The use of abdominal massage to treat chronic constipation.

Constipation is a disorder of gastrointestinal motility characterized by difficult or decreased bowel movements, and is a common condition in Western countries. Laxatives are the most common strategy for managing constipation. However, long-term use of some laxatives may be associated with harmful side-effects including increased constipation and fecal impaction. Abdominal massage, once an accepted method of treating constipation, is no longer standard of care, but may be a desirable therapy for this condition because it is inexpensive, non-invasive, free of harmful side-effects, and can be performed by patients themselves. However, until recently, evidence for its effectiveness was not strong enough to make a recommendation for its use in constipated patients. In 1999, Ernst reviewed all available controlled clinical trials, and found that there was no sound evidence for the effectiveness of abdominal massage in the treatment of chronic constipation. This article reviews scientific evidence from 1999 to the present, regarding abdominal massage as an intervention for chronic constipation. Since that time, studies have demonstrated that abdominal massage can stimulate peristalsis, decrease colonic transit time, increase the frequency of bowel movements in constipated patients, and decrease the feelings of discomfort and pain that accompany it. There is also good evidence that massage can stimulate peristalsis in patients with post-surgical ileus. Individual case reports show that massage has been effective for patients with constipation due to a variety of diagnosed physiologic abnormalities, as well as in patients with long-term functional constipation.