Abdominal massage for the treatment of idiopathic constipation in children with profound learning disabilities: a single case study design

Abstract

Accessible summary• This report describes how abdominal massage was provided to five children, to see if it would help with their constipation. • Children and adults with learning disabilities often have long-term constipation that is treated with laxatives. • The abdominal massage was not effective for all the children.• However the parents enjoyed doing the massage and all thought that it was a helpful and enjoyable experience for them and their children. SummaryChronic constipation is a common problem in people with learning disabilities. Treatment often involves dietary changes or long-term laxative use. The aim of this study was to examine the effectiveness of abdominal massage. The participants were five children with profound learning disabilities and additional physical difficulties. Their long-standing idiopathic constipation was managed by laxatives. Intervention lasted up to 35 weeks, during which participants received 20 min of massage at least twice daily. Parents were asked to maintain stable use of laxatives during the intervention phase, although some chose to withdraw laxatives during abdominal massage intervention. Abdominal massage appeared to result in stools of a more 'normal' consistency in some cases. However, no significant differences were found in stool frequency. Parents reported that abdominal massage was a positive experience. In addition, they believed that massage was an effective treatment for constipation. As a result, laxative use was reduced in some cases, apparently with no ill-effects. These subjective beliefs were not, however, generally borne out by the objective results.

Abdominal Massage for the Relief of Constipation in People with Parkinson’s: A Qualitative Study

“…Abdominal massage was reported as a pleasant and relaxing experience which aligns with previous work [20, 22]. Most participants in the intervention group reported positive impacts both physically (including improved bowel function, reduction in time spent defecating, less straining and bloating, increased completeness of evacuation, and reduced dependence on laxatives) and emotionally, for example, feeling empowered to self-manage their symptoms.…”

“…The resulting increase in intra-abdominal pressure promotes peristalsis and bowel sensation [16]. Using abdominal massage as a form of constipation management has also been proposed to reduce laxative use (and thus also their side-effects) [17, 18], improve health related quality of life (QoL) [19, 20], and ease the substantial cost of constipation-related-medicines to primary care [21]. …”

The Effect of Abdominal Massage on Gastric Residual Volume

“…Increasing peristalsis accelerates the passage of foods through the GI system (Emly, 2007). The literature stated that abdominal massage is used as a palliative treatment method in chronic constipation, fecal incontinence, changes in abdominal muscle tonus, and abdominal pain, and has no known side effect (Emly, 2007;Harrington & Haskvitz, 2006;Liu et al, 2005;Moss, Smith, Wharton, & Hames, 2007;Preece, 2002). No research was found, however, showing that abdominal massage prevents delayed gastric emptying in enterally fed patients except for the study in which Bastin et al (2004) made a small sampling.…”

Massage as therapy for persons with intellectual disabilities: A review of the literature

“…The focus of the review targeted on relaxation and behavioural changes following massage therapy. Outcomes involving medical problems were excluded from the review, for instance, massage therapy for the treatment of constipation (Moss et al, 2007) or bruxism (Rudrud and Halaszyn, 1981). The following selection criteria were formulated.…”