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Effect of acupressure on constipation in patients with advanced cancer

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Supportive Care in Cancer Aims and scope Submit manuscript

A Correction to this article was published on 06 December 2019

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Abstract

Purpose

Constipation is a common and distressing symptom for patients with advanced cancer. Few reports have focused on the symptoms of constipation in patients with advanced cancer. The aim of this study was to investigate the effect of a short-term acupressure intervention on patients with advanced cancer.

Methods

This study used a non-randomized, pre-post study design to assess the effect of acupressure intervention. A total of 30 patients with advanced cancer were recruited from the hospice unit of a medical center in southern Taiwan. In addition to routine care, patients in the intervention group received an 8-min acupressure treatment daily for 3 consecutive days. Three acupoints were used in this study: Zhongwan (CV12), Guanyuan (CV4), and Tianshu (ST25). Analysis of covariance was used to compare the differences in symptoms of constipation between the two groups, adjusted for baseline values. Effect sizes were calculated using partial eta squared (η2).

Results

Significant improvements in symptoms of constipation (partial η2 = 0.40, p < 0.001 for straining during defecation; partial η2 = 0.30, p = 0.002 for hard stools; partial η2 = 0.42, p < 0.001 for sensation of incomplete evacuation; and partial η2 = 0.29, p = 0.002 for sensation of anorectal obstruction), Bristol stool form scale scores (partial η2 = 0.40, p < 0.001), comfort levels during defecation (partial η2 = 0.82, p < 0.001), and colonic motility (partial η2 = 0.85, p < 0.001) were observed in patients receiving acupressure intervention compared with the controls.

Conclusions

Findings from this study indicated that short-term acupressure was effective in alleviating symptoms of constipation among patients with advanced cancer. Further, randomized controlled trials are warranted to confirm the results.

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Change history

  • 06 December 2019

    The institutional review board number is incorrect, it should be No. 104-3133B.

  • 06 December 2019

    The institutional review board number��is incorrect, it should be No. 104-3133B.

References

  1. Sbahi H, Cash BD (2015) Chronic constipation: a review of current literature. Curr Gastroenterol Rep 17:47

    Article  Google Scholar 

  2. Walsh D, Donnelly S, Rybicki L (2000) The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer 8:175–179

    Article  CAS  Google Scholar 

  3. Rhondali W, Nguyen L, Palmer L, Kang DH, Hui D, Bruera E (2013) Self-reported constipation in patients with advanced cancer: a preliminary report. J Pain Symptom Manag 45:23–32

    Article  Google Scholar 

  4. Perdue C (2005) Managing constipation in advanced cancer care. Nurs Times 101:36–40

    PubMed  Google Scholar 

  5. Abramowitz L, Beziaud N, Labreze L, Giardina V, Causse C, Chuberre B, Allaert FA, Perrot S (2013) Prevalence and impact of constipation and bowel dysfunction induced by strong opioids: a cross-sectional survey of 520 patients with cancer pain: DYONISOS study. J Med Econ 16:1423–1433

    Article  CAS  Google Scholar 

  6. Sykes NP (2006) The pathogenesis of constipation. J Support Oncol 4:213–218

    PubMed  Google Scholar 

  7. Dhingra L, Shuk E, Grossman B, Strada A, Wald E, Portenoy A, Knotkova H, Portenoy R (2013) A qualitative study to explore psychological distress and illness burden associated with opioid-induced constipation in cancer patients with advanced disease. Palliat Med 27:447–456

    Article  Google Scholar 

  8. Ford AC, Brenner DM, Schoenfeld PS (2013) Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and meta-analysis. Am J Gastroenterol 108:1566–1574

    Article  CAS  Google Scholar 

  9. Lembo AJ, Schneier HA, Shiff SJ, Kurtz CB, MacDougall JE, Jia XD, Shao JZ, Lavins BJ, Currie MG, Fitch DA, Jeglinski BI, Eng P, Fox SM, Johnston JM (2011) Two randomized trials of linaclotide for chronic constipation. N Engl J Med 365:527–536

    Article  CAS  Google Scholar 

  10. Liu Z, Yan S, Wu J et al (2016) Acupuncture for chronic severe functional constipation: a randomized trial. Ann Intern Med 165:761–769

    PubMed  Google Scholar 

  11. Li MK, Lee TF, Suen KP (2010) A review on the complementary effects of auriculotherapy in managing constipation. J Altern Complement Med 16:435–447

    Article  Google Scholar 

  12. Woodward S, Norton C, Chiarelli P (2014) Biofeedback for treatment of chronic idiopathic constipation in adults. Cochrane Database Syst Rev 3:CD008486

    Google Scholar 

  13. Lee MS, Choi TY, Park JE, Ernst E (2010) Effects of moxibustion for constipation treatment: a systematic review of randomized controlled trials. Chin Med 5:28

    Article  Google Scholar 

  14. Sinclair M (2011) The use of abdominal massage to treat chronic constipation. J Bodyw Mov Ther 15:436–445

    Article  Google Scholar 

  15. Wang X, Yin J (2015) Complementary and alternative therapies for chronic constipation. Evid Based Complement Alternat Med 2015:396396

  16. Zhang T, Chon TY, Liu B, Do A, Li G, Bauer B, Wang L, Liu Z (2013) Efficacy of acupuncture for chronic constipation: a systematic review. Am J Chin Med 41:717–742

    Article  Google Scholar 

  17. Mehta P, Dhapte V, Kadam S, Dhapte V (2017) Contemporary acupressure therapy: adroit cure for painless recovery of therapeutic ailments. J Tradit Complement Med 7:251–263

    Article  Google Scholar 

  18. Shin HS, Song YA, Seo S (2007) Effect of Nei-Guan point (P6) acupressure on ketonuria levels, nausea and vomiting in women with hyperemesis gravidarum. J Adv Nurs 59:510–519

    Article  Google Scholar 

  19. Song HJ, Seo HJ, Lee H, Son H, Choi SM, Lee S (2015) Effect of self-acupressure for symptom management: a systematic review. Complement Ther Med 23:68–78

    Article  CAS  Google Scholar 

  20. Levett KM, Smith CA, Dahlen HG, Bensoussan A (2014) Acupuncture and acupressure for pain management in labour and birth: a critical narrative review of current systematic review evidence. Complement Ther Med 22:523–540

    Article  CAS  Google Scholar 

  21. Chen YW, Wang HH (2014) The effectiveness of acupressure on relieving pain: a systematic review. Pain Manag Nurs 15:539–550

    Article  Google Scholar 

  22. Ling WM, Lui LY, So WK, Chan K (2014) Effects of acupuncture and acupressure on cancer-related fatigue: a systematic review. Oncol Nurs Forum 41:581–592

    Article  Google Scholar 

  23. Lau CH, Wu X, Chung VC et al (2016) Acupuncture and related therapies for symptom management in palliative cancer care: systematic review and meta-analysis. Medicine (Baltimore) 95:e2901

    Article  Google Scholar 

  24. Abbott R, Ayres I, Hui E, Hui KK (2015) Effect of perineal self-acupressure on constipation: a randomized controlled trial. J Gen Intern Med 30:434–439

    Article  Google Scholar 

  25. Shin J, Park H (2016) Effects of auricular acupressure on constipation in patients with breast cancer receiving chemotherapy: a randomized control trial. West J Nurs Res 40:67–83. https://doi.org/10.1177/0193945916680362

    Article  PubMed  Google Scholar 

  26. Patsopoulos NA (2011) A pragmatic view on pragmatic trials. Dialogues Clin Neurosci 13:217–224

    PubMed  PubMed Central  Google Scholar 

  27. World Health Organization (2008) WHO standard acupuncture point locations in the Western Pacific region. World Health Organization, Manila, Philippines

  28. Lin SF, Tang WR, Chang YC, Maa SH (2011) Effectiveness of acupressure on elderly patients with constipation. J Nurs Healthc Res (Taipei) 7:175–187

    Google Scholar 

  29. Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32:920–924

    Article  CAS  Google Scholar 

  30. Gonzalez CE, Halm JK (2016) Constipation in cancer patients. In: Todd KH, Thomas CR Jr (eds) Oncologic emergency medicine: principles and practice. Springer, Switzerland, pp 327–332

    Chapter  Google Scholar 

  31. Lee EJ, Frazier SK (2011) The efficacy of acupressure for symptom management: a systematic review. J Pain Symptom Manag 42:589–603

    Article  Google Scholar 

  32. Lee MS, Kang JW, Ernst E (2010) Does moxibustion work? An overview of systematic reviews. BMC Res Notes 3:284

    Article  Google Scholar 

  33. Chang CM, Lin HF (2011) A systematic review of acupressure in constipation. Chang Gung Nursing 22:311–320

    Google Scholar 

  34. Yin J, Chen JD (2010) Gastrointestinal motility disorders and acupuncture. Auton Neurosci 157:31–37

    Article  Google Scholar 

  35. Luo D, Liu S, Xie X, Hou X (2008) Electroacupuncture at acupoint ST-36 promotes contractility of distal colon via a cholinergic pathway in conscious rats. Dig Dis Sci 53:689–693

    Article  Google Scholar 

  36. Hróbjartsson A, Emanuelsson F, Skou Thomsen AS, Hilden J, Brorson S (2014) Bias due to lack of patient blinding in clinical trials. A systematic review of trials randomizing patients to blind and nonblind sub-studies. Int J Epidemiol 43:1272–1283

    Article  Google Scholar 

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Acknowledgements

We thank Dr. Malcolm Koo for the statistical advice.

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Authors and Affiliations

  1. Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Dapi Road, Kaohsiung City, 83301, Taiwan

    Pei-Ming Wang & Chih-Fang Huang

  2. Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan

    Ching-Wen Hsu, Ting-Yu Lai & Fe-Ling Tzeng

  3. Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan

    Chun-Ting Liu

  4. Department of Long Term Care, Chung Hwa University of Medical Technology, Tainan City, Taiwan

    Chih-Fang Huang

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  1. Pei-Ming Wang
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Correspondence to Chih-Fang Huang.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Wang, PM., Hsu, CW., Liu, CT. et al. Effect of acupressure on constipation in patients with advanced cancer. Support Care Cancer 27, 3473–3478 (2019). https://doi.org/10.1007/s00520-019-4655-1

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  • DOI: https://doi.org/10.1007/s00520-019-4655-1

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