis over an extended period of time. A regular breathing pattern and nervous system functioning can be restored by working on the diaphragm and desensitising the respiratory system. This will improve sleep, improve metabolic function, and boost the ability to manage discomfort.

 

Breathlessness and bloating in the abdomen can be caused by a number of illnesses. In addition to women's health problems, including menstruation and ovarian cancer, breathing-related respiratory disorders like cystic fibrosis, asthma, and COPD can also cause stomach bloating. During pregnancy, bloating, nausea, and shortness of breath may arise from the foetus pressing against the diaphragm. Because of the altered breathing patterns, stress-related problems like anxiety, panic attacks, and hyperventilation can also be a factor. Certain meals, such as lentils, beans, cabbage, and carbonated drinks, may lead to excess gas and raise pressure on the diaphragm. Overeating and excessive air swallowing can also increase pressure on the diaphragm, encouraging dyspnoea. Digestion is a clear contributing element, in addition to these problems and ailments like cancer, gallstones, hernias, pancreatic insufficiency, and peripheral neuropathy. It is possible to have digestive problems due to obesity, lactose intolerance, celiac disease, gastroparesis, or constipation, but irritable bowel syndrome is most likely the most prevalent.

 

However, studies have revealed that electrical diaphragmatic activity is frequently abnormal in IBS patients, which may be a factor in the lower back pain that coexists with IBS. Also, there may be a detrimental effect on intestinal motility if the diaphragm's contractile power is limited.

 

IBS is frequently accompanied by visible stomach bloating and tightness, which can cause breathing difficulties because of limited mobility and elevated diaphragm pressure. Breathlessness can then result in rapid, shallow breathing, which further impedes diaphragmatic movement or the swallowing of air, exacerbating bloating.

 

Summary

 

You can anticipate better immune system performance, fewer menstrual cramps, less constipation, enhanced digestive organ function, and even better respiratory function with frequent stomach massage use. By taking additional precautions like drinking lots of water, engaging in deep breathing exercises, and maintaining a balanced diet, the benefits of these massages can be maximised.

 

If done gently, abdominal massage is generally safe, although it should not be given to someone who has recently had abdominal surgery or who is pregnant. The benefits of deep colon massage therapy and the range of conditions it can help with speak for themselves, dispelling the massage industry's argument that stomach massages are too personal or inappropriate in some other way. However, there are risks associated with deep colon massages if they are being sought for a medical condition, so it is important to see a therapist who is suitably qualified, experienced, and insured at the highest level.

 

So, why are more therapists not providing massages for the stomach?


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Sam Mishra Brainz Magazine
 

Sam Mishra, Executive Contributor Brainz Magazine

Sam Mishra (The Medical Massage Lady), is a multi-award winning massage therapist, aromatherapist, accredited course tutor, oncology practitioner, trauma practitioner and breathwork facilitator. Her medical background as a nurse and a midwife, combined with her own experiences of childhood disability and abuse, have resulted in a diverse and specialised service. She is motivated by the adversity she has faced, using it as a driving force in her charity work and in offering the vulnerable a means of support. Her aim is to educate about medical conditions using easily understood language, to avoid inappropriate treatments being carried out and for health promotion purposes in the general public.

 

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  • Martínez-Ochoa M. J, Fernandez-Dominguez J. C, Morales-Asencio J. M, Gonzalez-Iglesias J, Ricard F & Oliva-Pascual-Vaca A (2018) Effectiveness of an Osteopathic Abdominal Manual Intervention in Pain Thresholds, Lumbopelvic Mobility, and Posture in Women with Chronic Functional Constipation. Journal of Alternative and Complementary Medicine, 24 (8), pp. 816-824

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