Capsule Commentary on Abbot et al., Effect of Perineal Self-Acupressure on Constipation: A Randomized Controlled Trial
KeywordsConstipation Dietary Fiber Primary Outcome Measure Hemorrhoid Secondary Outcome Measure
Constipation is a common and costly condition, affecting up to 20% of the North American population,1 and may have great impact on a patient’s quality of life.2 Recommended treatment for constipation generally consists of a regimen of medications, increased dietary fiber and fluid, and exercise, though these measures are often ineffective.3 Some non-randomized or non-controlled studies suggest that perineal pressure may aid in defecation,4 however; there is a lack of controlled, randomized studies addressing this. Additionally, very few studies address the effect on patient quality of life.
This randomized, parallel group trial by Abbot and colleagues5 evaluated the impact of perineal self-acupressure on bowel function and patient quality of life. Patients in the treatment group received training in perineal self-acupressure, and both groups received information about standard constipation treatment. The primary outcome measure, Patient Assessment of Constipation Quality of Life, was significantly improved in the treatment group. The secondary outcome measure of bowel function was also significantly improved. The patients in the treatment group also reported satisfaction with perineal self-acupressure, and the majority indicated they would continue to use the technique.
There are some notable limitations of this study that should be considered. The sample size was small, and although randomized, the trial was not blinded. It is also unclear if these results will be relevant for other patient populations, including patients with hemorrhoids or other sequelae from chronic constipation, or patients without constipation in which this technique may be used as a preventative measure.
In terms of clinical application, perineal self-acupressure appears to be a safe and simple intervention that may greatly improve bowel function and quality of life for patients with chronic constipation, when used in conjunction with standard treatment.
Conflict of Interest
The author declares that he/she does not have a conflict of interest.
- 2.Sun SX, Dibonaventura M, Purayidathil FW, Wagner JS, Dabbous O, Mody R. Impact of chronic constipation on health-related quality of life, work productivity, and healthcare resource use: an analysis of the National Health and Wellness Survey. Dig Dis Sci. 2011;56(9):2688–95.CrossRefPubMedGoogle Scholar