Connective Tissue Manipulation Improves Symptoms and Quality of Life in Patients With Chronic Constipation

Connective tissue manipulation (CTM) is a manual reflex therapy, which increases intestinal motility by stimulating autonomic nervous system to re-balance the parasympathetic and sympathetic functions. However, there is no randomized controlled trial (RCT) regarding the efficacy of CTM on constipation. This study was planned to investigate the effects of CTM in patients with chronic constipation. Patients who have diagnosis of chronic constipation according to Rome III criteria were recruited and randomized to intervention and control group. The intervention group received CTM in addition to the lifestyle advice, while the control group was given only lifestyle advice for constipation. All assessments were performed at baseline and at the end of 4 weeks. The primary outcome measure was the Constipation Severity Instrument (CSI). Secondary outcomes included Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL), Bristol Stool Scale (BSS) and 7-day bowel diary. Differences between groups were analyzed with t-tests, Mann-Whitney U test and Chi-square test.