International Journal of Biometeorology

, Volume 61, Issue 6, pp 1139–1148 | Cite as

Can balneotherapy improve the bowel motility in chronically constipated middle-aged and elderly patients?

  • Taner DandinogluEmail author
  • Ozgur Dandin
  • Tuncer Ergin
  • Deniz Tihan
  • Yasam Kemal Akpak
  • Oguz Ugur Aydın
  • Uygar Teomete
Original Paper


Balneotherapy or spa therapy is usually known for different application forms of medicinal waters and its effects on the human body. Our purpose is to demonstrate the effect of balneotherapy on gastrointestinal motility. A total of 35 patients who were treated for osteoarthritis with balneotherapy from November 2013 through March 2015 at our hospital had a consultation at the general surgery for constipation and defecation disorders. Patients followed by constipation scores, short-form health survey (SF-12), and a colonic transit time (CTT) study before and after balneotherapy were included in this study, and the data of the patients were analyzed retrospectively. The constipation score, SF-12 score, and CTT were found statistically significant after balneotherapy (p < 0.05). The results of our study confirm the clinical finding that a 15-day course of balneotherapy with mineral water from a thermal spring (Bursa, Turkey) improves gastrointestinal motility and reduces laxative consumption in the management of constipation in middle-aged and elderly patients, and it is our belief that treatment with thermal mineral water could considerably improve the quality of life of these patients.


Balneotherapy Bowel motility Constipation 



Compliance with ethical standards

The Institutional Review Board of Sevket Yılmaz Training and Research Hospital approved this study. All the patients provided informed written consent.


No funding, grants, or equipment were received for this study.

Conflict of interest

The authors declare that they have no conflict of interest


  1. Adler E (1961) Some clinical experiences with the springs at Zohar on the shore of the Dead Sea. Israel Medical Journal 20:304–308Google Scholar
  2. Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD (1996) A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon rectum 39:681–685Google Scholar
  3. Barbara G. Wells JTD, Terry L. Schwinghammer, Cecily V. DiPiro (2009) Pharmacotherapy handbook. In., Seventh Edition edn. The McGraw-Hill Press, p 250Google Scholar
  4. Chattat R et al (1997) Illness behavior, affective disturbance and intestinal transit time in idiopathic constipation. J Psychosom Res 42:95–100CrossRefGoogle Scholar
  5. Chaussade S, Roche H, Khyari A, Couturier D, Guerre J (1986) Measurement of colonic transit time: description and validation of a new method. Gastroenterologie clinique et biologique 10:385–389Google Scholar
  6. Coca Perraillon M, Shih YC, Thisted RA (2015) Predicting the EQ-5D-3L preference index from the SF-12 health survey in a national US sample: a finite mixture approach. Medical Decision Making. doi: 10.1177/0272989x15577362 Google Scholar
  7. Deyo RA, Von Korff M, Duhrkoop D (2015) Opioids for low back pain. BMJ 350:g6380. doi: 10.1136/bmj.g6380 CrossRefGoogle Scholar
  8. Elliott WJ, Ram CV (2011) Calcium channel blockers. J Clin Hypertens (Greenwich) 13:687–689. doi: 10.1111/j.1751-7176.2011.00513.x CrossRefGoogle Scholar
  9. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M (2011) Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Rheumatol Int 31:1–8. doi: 10.1007/s00296-010-1628-6 CrossRefGoogle Scholar
  10. Gaal J, Varga J, Szekanecz Z, Kurko J, Ficzere A, Bodolay E, Bender T (2008) Balneotherapy in elderly patients: effect on pain from degenerative knee and spine conditions and on quality of life. The Israel Medical Association Journal: IMAJ 10:365–369Google Scholar
  11. Gower WR Jr et al (1994) Atrial natriuretic peptide gene expression in the rat gastrointestinal tract. Biochem Biophys Res Commun 202:562–570. doi: 10.1006/bbrc.1994.1965 CrossRefGoogle Scholar
  12. Gutenbrunner CHG (1998) Textbook of balneology and medical climatology. Springer, HeidelbergGoogle Scholar
  13. Hayashi T, Ago K, Ago M, Ogata M (2010) Bath-related deaths in Kagoshima, the southwest part of Japan. Med Sci Law 50:11–14CrossRefGoogle Scholar
  14. Hebden JM, Blackshaw PE, Perkins AC, D’Amato M, Spiller RC (1998) Small bowel transit of a bran meal residue in humans: sieving of solids from liquids and response to feeding. Gut 42:685–689CrossRefGoogle Scholar
  15. Holgate AM, Read NW (1983) Relationship between small bowel transit time and absorption of a solid meal. Influence of metoclopramide, magnesium sulfate, and lactulose. Dig Dis Sci 28:812–819CrossRefGoogle Scholar
  16. Janicke DM, Pundt MR (1996) Anorectal disorders. Emerg Med Clin North Am 14:757–788CrossRefGoogle Scholar
  17. Kappel M, Gyhrs A, Galbo H, Pedersen BK (1997) The response on glucoregulatory hormones of in vivo whole body hyperthermia. Int J Hyperth 13:413–421CrossRefGoogle Scholar
  18. Korchinskii VS (1995) The effect of radon baths at the Khmel’nik health resort on the central hemodynamic indices and calcium-regulating hormones in patients with essential hypertension. Lik Sprava:84–87Google Scholar
  19. Kuczera M, Kokot F (1996) Effect of spa therapy on the endocrine system. I. Stress reaction hormones. Polskie Archiwum Medycyny Wewnetrznej 95:11–20Google Scholar
  20. Kurabayashi H, Tamura K, Tamura J, Kubota K (2001) The effects of hydraulic pressure on atrial natriuretic peptide during rehabilitative head-out water immersion. Life Sci 69:1017–1021CrossRefGoogle Scholar
  21. Martinez Seeber A, Vidal NA, Carchio SM, Karara AL (1986) Inhibition of water-sodium intestinal absorption by an atrial extract. Can J Physiol Pharmacol 64:244–247CrossRefGoogle Scholar
  22. Mason HJ, Serrano-Ikkos E, Kamm MA (2000) Psychological morbidity in women with idiopathic constipation. Am J Gastroenterol 95:2852–2857. doi: 10.1111/j.1572-0241.2000.02313.x CrossRefGoogle Scholar
  23. McConnell EA (1993) Giving your patient a sitz bath. Nursing 23:14CrossRefGoogle Scholar
  24. Melzack R, Wall P, Steptoe A, Wardle J (1994) Pain mechanisms: a new theory. Psychosocial Processes and Health: A Reader: 112–131Google Scholar
  25. Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG (1987) Simplified assessment of segmental colonic transit. Gastroenterology 92:40–47CrossRefGoogle Scholar
  26. Moses SW, David M, Goldhammer E, Tal A, Sukenik S (2006) The Dead Sea, a unique natural health resort. The Israel Medical Association Journal: IMAJ 8:483–488Google Scholar
  27. Nasermoaddeli A, Kagamimori S (2005) Balneotherapy in medicine: a review. Environ Health Prev Med 10:171–179. doi: 10.1007/bf02897707 CrossRefGoogle Scholar
  28. O’Hare JP et al (1985) Observations on the effect of immersion in bath spa water. Br Med J (Clin Res Ed) 291:1747–1751CrossRefGoogle Scholar
  29. Paran E, Neuman L, Sukenik S (1998) Blood pressure changes at the Dead Sea (a low altitude area). J Hum Hypertens 12:551–555CrossRefGoogle Scholar
  30. Persiianova-Dubrova AL et al (2010) Spa-based water procedures and complications in the course of their performance. Vopr Kurortol Fizioter Lech Fiz Kult:40–43Google Scholar
  31. Rambotti MG, Giambanco I, Spreca A (1997) Detection of guanylate cyclases A and B stimulated by natriuretic peptides in gastrointestinal tract of rat. Histochem J 29:117–126CrossRefGoogle Scholar
  32. Routh HB, Bhowmik KR, Parish LC, Witkowski JA (1996) Balneology, mineral water, and spas in historical perspective. Clin Dermatol 14:551–554CrossRefGoogle Scholar
  33. Sabbatini ME (2009) Natriuretic peptides as regulatory mediators of secretory activity in the digestive system. Regul Pept 154:5–15. doi: 10.1016/j.regpep.2009.02.009 CrossRefGoogle Scholar
  34. Shruti Sharma BBA (2012) Scoring systems in evaluation of constipation and oebstructed defecation syndrome (ODS). JIMSA 25Google Scholar
  35. Siewert H, Winterfeld HJ, Strangfeld D, Aurisch R (1992) Ventilation and hemodynamics as control parameters of spa treatment. Z Gesamte Inn Med 47:355–358Google Scholar
  36. Sukenik S, Flusser D, Abu-Shakra M (1999) The role of spa therapy in various rheumatic diseases. Rheum Dis Clin N Am 25:883–897CrossRefGoogle Scholar
  37. Tejirian T, Abbas MA (2005) Sitz bath: where is the evidence? Scientific basis of a common practice. Dis Colon rectum 48:2336–2340. doi: 10.1007/s10350-005-0085-x
  38. Umay E, Tezelli MK, Meshur M, Umay S (2013) The effects of balneotherapy on blood pressure and pulse in osteoarthritis patients with hypertension. Altern Ther Health Med 19:16–21Google Scholar
  39. Velde SV, Notebaert A, Meersschaut V, Herregods N, Van Winckel M, Van Biervliet S (2013) Colon transit time in healthy children and adolescents. Int J Color Dis 28:1721–1724. doi: 10.1007/s00384-013-1750-5 CrossRefGoogle Scholar
  40. Ware J Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233CrossRefGoogle Scholar
  41. Wexner SDJD (1989) Constipation postgrad. Adv Colorectal Surg 1:1–22Google Scholar
  42. Whitehead WECS, Corazziari E, Kumar D (1991) Report of an international workshop on management of constipation. Int J Gastroenterol 4:99–113Google Scholar
  43. Winterfeld HJ, Siewert H, Strangfeld D, Grosse W, Engelmann U, Frenzel R, Aurisch R (1992) The effect of health resort therapy on cardio-regulation following heart transplantation with special reference to CO2 balneotherapy. Z Gesamte Inn Med 47:299–302Google Scholar

Copyright information

© ISB 2016

Authors and Affiliations

  1. 1.Department of Physical Medicine and RehabilitationBursa Military HospitalBursaTurkey
  2. 2.Department of General SurgeryBursa Military HospitalBursaTurkey
  3. 3.Department of RadiologyGulhane Military Medical AcademyAnkaraTurkey
  4. 4.Department of SurgerySevket Yılmaz Research And Training HospitalBursaTurkey
  5. 5.Mevki Military HospitalAnkaraTurkey
  6. 6.Guven HospitalAnkaraTurkey
  7. 7.Department of RadiologyUniversity of Miami Miller School of MedicineFloridaUSA

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