Effect of Abdominal Massage Versus Visceral Manipulation on Constipation

Inclusion Criteria:

• Patients of both sex with age ranges (20-40) years old.

• having a diagnosis of functional constipation according to Rome IV criteria onset ofconstipation symptoms from 6-12 months .

• having body mass index 18.5-29.9 kg/m2 , waist height ratio </=0.5

• Subjects bothered by their constipation

Exclusion Criteria:

• Pregnancy.

• Having comorbidities (chronic pelvic pain, neurological (Parkinson's, multiplesclerosis, spinal cord lesion, etc.), metabolic / endocrine (diabetes mellitus,hypercalcemia, hypothyroid, etc.), cardiorespiratory diseases

• Health problems which may prevent standing from sitting, walking (orthopedic,neurological, cardiorespiratory, etc.)

• Malignancy, acute inflammation, intestinal tumor

• History of gastrointestinal and pelvic surgery or spinal surgery other thancholecystectomy, appendectomy, or hysterectomy

• Visual, auditory or cognitive problems which may prevent participation to the study.

• Tumor, presence of skin problems in the application area

• Presence of laxative use for functional constipation in the last four weeks orpatients on laxative therapy.

• Alarm symptoms (unexplained, more than 10% weight loss in 3 months, hemorrhoids andanal fissures, rectal bleeding, family history of colon cancer)