Chronic constipation is one of those health scourges nobody likes to discuss with friends over coffee. It significantly impacts your quality of life, it's a very unglamorous problem, and conventional healthcare does not offer a lot of solutions (and to be fair even good integrative healthcare sometimes struggles to achieve that as well.)

Once medical reasons for chronic constipation have been ruled out, and they are quite few of them actually, patients are instructed to follow some basic self-care practices to improve transit time. By the time people reach us, they have already improved their hydration, increased their fiber intake, and their aerobic activity to no avail. They walk in the door with a diagnosis of "functional constipation" which basically means they are chronically constipated and we have no idea why.

This blog entry is not meant to be a comprehensive review of the algorithm to workup chronic constipation, since that would take 20 pages, but to review one particular aspect of managing functional constipation that most patients have never been exposed to: the effectiveness of self directed abdominal massage to improve normal bowel muscular activity. The technique is quite simple, can be taught in about 20 minutes, is painless, and only takes a few minutes a day. What is even more remarkable is that a recent double-blind controlled clinical trial showed it to be remarkably more effective than placebo and other conventional methods.

In the video Anne demonstrates the basic technique you can use on yourself. I highly recommend however that you make an appointment with a massage therapist for 30 minutes to practice the method on yourself so you feel confident that you will get the benefit of doing it at home.

https://www.youtube.com/watch?v=BykR20PmdQs

https://pubmed.ncbi.nlm.nih.gov/35554601/