If lower abdominal distension is present, make sure there are no contraindications to abdominal massage, such as gastrointestinal bleeding or ruptured intra-abdominal organs, based on a clear etiology and appropriate other management. The patient can be placed flat on the bed and the abdomen can be rubbed in a clockwise direction.
The speed should probably be controlled to about 10-15 times per minute and the massage can be continued for 10-15 minutes.