مجله دانشکده پزشکی اصفهان (Jul 2018)
A Comparison between Polyethylene Glycol and Abdominal Massage on Symptoms and Quality of Life Improvement in Functional Constipation: A Randomize Clinical Trial Study
Abstract
Background: Chronic functional constipation is one of functional gastrointestinal disorders. Constipation has negative impact on quality of life (QOL). Pharmacological and non-pharmacological treatments are considered for constipation. This study was designed to compare the efficacy of polyethylene glycol (PEG) and abdominal massage on symptoms and quality of life improvement in functional constipation. Methods: In this randomize clinical trial study, all the patients with functional constipation, based on Rome IV criteria, with age of 18-65 years, who referred to gastroenterology clinic of Rasoul-e-Akram university hospital, Tehran, Iran, were enrolled. The patients were randomly assigned to two groups of treatment with polyethylene glycol or abdominal massage. Basic demographic data, Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, Bristol score, and presenting symptoms were recorded. We visited our patients in 2 weeks at the end of treatment and 2 weeks after completing treatment. Drug adverse effects and patient's adherence to treatment were recorded in data gathering sheets, too. The data were compared between the two groups using SPSS software. Findings: 94 patients (47 patients in each group) completed the study. Constipation was more common in women, and low income, educated, and married patients. No significant difference was seen in demographic data between the groups. Quality of life score was significantly better in polyethylene glycol therapy than abdominal massage (P = 0.028). Moreover, symptoms (P = 0.032) and Bristol score (P < 0.001) were significantly improved more in polyethylene glycol therapy. Treatment side effects were seen in 8% of polyethylene glycol group, as well as 1% in abdominal massage group (P < 0.001), which were transient and mild. Conclusion: Abdominal massage is a non-surgical non-medical modality for treatment of functional constipation. It is feasible, without any cost and adverse effect; but it is not an effective modality, lonely. Further studies should be considered to combine abdominal massage with other treatment modalities in these patients.
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