Nonpharmacologic treatment for elderly with constipation: a systematic review and meta-analysis

Area of Science:

• Gerontology
• Gastroenterology
• Integrative Medicine

Background:

• Constipation is a prevalent issue among the elderly, significantly impacting their quality of life.
• Conventional treatments may have limitations or adverse effects, necessitating exploration of alternative therapies.

Purpose of the Study:

• To evaluate the efficacy and safety of non-pharmacological interventions for constipation in older adults.
• To synthesize evidence from randomized controlled trials (RCTs) on treatments like acupuncture, abdominal massage, ear acupoints, probiotics, and dietary fiber.

Main Methods:

• A systematic review and meta-analysis of RCTs published up to March 2025.
• Searches were conducted across major databases including Cochrane Library, PubMed, Web of Science, Embase, and Chinese databases.
• Quality assessment used the Cochrane risk of bias tool, with data analyzed using RevMan5.4.1 and Stata.

Main Results:

• Forty-one RCTs with 3,005 elderly patients (≥60 years) were included.
• Non-pharmacological interventions showed significantly higher efficacy (RR=1.15) and fewer adverse events (RR=0.35) compared to controls.
• Acupuncture, abdominal massage, and ear acupoint therapy demonstrated superior therapeutic effects. Improvements were noted in quality of life, stool consistency, and bowel movement frequency, particularly with interventions longer than 4 weeks.

Conclusions:

• Non-pharmaceutical interventions are more effective than conventional treatments for elderly constipation.
• Long-term application of these therapies enhances their benefits.
• Future high-quality, large-sample RCTs are recommended to confirm long-term efficacy and elucidate mechanisms, despite current heterogeneity.