As pelvic physical therapists in Boulder County, functional constipation has been something treated in our clinics via various techniques. A new randomized controlled trial has shown one commonly performed intervention to be an effective first-line treatment for functional constipation. Functional constipation is defined by the Rome IV criteria.

Rome IV criteria:

Must include two or more of the following to be considered functional constipation

1. Straining during more than 25% of defecations

2. Lumpy or hard stools (Bristol Stool Form Scale 1-2) more than 25% of defecations

3. Sensation of incomplete evacuation more than 25% of defecations

4. Manual maneuvers to facilitate more than 25% of defecations (e.g. digital evacuation, support of the pelvic floor)

5. Fewer than 3 spontaneous defecations per week

6. Loose stools are rarely present without the use of laxatives

7. Insufficient criteria for irritable bowel syndrome

Abdominal massage targets the ‘slow motility’ component in functional constipation. The massage works through mechanical stimulation and the neurologic/autonomic responses associated with this stimulation. It stimulates peristalsis and improves blood flow to the digestive tract, thus increasing motility (the movement of food through our digestive tract).

In this recent study, a control group received lifestyle advice and placebo therapeutic ultrasound. An experimental group received lifestyle advice and abdominal massage. See below for a video of the abdominal massage used in the study that you can perform on yourself. This group received the massage 3x per week for about a 10 minute duration for the course of 4 weeks.

Results: 70% improvement in constipation severity, 56% improvement in Quality of Life, and 70% increase in defecation frequency in the abdominal massage group.

This study highlights the importance of a first-line conservative treatment that can be effective for constipation in order for someone to avoid pharmaceutical or medical intervention. With constipation being closely intertwined with many other pelvic floor dysfunctions, this is an especially important intervention that can be utilized to help issues even beyond constipation.

Come schedule an appointment with one of our pelvic health physical therapists at Mend in Boulder or Lafayette to learn this massage and other treatments to conservatively treat your constipation!

Irem Gul Dogan, PT, MSC, Ceren Gursen, PT, PhD, Turkan Akbayrak, PT, PhD, Yasemin Hatice Balaban, MD, Cavansir Vahabov, MD, Esra Uzelpasaci, PT, MSC, Serap Ozgul, PT, PhD, Abdominal Massage in Functional Chronic Constipation: A Randomized Placebo-Controlled Trial, Physical Therapy, Volume 102, Issue 7, July 2022