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EFFECT OF VISCERAL MANIPULATION ON CHILDREN WITH REFRACTORY CHRONIC FUNCTIONAL CONSTIPATION: A RANDOMIZED CONTROLLED
Seyed Arman Zakaryaei1, Majid Ravanbakhsh2,3, Hazhir Javaherizadeh4
1Student Research Committee, School of Rehabiliatation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Insights
Visceral manipulation (VM) offers a safe, effective complementary treatment for children with chronic functional constipation (FC) unresponsive to standard care. This approach significantly improved symptoms and reduced laxative dependence in a randomized controlled trial.
Area of Science:
- Pediatric Gastroenterology
- Manual Therapy
- Clinical Trial Research
Background:
- Functional constipation (FC) is a prevalent global health issue affecting children.
- Refractory FC cases often require alternative therapeutic strategies beyond standard medical care.
Purpose of the Study:
- To assess the efficacy of visceral manipulation (VM) as an adjunct therapy for pediatric chronic functional constipation (FC).
- To evaluate VM's impact on children with FC refractory to standard treatments.
Main Methods:
- A randomized, single-blind controlled trial involving 52 children with refractory FC.
- Participants received either standard medical care (SMC) or SMC plus VM for 4 weeks.
- Outcomes included abdominal pain, defecation pain, stool consistency, frequency, and laxative dose.
Main Results:
- The VM group showed significant improvements in pain, defecation, and stool consistency compared to controls.
- Oral laxative dosage significantly decreased in the VM group but not in the control group.
- While overall Bristol stool form scale scores didn't differ significantly between groups, normal stool consistency increased in the VM group.
Conclusions:
- Visceral manipulation (VM) is a safe and effective complementary treatment for managing chronic functional constipation (FC) in children.
- VM, alongside standard medical care, offers a promising therapeutic option with no reported side effects.
- Further research is warranted to explore the long-term effects of VM in pediatric FC management.
Background:
Functional constipation (FC) is a common global high prevalence issue in children.
Objective:
The purpose of the present study is to evaluate the effect of visceral manipulation (VM) on children with chronic interacble FC unresponsive to the standard treatment.
Methods:
This study was conducted as a randomized, single-blind controlled trial. Fifty-two children with refractory chronic functional constipation unresponsive to the standard medical treatment were randomly allocated to two groups of 26 control (standard medical care (SMC)) and 26 intervention (SMC with VM) for 4 weeks. Abdominal pain, painful defecation, stool consistency, defecation frequency, and the dose of oral laxative were evaluated before and after the treatment period using the Pain Rating Scale, Bristol stool form scale, and patient/parents report.
Results:
At the end of treatment, except for the dose of oral laxative in the control group, all of the results showed a significant difference in both groups (P<0.05). The dose of oral laxative in the intervention group decreased significantly (P<0.05), however, no significant change was observed in the control group (P>0.05). In the intervention group comparison, statistically significant differences were found in all va-riables except the Bristol stool form scale (P<0.05). The Bristol stool form scale after treatments was not different when the groups were compared (P=0.32), but the number of subjects who had normal stool consistency was significantly increased in the intervention group than in the control group (P<0.05).
Conclusion:
VM can be considered as a possible treatment without side effects besides SMC for the management of chronic FC. Further studies are needed to investigate the long-term effect of VM.
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