Effect of “Diaphragmatic Breathing Exercises” on Functional Constipation, Anxiety and Depression

Çigdem Ölke, Pemra C. Unalan, Arzu Uzuner, Pınar Kocabas

Keywords: Functional constipation, constipation, diaphragmatic breathing, belly breathing, anxiety, depression

Background:

Chronic constipation is one of the most common gastrointestinal disorders worldwide. Therefore, it is important to make the accurate diagnosis according to internationally accepted criteria and evaluate each patient individually for a proper treatment. Adjusting the diet, fiber supplementation and laxatives are the most common treatment methods. However, there are limited number of studies which suggest that diaphragmatic breathing exercises are also effective on chronic constipation problem.

Research questions:

Do diaphragmatic breathing exercises have any effect on chronic constipation disorder (functional constipation or constipation dominant irritable bowel
syndrome)?

Method:

This is a mixed type study in which a clinical trial follows a cross-sectional descriptive research. In the first part, “Diagnostic Questionnaire for Constipation”(DQC) derived from Rome IV Functional Constipation Criteria, applied to 375 students studying at faculties of Marmara University Health Campus. Among all 101 participants were defined to have constipation. Those who have consent to attend the diaphragmatic breathing sessions in
small groups, either face-to-face or via an online meeting in a 3-week period were 31 individuals. To evaluate severity of constipation, Turkish version of Constipation Assessment Scale (CAS) which has a total score of 16 was used in which higher score means higher severity of constipation “Anxiety Symptoms Questionnaire” (ASQ) and “Depression Risk Questionnaire” (DRQ) were also applied.

Results:

The median of the CAS total score was 6, 3 and 2 at baseline, on the third and 19 th weeks of follow up consequently. (p<0,001). The median of the ASQ total score was 64 at baseline, 35 at third week and 34 at 19 th week (p<0,001, p=0,006). According to DRQ results, depression risks were found significantly lower at 19 th week than it was at the baseline (p=0,047).

Conclusions:

Our results show that diaphragmatic breathing exercises have a statistically significant effect on relieving constipation, improving anxiety symptoms and lowering depression risks.

Points for discussion:

Do you have learning relaxation techniques such as "breathing exercises" in your residency curriculum?

What kind of analysis can be added to this study to discuss more about the effects of diaphragmatic breathing exercises on quality of life?

#197