Perspective on Physical Therapist Management of Functional Constipation

Functional constipation is a common bowel disorder leading to activity restrictions and reduced health-related quality of life. Typically, this condition is initially managed with prescription of laxatives or fiber supplementation, or both. However, these interventions are often ineffective and fail...

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Bibliographic Details
Published in:Physical therapy 2017-04, Vol.97 (4), p.478-493
Main Authors: George, Susan E, Borello-France, Diane F
Format: Article
Language:English
Subjects:
Abdomen
Adults
Analysis
Blood pressure
Care and treatment
Constipation
Constipation - therapy
Dietary fiber
Epidemiology
Fecal incontinence
Health aspects
Homeostasis
Humans
Inflammatory bowel disease
Laxatives
Laxatives - therapeutic use
Lifestyles
Medical History Taking
Medical referrals
Pain
Patients
Physical Examination
Physical therapists
Physical therapy
Physical Therapy Modalities
Physiology
Quality of Life
Surveys and Questionnaires
Terminology as Topic
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Summary:Functional constipation is a common bowel disorder leading to activity restrictions and reduced health-related quality of life. Typically, this condition is initially managed with prescription of laxatives or fiber supplementation, or both. However, these interventions are often ineffective and fail to address the underlying pathophysiology and impairments contributing to this condition. Physical therapists possess the knowledge and skills to diagnose and manage a wide range of musculoskeletal and motor coordination impairments that may contribute to functional constipation. Relevant anatomic, physiologic, and behavioral contributors to functional constipation are discussed with regard to specific constipation diagnoses. A framework for physical therapist examination of impairments that can affect gastrointestinal function, including postural, respiratory, musculoskeletal, neuromuscular, and behavioral impairments, is offered. Within the context of diagnosis-specific patient cases, multifaceted interventions are described as they relate to impairments underlying functional constipation type. The current state of evidence to support these interventions and patient recommendations is summarized. This perspective article aims not only to heighten physical therapists' awareness and management of this condition, but also to stimulate clinical questioning that will open avenues for future research to improve patient care.
ISSN:0031-9023
1538-6724
DOI:10.2522/ptj.20160110