Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review

J Nurs Scholarsh. 2020 May;52(3):261-269. doi: 10.1111/jnu.12555. Epub 2020 Apr 22.


Purpose: To identify nonpharmacological clinically effective interventions for constipation in adults.

Methods: A systematic review of experimental studies of nonpharmacological interventions addressing participants' management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693.

Results: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant's modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage.

Conclusions: Specific nonpharmacological interventions are crucial for nurses' clinical practice and of major importance for clients and families. Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice.

Clinical relevance: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.

Keywords: Clinical effectiveness; constipation; experimental design; nursing; systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Constipation / nursing*
  • Humans
  • Massage / nursing
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Treatment Outcome