The effectiveness of abdominal massage in chronic constipation

The aim of this study was to investigate the efficacy of abdominal massage in patients with chronic constipation (CC) in a randomized placebo-controlled design. A total of 74 patients who were diagnosed with CC according to the Rome IV diagnostic criteria were included in our study. Patients were randomly divided into two groups; intervention group (abdominal massage + advices for lifestyle changes) and control group (placebo therapeutic ultrasound+advices for lifestyle changes). Abdominal massage was applied 3 days a week for 4 weeks, while placebo therapeutic ultrasound was applied for 4 weeks, 2 days a week. Severity of constipation which is primary outcome measure was evaluated using Constipation Severity Instrument. Secondary outcome measures, bowel functions (defecation frequency, defecation time and stool consistency) and quality of life associated with constipation were assessed using the 7-day bowel diary and the Patient Assessment of Constipation Quality of Life Questionnaire. At the end of the 4th week, subjective perception of improvement was recorded using the Global Rating of Change Scale. At the end of the study period, it was determined that the within-group changes of all outcome measures over time in both groups were statistically significant (p<0,001). When the group effect on these changes was investigated, it was found that the group interaction with time was also statistically significant (p<0,001). A higher level of improvement was seen in all outcome measures in the intervention group compared to the control group (p<0,05). It was also found that perceived improvement in symptoms of constipation was greater in the intervention group compared to the control group (p<0,001). As a result of this study, it was found that abdominal massage was more effective than placebo intervention in the treatment of CC in the short term. Further studies with long-term follow-up are needed to demonstrate the effectiveness of abdominal massage with different application parameters and/or protocols. Further studies can be planned for the effectiveness of abdominal massage in patients with secondary constipation.