Nursing Practices in Constipation Symptom Management: Systematic Review

Öz

Aim: This systematic review was conducted to examine studies evaluating the effects of non-pharmacological interventions used in individuals experiencing constipation.

Methods: The study population consisted of 1151 articles, with 23 studies meeting the inclusion criteria. The review followed PRISMA-P guidelines. Literature searches were performed in PUBMED, Science Direct, CINAHL, and the Turkish Higher Education Council (YÖK) Thesis Database using the keywords “constipation,” “symptom management,” and “nursing care.” The search was limited to studies published in the last five years; however, YÖK theses published within the last twelve years were also included. Studies available in full text and published in English or Turkish were eligible.

Results: Non-pharmacological interventions were categorized into five groups: abdominal massage, reflexology, auricular applications (acupressure/massage), aromatherapy massage, and transcutaneous electrical stimulation. Their frequency in the included studies was as follows: abdominal massage 56.5%, auricular applications 21.7%, reflexology 17.4%, aromatherapy massage 8.7%, and transcutaneous electrical stimulation 4.3%. Abdominal massage increased defecation frequency and reduced abdominal distension; reflexology regulated bowel movements; auricular applications and electrical stimulation reduced symptom severity, particularly in elderly and chemotherapy patients. Aromatherapy massage positively influenced bowel function by providing psychological and physiological relaxation.

Conclusion: Non-pharmacological nursing interventions are effective, safe and feasible for managing constipation symptoms. Integrating these practices into clinical care may improve patient outcomes. Further studies with larger samples and long-term follow-up are needed to provide stronger evidence of their effectiveness.

Anahtar Kelimeler

• constipation
• symptom management
• nursing care

Kaynakça

1. Diaz S, Bittar K, Hashmi MF, Mendez MD. Constipation. In: StatPearls. StatPearls Publishing; 2023. google scholar Dedeli Ö, Pakyüz SC. Bowel movements: are they a sixth vital sign? Clin Exp Health Sci. 2016;6(3):135–9. google scholar
2. Akyüz Özdemir F, Can G. Konstipasyon. In: Oğuz S, Ünver V, Çamcı G, Kocatepe V, editors. Semptom yönetimi ve hemşirelik. İstanbul: İstanbul Tıp Kitabevleri; 2023. p. 318–41 google scholar
3. Vazquez Roque M, Bouras EP. Epidemiology and management of chronic constipation in elderly patients. Clin Interv Aging. 2015; 10:919–30. https://doi.org/10.2147/CIA.S54304 google scholar
4. Lafcı D, Kaşikçi M. Effect of aroma massage on constipation in elderly individuals. Exp Gerontol. 2023;171:112023. https://doi.org/10.1016/j.exger.2022.112023 google scholar
5. Dehghan M, Malakoutikhah A, Ghaedi Heidari F, Zakeri M. Effect of abdominal massage on gastrointestinal functions: a systematic review. Complement Ther Med. 2020;54:102553. https://doi.org/10.1016/j.ctim.2020.102553 google scholar
6. Fekri Z, Aghebati N, Sadeghi T, Farzadfard MT. Effects of “I LOV U” abdominal massage with lifestyle training on constipation and distension in elderly stroke patients. Complement Ther Med. 2021;57:102665. google scholar
7. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71 google scholar
8. Eren N, Ün N, Altuner E, Yılmaz İ. Effect of abdominal massage on constipation management in palliative care patients: a randomized controlled trial. Sağlık Bakım Rehabil Derg. 2024;3(3):47–58. google scholar

9. Kahveci MM. Management of functional constipation in elderly with abdominal massage: a randomized controlled study [PhD Thesis]. Muğla Sıtkı Koçman University; 2024. YÖK Ulusal Tez Merkezi; No. 912177. google scholar
10. Dirlik Er B. Effect of abdominal massage on constipation and quality of life in palliative care patients [Master’s Thesis]. Eskişehir Osmangazi University; 2023. YÖK Ulusal Tez Merkezi; No. 822099. google scholar
11. Çetinkaya O. Effect of abdominal massage on constipation in elderly individuals in nursing homes [PhD Thesis]. Gaziantep University; 2022. YÖK Ulusal Tez Merkezi; No. 767875. google scholar
12. Aydınlı A. Yaşlı bireylere lavanta ve zencefil yağıyla uygulanan abdominal masajın konstipasyon üzerine etkisi [PhD Thesis]. Erciyes University; 2020. YÖK Ulusal Tez Merkezi; No. 651147. google scholar
13. Baran A. Yaşlılarda konstipasyon yönetiminde abdominal masajın etkisi: randomize kontrollü çalışma [Master’s Thesis]. Üsküdar University; 2015. YÖK Ulusal Tez Merkezi; No. 426661. google scholar
14. Olgun S. Effect of abdominal massage on chronic constipation and quality of life in elderly residents of nursing homes [PhD Thesis]. Ege University; 2013. YÖK Ulusal Tez Merkezi; No. 388635. google scholar
15. Park YG, Kim BS, Kang KT, Ha YC. Effects of Abdominal Massage for Preventing Acute Postoperative Constipation in Hip Fractures: A Prospective Interventional Study. Clin Orthop Surg. 2023 Aug;15(4):546-551. doi: 10.4055/cios22091. google scholar
16. Broon FJ, Salmani F, Taghanaki HB, Hosseini H, Torshizi M. Effect of acupressure and reflexology on pregnancy constipation: a quasi-experimental study. Eur J Med Res. 2025 Sep 26;30(1):877. doi: 10.1186/s40001-025-03166-2. google scholar
17. Abbasi P, Mojalli M, Kianmehr M, Zamani S. Effect of acupressure on constipation in patients undergoing hemodialysis: A randomized double-blind controlled clinical trial. Avicenna J Phytomed. 2019 Jan-Feb;9(1):84-91. google scholar
18. Lafcı, D., & Kaşikçi, M. (2023). The effect of aroma massage on constipation in elderly individuals. Experimental gerontology, 171, 112023. doi.org/10.1016/j.exger.2022.112023 google scholar
19. Bayram A. Comparison of the effects of foot reflexology and abdominal massage on constipation in elderly individuals [PhD Thesis]. Karadeniz Teknik University; 2024. YÖK Ulusal Tez Merkezi; No. 906242. google scholar
20. Çevik K. Effect of reflexology on constipation in elderly individuals [PhD Thesis]. Ege University; 2013. YÖK Ulusal Tez Merkezi; No. 388638. google scholar
21. Akyüz Özdemir F. Opioid ilişkili konstipasyonun yönetiminde refleksoloji çorabının etkisi [PhD Thesis]. İstanbul University-Cerrahpaşa; 2022. YÖK Ulusal Tez Merkezi; No. 744104. google scholar
22. İnkaya B, Tüzer H. Effect of reflexology on constipation in elderly individuals. Yonago Acta Med. 2020;63(2):115–21. https://doi.org/10.33160/yam.2020.05.007. google scholar
23. Mao T, Liu X, Cheng Q, Chen Y. Transcutaneous acupoint electrical stimulation for chemotherapy-induced constipation in non-small cell lung cancer patients: a randomized controlled trial. Asia Pac J Oncol Nurs. 2021;8(4):385–92. https://doi.org/10. 4103/2347-5625.311129 google scholar
24. Aminizadeh M, Tirgari B, Rashtabadi OR, Jahani Y, Tajadini H. Effectiveness of auricular acupressure on constipation and related quality of life among older people in residential care home: a randomized clinical trial. BMC Geriatr. 2023;23(1). https://doi. org/10.1186/s12877-023-03881-7 google scholar
25. Bıçak Ayık D. Effect of auricular acupressure on constipation management in palliative care patients [PhD Thesis]. İstanbul University; 2020. YÖK Ulusal Tez Merkezi; No. 635125. google scholar
26. Li, Y., Li, X., Zang, J., Hao, L., Gao, Y., & Liao, Y. Clinical Efficacy of Abdominal Massage Combined With Moxibustion for Treatment of Chronic Constipation in Elderly Patients. Neurogastroenterology & Motility. 2026; 38(1): e70207. https://doi.org/10.1111/ nmo.70207 google scholar
27. Doğan İG, Gürşen C, Akbayrak T, Balaban YH, Vahabov C, Üzelpasacı E, Özgül S. Abdominal Massage in Functional Chronic Constipation: A Randomized Placebo-Controlled Trial. Phys Ther. 2022;102(7):58. doi: 10.1093/ptj/pzac058. google scholar
28. Shi X, Hu Y, Zhang B, Li W, Chen JD, Liu F. Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation. JCI Insight. 2021;6(14):e150052. doi: 10.1172/jci.insight.150052. google scholar
29. Liu J, Lv C, Yin M, Zhu M, Wang B, Tian J, Hashimoto K, Yu Y. Efficacy and Safety of Transcutaneous Auricular Vagus Nerve Stimulation in Patients With Constipation-Predominant Irritable Bowel Syndrome: A Single-Center, Single-Blind, Randomized Controlled Trial. Am J Gastroenterol. 2024;120(9):2139-2153. doi: 10.14309/ ajg.0000000000003257. google scholar
30. Artale S, Terzoni S, Destrebecq A, Sansone CM, Vitale MT, Sala E, Ferrara P. Abdominal massage and laxative use for constipation: a pilot study. Br J Nurs. 2023;32(14):666-671. doi: 10.12968/bjon.2023.32.14.666. google scholar
31. Tang K, Deng H, Li M, Fang X, He C. Non-Invasive Auricular Acupoint Stimulation Improves Slow-Transit Constipation: Evidence From a Randomized Controlled Trial. Med Sci Monit. 2025;31:e946714. doi: 10.12659/MSM.946714. google scholar
32. Nouhi E, Mansour-Ghanaei R, Hojati SA, Chaboki BG. The effect of abdominal massage on the severity of constipation in elderly patients hospitalized with fractures: A randomized clinical trial. Int J Orthop Trauma Nurs. 2022;47:100936. doi: 10.1016/j.ijotn.2022.100936. google scholar