How adding the abdominal massage to polyethylene glycol can improve symptom and quality of life in patients with functional constipation in comparison with each one of the treatment modalities alone: A randomized clinical trial

Effectiveness of acupoint stimulation combined with neurogenic bowel training on constipation in stroke patients: a retrospective study

OBJECTIVE

To analyze the effectiveness of acupoint stimulation combined with neurogenic bowel training on constipation in stroke patients.

METHODS

A retrospective analysis was conducted on the clinical data of 89 stroke patients with constipation admitted to our hospital from July 2022 to January 2024. All patients met the inclusion and exclusion criteria. The control group (n = 42) received neurogenic bowel training intervention, while the experimental group (n = 47) received finger acupoint stimulation combined with neurogenic bowel training intervention. Four outcome measures including intervention effects, bowel movements, Constipation Scoring System (CSS), and Scores on the Patient Assessment of Constipation Quality of Life (PAC-QOL) were compared between the two groups.

RESULTS

The total intervention effective rate in the experimental group (91.49%) was significantly higher than that in the control group (73.81%) (p < 0.05). Two weeks after intervention, the experimental group had significantly better first bowel movement time, average bowel movement time, and bowel movement interval time compared to the control group (p < 0.05). One and 2 weeks after intervention, the CSS and PAC-QOL scores in the experimental group were significantly better than those in the control group (p < 0.05).

CONCLUSION

Acupoint stimulation combined with neurogenic bowel training significantly improves constipation in stroke patients. Compared to neurogenic bowel training alone, the combined application of acupoint stimulation further improves bowel movements, reduces constipation severity, and enhances the quality of life in patients. Therefore, it is worthy of clinical promotion.

Analysis of the efficacy of abdominal massage on functional constipation: A meta-analysis

Background

Constipation is a digestive disorder with a high global prevalence, with approximately 20-25% of the population suffering from constipation, and the majority of constipated patients experience functional constipation (FC). Although abdominal massage is an effective intervention, there is a lack of analysis of the efficacy of abdominal massage in the treatment of functional constipation. Objective: To evaluate the clinical efficacy of abdominal massage in the treatment of functional constipation.

Methods

A computerized retrieval of randomized controlled trials on abdominal massage for functional constipation was conducted on China National Knowledge Infrastructure (CNKI), Wanfang, VIP Chinese Science and Technology Periodical Database, Chinese BioMedical Literature Database, Cochrane Database, PubMed, Embase, and Web of Science until October 1, 2022. Meta-analysis was performed using RevMan 5.3 software after the initial screening and re-screening of the literature.

Results

A total of 13 papers involving 830 patients were included. The results of the meta-analysis showed that abdominal massage had better efficacy in the treatment of functional constipation. Constipated patients in the treatment group showed greater improvement in the frequency of defecation, difficulty in defecation, stool properties, and PAC-QOL scores than those in the control group. The SMD/MD values and 95% CI of each score were: SMD = 1.05, 95%CI (0.63,1.46); SMD = -1.51, 95%CI (-2.35,-0.68); SMD = 0.95, 95%CI (0.31,1.59); MD = -13.24, 95%CI (-25.83, -0.65).

Conclusion

Abdominal massage can increase the frequency of defecation, reduce the symptoms of difficulty in defecation, improve stool properties, and positively affect the quality of life of patients with constipation. Hence, abdominal massage therapy shows definite therapeutic efficacy for functional constipation, providing a more specific plan for clinical treatment.

Abdominal massage: A review of clinical and experimental studies from 1990 to 2021

OBJECTIVE

To systematically review the current state and holistic application of abdominal massage (AM).

DESIGN

A systematic review of qualitative evidence was conducted. All English articles exploring the topic of AM that had been published until the end of June 2021 were retrieved.

DATA SOURCES

The PubMed, Cochrane library, and Embase databases were accessed. Some original texts were obtained from Google Scholar.

DATA EXTRACTION AND SYNTHESIS

Two authors independently evaluated all search data to identify relevant studies. Disagreements were settled by discussion with a third author. Results were independently extracted into standardized sheets and checked for accuracy.

MAIN RESULTS

A total of 107 full-text reports were eligible for inclusion. Adult digestive disorders, pediatric disorders, gynecological disorders, obstetric disorders, metabolic disorders, psychological disorders, the side effects of AM, and animal experiments accounted for 49.53%, 14.02%, 7.48%, 7.48%, 4.67%, 4.67%, 5.61%, and 6.54% of all these papers, respectively, with most reports focusing on clinical studies.

CONCLUSION

The variety of diseases treated with AM is gradually increasing, and the treatment programs of AM for many diseases are being gradually optimized. Different forms of AM, especially mechanical AM, have been widely studied; the side effects of AM have also been considered; and the possible mechanisms of AM therapy continue to be discovered. In general, AM is an effective and safe therapy and can be widely used in various diseases, but further studies are necessary to clarify the mechanism of AM for different diseases. In the future, AM could become an even safer, more popular, and more modern therapy.

Gastrointestinal Dysfunction in Parkinson’s Disease: Current and Potential Therapeutics

Abnormalities in the gastrointestinal (GI) tract of Parkinson’s disease (PD) sufferers were first reported over 200 years ago; however, the extent and role of GI dysfunction in PD disease progression is still unknown. GI dysfunctions, including dysphagia, gastroparesis, and constipation, are amongst the most prevalent non-motor symptoms in PD. These symptoms not only impact patient quality of life, but also complicate disease management. Conventional treatment pathways for GI dysfunctions (i.e., constipation), such as increasing fibre and fluid intake, and the use of over-the-counter laxatives, are generally ineffective in PD patients, and approved compounds such as guanylate cyclase C agonists and selective 5-hyroxytryptamine 4 receptor agonists have demonstrated limited efficacy. Thus, identification of potential targets for novel therapies to alleviate PD-induced GI dysfunctions are essential to improve clinical outcomes and quality of life in people with PD. Unlike the central nervous system (CNS), where PD pathology and the mechanisms involved in CNS damage are relatively well characterised, the effect of PD at the cellular and tissue level in the enteric nervous system (ENS) remains unclear, making it difficult to alleviate or reverse GI symptoms. However, the resurgence of interest in understanding how the GI tract is involved in various disease states, such as PD, has resulted in the identification of novel therapeutic avenues. This review focuses on common PD-related GI symptoms, and summarizes the current treatments available and their limitations. We propose that by targeting the intestinal barrier, ENS, and/or the gut microbiome, may prove successful in alleviating PD-related GI symptoms, and discuss emerging therapies and potential drugs that could be repurposed to target these areas.

Bifidobacterium animalis F1-7 in combination with konjac glucomannan improves constipation in mice via humoral transport

Probiotics and natural products can promote humoral transport and effectively relieve intestinal motility. This study investigated the effects of probiotics in combination with konjac glucomannan (KGM) and an aqueous extract of Prunus persica on constipation. The growth promotion effect of these natural products on probiotics was investigated using co-culture in vitro. The combined effect of probiotics and natural products on constipation was observed in mice. The tryptophan, tryptamine and short-chain fatty acid levels were determined using enzyme-linked immunosorbent assay, reverse-phase high-performance liquid chromatography, and gas chromatography. The key genes and proteins involved in humoral transport were identified using real-time polymerase chain reaction, western blotting and fluorescence immunoassay. KGM promoted the growth of Bifidobacterium animalis F1-7 in vitro, and a mixture of KGM and B. animalis F1-7 effectively promoted defaecation in mice, increased the faecal water content, shortened the defaecation time and improved the gastrointestinal transit rate. In mice, the KGM + F1-7 mixture reduced the tryptophan level and increased the levels of tryptamine, acetic acid, propionic acid, butyric acid and valeric acid. In addition, the KGM + F1-7 mixture effectively increased the mRNA level of 5-HT₄-G-protein-coupled receptors (5-HT₄GPCR)/mucins-2 (MUC-2) and reduced the level of aquaporins (AQP₃); furthermore, it upregulated the protein level of 5-HT₄GPCR/MUC-2 and downregulated the protein level of AQP₃. These findings indicated that the KGM + F1-7 mixture effectively improved intestinal motility and alleviated constipation through humoral transport-related pathways.

The effects of abdominal "I LOV U" massage along with lifestyle training on constipation and distension in the elderly with stroke

INTRODUCTION

Constipation and distension are dominant gastrointestinal problems after stroke in the elderly. Always they are treated by the use of laxatives and fibers. Abdominal massage along with a healthy lifestyle can be a solution.

PURPOSE

This study aimed to investigate the effect of abdominal massage and lifestyle training on constipation and distention of the elderly with stroke.

METHOD

This study was a randomized clinical trial that was conducted on elderly patients with stroke at Qaem hospital of Mashhad, Iran. 68 patients were randomly allocated into control (n = 34) and intervention (n = 34) groups in 2017-2018. Finally 29 elderly in the intervention and 34 in the control group completed the study. Intervention included the abdominal massage by using "I LOV U" method along with lifestyle education. Each abdominal massage lasted for 15 min, twice daily for ten days that was performed at first session by the researcher and then continued by the key care giver. Data were collected by the demographic form, constipation assessment score (CAS), distension measurement tool (meter), and food tolerance evaluation checklist.

RESULTS

The results indicated that both groups were homogeneous in demographic variables (P > 0.05). The repeated ANOVA showed a more significant decrease in abdominal circumference of the intervention group during the 10- days study (P = 0.029).The Friedman test showed a significant difference in frequency of defecation in two groups in 10- day study (P < 0.0001). Therefore the CAS Score was significantly decreased in intervention group more than the control group (0.30 < 0.98 < 1.59, P = 0.001, EF = 0.44). The food tolerance frequencies through Gavage (P = 0.20), and also orally (P < 0.001) were significantly improved in the intervention group.

CONCLUSION

According to results, the abdominal massage along with lifestyle training could improve constipation and distension and also increase food intake tolerance in the elderly patients with stroke.