Abdominal massage with peppermint oil in the management of bowel function in children with severe and multiple learning difficulties

Objective

To carry out a pragmatic, randomised, controlled trial to investigate whether abdominal massage using peppermint oil is an effective tool for bowel management in children with severe and multiple learning difficulties.

Materials and methods

A randomised controlled crossover trial was carried out on 34 students (aged 6–19 years) at a residential school. Chronic constipation is common in the subject group and conventional intervention (CI) consists of a regimen increasing from oral aperients to enemas, until bowel movements occur, which can cause discomfort and distress. Subjects that met the inclusion criteria were randomly allocated to either CI or Ci + daily abdominal massage with peppermint essential oil (Mentha piperata) diluted in vegetable oil. The trial ran for 12 weeks with a crossover at 6 weeks. Nurses taking decisions on bowel management interventions were blinded to the trial. Outcome data included measures of frequency of bowel movements and medication given.

Results

Only one subject failed to complete the study. The statistical analysis of the data will be presented at the conference.

Conclusion

Abdominal massage as a tool for bowel management is non-invasive and generally acceptable to staff and students. The project highlights important issues related to the balance between developing a rigorous trial design and maintaining a pragmatic approach.

This project was initially supported by a First Rung award from the Research Council for Complementary Medicine.