Background and Effects of Physical Therapy for Adult Patients with Constipation, A Systematic Review

Author(s): Bary Berghmans, Maura Seleme

Constipation is a – often chronic - common and prevalent gastrointestinal motility disorder with high impact on quality of life, daily, sport and work activities of patients. Constipation has been defined as abnormal stool frequency < 3 bowel movements (BMs) per week. Besides this, also other symptoms, such as excessive straining, passage of hard stool, inability to defecate at will, unproductive urges, and sensation of incomplete evacuation, occur. Few systematic reviews have investigated the effectiveness of physical therapy. Several conservative treatment modalities for patients with constipation exist, in many cases up to now without sufficient or convincing scientific or clinical evidence. Often based on limited data about their effect, recommendations, advise, as first-line treatments, before any specific medication is subscribed, the use of general exercises or physical activity, behavioral changes regarding fluid intake and bowel habit and – regimen are mentioned. Next to this, physical therapy is recommended. This systematic review evaluated the effects of physical therapy on constipation, quality of life (QOL), and muscle strength and -relaxation in adult patients with constipation. Six RCTs met our study selection criteria. The PEDro rating score was used to classify the methodological quality, resulting in moderate to high methodological quality of the studies. Current RCT data may indicate positive effects of physical therapy for patients with pelvic floor dysfunction related to constipation, but more high-quality studies are warranted.