Effects of abdominal massage on constipation in palliative care patients – a pilot study

Introduction
The problem of constipation in Poland concerns 13.4% of the healthy population. In the case of patients treated with opioids, this number increases to 70-90%, which constitutes a serious problem that lowers the patients' quality of life. The aim of the study was to assess the effects of abdominal massage, which successfully reduces constipation in various diseases, on palliative care patients.

Material and methods
The research included 18 patients of a palliative care facility (mean age 78.3 ± 10 years), 11 of whom completed the study. The study participants were randomly divided into two groups, i.e. a pilot group (abdominal massage and kinesiotherapy) and a control group (kinesiotherapy). The therapy lasted 8 weeks and blind evaluation was carried out once per week. The study involved evaluating constipation intensity (The Bowel Function Index), the frequency of defecation (medical documentation) and abdomen circumference (anthropometric tape). The collected data were analysed statistically with the use of Statistica software.

Results
The observed differences between the studied groups undergoing different therapies in subsequent weeks were not statistically significant. However, in the group in which abdominal massage was implemented, a decrease in the intensity of constipation, an increase in the frequency of defecation and a reduction in abdomen circumference were noted compared to the control group. The patients also indicated additional positive effects of this form of therapy, i.e. an improvement in breathing, easier urination, release of excessive gas and abdominal pain reduction.

Conclusions
The collected data led to the conclusion that abdominal massage may result in a decrease in disorders accompanying opioid-induced constipation. Therefore, it is worth considering the implementation of this form of therapy in the case of patients in an advanced stage of cancer. There is also a need for further research in this field which will include a larger number of patients.