Abstract
BACKGROUND: Chronic constipation is common in the elderly, impairing quality of life and increasing healthcare use. While pharmacologic options exist, low-cost non-pharmacological alternatives remain underutilized. AIMS: To compare the effectiveness of traditional Thai abdominal massage versus prune consumption in relieving functional constipation in older women. METHODS: This single-blind randomized controlled trial was conducted in 2024 at Rafsanjan Primary Healthcare Centers. One hundred five elderly women with constipation (Rome III criteria) were assigned to Thai abdominal massage, prune consumption (50 g twice weekly), or control (n = 35 each) for 8 weeks. Outcomes included constipation severity (Constipation Assessment Scale, CAS), stool consistency (Bristol Stool Index), pain intensity (Visual Analogue Scale, VAS), and quality of life (PAC-QoL). RESULTS: Thai massage significantly reduced constipation severity (-6.71 ± 2.84), pain (-5.55 ± 1.92), and improved stool consistency (-2.03 ± 0.84) compared to the prune and control groups. Prune consumption showed the greatest improvement in quality of life (+ 0.75 ± 0.44). Group-by-time interaction effects were significant for all outcomes (CAS: F = 33.04; VAS: F = 84.33; Bristol: F = 26.74; QoL: F = 59.33; all p < 0.001). DISCUSSION: Thai massage was more effective in relieving constipation symptoms, while prunes offered subjective well-being benefits. Mechanistically, massage likely improved colonic motility and reduced anorectal discomfort. CONCLUSION: Thai abdominal massage offers a superior, low-cost intervention for functional constipation in elderly women, while prune consumption may complement care through quality-of-life gains.