The Effects of Abdominal Massage on the Management of Constipation: A Systematic Review of Randomised Controlled Trials

This study aimed to assess the effectiveness of abdominal massage in the management of constipation. We conducted this systematic review by scanning Pubmed, CINAHL, EBSCOhost, ScienceDirect, Ovi, ProQuest, Web of Science and ULAKBIM National Databases without any time restriction. To search the literature, we used the following keywords: "constipation", "constipation management" and "abdominal massage". We included into the systematic review randomised controlled trials on constipation management whose full texts were available both in English and Turkish, while studies without the full text and/or ongoing studies were excluded. A total of 31 articles were found; however, only 9 of these studies met the inclusion criteria. The effects of abdominal massage on constipation management have been assessed in different randomised controlled trials, with the participation of cancer, parkinson, multiple sclerosis and orthopedics and traumatology patients. The abdominal massage was applied to the patients in the supine position and in the direction of the colon, with different techniques of circular movements (kneading, vibration, effleurage, superficial or deep stroking techniques) for different periods (10-40 minutes) and at different frequencies (1 to 2 times in a day or week). In six trials, abdominal massage and laxatives were applied to the experimental group, whereas the standard clinical protocol (laxative and/or change in the lifestyle) was applied to the control group. In a study, massage based on the tensegrity principle (balance the tension of muscles, fasciae and ligaments that are structurally associated) was applied to the control group. In another study, the classical abdominal massage was applied to one group, the aroma massage was applied to the second group and only laxatives were administered to the third group. To assess constipation, the Gastrointestinal Symptom Rating scale, Constipation Severity index, Bristol Visual Stool scale, Constipation Quality of Life Questionnaire and Neurogenic Bowel Dysfunction or bowel diary were used in these studies. Our results showed that abdominal massages were effective in reducing constipation-related symptoms, increasing the frequency of defaecation and enhancing the quality of life of patients.