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Abdominal massage and laxative use for constipation: a pilot study

27 July 2023
Volume 32 · Issue 14



Constipation is a very frequent condition. Pharmacological treatment leads to the onset of complications in the long term.


To study the effects of abdominal massage and bowel training combined with polyethene glycol compared with laxative alone. Researchers studied the frequency of evacuations, use of laxatives, appetite, and food intake of older persons. In addition, feasibility in the daily routine of nursing care was studied.


A pilot, randomised controlled trial was conducted. Older people living in a facility for self-sufficient residents were enrolled and randomised to the intervention or control group. The massage was administered for 4 weeks. The stool type according to the Bristol Stool Form Scale and secondary outcomes were collected at baseline, before any massage session and at the end of the intervention.


32 participants were enrolled. Significant improvements were found in the number of evacuations, need for enemas, Bristol scores, appetite and food intake.


Significant improvements were found in all major outcomes.

Constipation describes symptoms such as hard stools, overstraining, infrequent bowel movements, digital manoeuvres, abdominal bloating and an incomplete evacuation (Rao et al, 2016). It is a frequent condition affecting about 20% of the population; incidence increases with age (Vazquez Roque and Bouras, 2015) causing discomfort, increased healthcare costs and loss of appetite (Çevik et al, 2018), an important symptom in older persons that can lead to impaired nutritional status (Bonetti et al, 2017; Bollo et al, 2019). Aetiology includes primary and secondary factors, the first being alterations of bowel function, which cause prolonged stool transit. Secondary factors include inadequate fluid and fibre intake, sedentariness, neurological conditions, neoplasms, and the use of medications such as opioids, antidepressants, and antipsychotics (Yurtdaş et al, 2020; Salari et al, 2023). According to the Rome IV Criteria (Lacy and Patel, 2017), functional constipation is the simultaneous presence of two or more factors among those listed in Box 1. In addition, these factors must have arisen at least 6 months before diagnosis (Simren et al, 2017; Russo et al, 2019).

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