Management Of Functional Constipation Research Articles

Rome IV Clinical Criteria and Management of Functional Constipation: Indonesian Health Care Professionals' Perspective.

The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.

Antegrade continence enema alone for the management of functional constipation and segmental colonic dysmotility (ACE-FC): A Pediatric Colorectal and Pelvic Learning Consortium Study.

The purpose of the study is to determine if antegrade continence enema (ACE) alone is an effective treatment for patients with severe functional constipation and segmental colonic dysmotility. A retrospective study of patients with functional constipation and segmental colonic dysmotility who underwent ACE as their initial means of management were reviewed. Data was collected from six participating sites in the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC). Patients who had a colonic resection at the same time as an ACE or previously were excluded from analysis. Only patients who were ≤21 years old and had at least one year follow up after ACE were included. All patients had segmental colonic dysmotility documented by colonic manometry (CMAN). Patient characteristics including preoperative colonic and anorectal manometry were summarized, and associations with colonic resection following ACE were evaluated using Fisher's exact test and Wilcoxon rank-sum test. P-values of <0.05 were considered significant. Statistical analyses and summaries were performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA). A total of 104 patients from six institutions were included in the study with an even gender distribution (males n=50, 48.1%) and a median age of 9.6 years (IQR 7.4, 12.8). At one year follow-up, 96 patients (92%) were successfully managed with ACE alone and eight patients (7%) underwent subsequent colonic resection for persistent symptoms. Behavioral disorder, type of bowel management, and the need for botulinum toxin administered to the anal sphincters was not associated with the need for subsequent colonic resection. On anorectal manometry, lack of pelvic floor dyssynergia was significantly associated with the need for subsequent colonic resection; 3/8, 37.5% without pelvic dyssynergia vs. 1/8, 12.5% (P=0.023) with pelvic dyssynergia underwent subsequent colonic resection. In patients with severe functional constipation and documented segmental colonic dysmotility, antegrade continence enema alone is an effective treatment modality at one year follow-up. Patients without pelvic floor dyssynergia on anorectal manometry are more likely to receive colonic resection after ACE. The vast majority of such patients can avoid a colonic resection.

Efficacy of a prebiotic formulation for treatment of functional constipation and associated gastrointestinal symptoms in adults: A randomised controlled trial

ObjectivesFunctional constipation is the result of a complex interplay between the gastrointestinal tract, the gut microbiome, the nervous system, along with diet and lifestyle factors. This study aimed to evaluate the efficacy of a prebiotic formulation containing plant-based extracts rich in dietary fibre and polyphenols in the management of functional constipation and associated gastrointestinal symptoms. DesignThis 3-week randomised controlled study assessed the effect of a prebiotic formulation (6 g powder taken in water twice daily), by comparison with a capsule designed to have minimal effect on gastrointestinal function, on indicators of bowel health in healthy adults with low fibre intake and meeting the Rome IV criteria for functional constipation. MethodsParticipants were informed that they may receive one of two products, either a powder or a capsule, both of which contained prebiotics. The primary outcome was change in frequency of complete spontaneous bowel movements. Secondary outcomes assessed were gastrointestinal symptoms, quality of life and mood using the PAC-SYM, PAC-QoL, and DASS-21. Safety and tolerability were also assessed. ResultsThere was a significant improvement in bowel movements (p < 0.001) and improved stool consistency (p < 0.01) in participants taking the prebiotic powder formulation compared to those taking the capsule. Accompanying this was a significant reduction in overall gastrointestinal symptoms (p < 0.001) including abdominal (p < 0.001), rectal (p = 0.004) and stool (p = 0.002) symptoms, and a significant improvement in quality of life (p 0.001). There was a significant reduction in mean score for depression, anxiety, and stress for participants in both groups, which indicated a significant improvement in mood during the study that was unrelated to bowel function. ConclusionsThe results showed that the prebiotic powder formulation taken twice per day for 21 days was effective in reducing clinical symptoms of functional constipation in individuals reporting a low fibre intake.

The effect of spinal magnetic stimulation on the management of functional constipation in adults

BackgroundFunctional constipation is a type of functional bowel disorder characterized by difficult defecation with a sense of incomplete evacuation. It is a common disorder with an increasing prevalence, and the underlying cause is poorly identified. Nonpharmacological management of functional constipation includes lifestyle and dietary modification, regular physical activity, advice about toileting posture, and behavioral therapy. Biofeedback training as part of the behavioral training showed great efficacy with long-term results. Spinal magnetic stimulation is the application of extracorporeal magnetic stimuli to the spinal nerves and deep pelvic muscles to enhance bowel evacuation without surgical drawbacks. This study was designed to enhance bowel elimination in functional constipation patients through the dual effect of biofeedback and spinal magnetic stimulation. This work aimed to study the efficacy of spinal magnetic stimulation and biofeedback training versus biofeedback alone in the management of functional constipation.ResultsThere was a statistically significant difference between before and after the intervention in both studied groups regarding the mean weekly spontaneous bowel movement, a Numerical Rating Scale for pain assessment, and the Patient Assessment of Constipation Quality of Life questionnaire. When comparing the two groups after the intervention, the spinal magnetic stimulation showed superiority in the mean weekly spontaneous bowel movement and manometric anal pressure at rest.ConclusionsSpinal magnetic stimulation in addition to biofeedback pelvic floor muscle training could increase the mean weekly complete spontaneous bowel movements and manometric anal pressure at rest in patients with functional constipation. It did not show any additive benefits in improving pain during defecation or patient quality of life.Trial registrationClinicalTrials.gov, 0305398. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000BQ0H&selectaction=Edit&uid=U0004JW0&ts=2&cx=-xmnims

Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation.

We found significant improvement in stool consistency, FI, abdominal pain, and hematochezia. This suggests that transcutaneous PTNS could be a promising noninvasive treatment for FC in children. Large studies are needed. • Functional constipation is one of the most common disorders in children. • Current management of functional constipation consists of an integrative approach that includes medications, diet and behavioral strategies. • Posterior tibial nerve stimulation is a novel noninvasive and easy to use therapy that can improve stool consistency, fecal incontinence and blood in stools.

Comparison of Effectiveness, Tolerability, and Compliance of Pharmacotherapies in Patients with Functional Constipation: A Real-World Evidence Study

Background: duphalac® bulk, a combination of bulking agents and an osmotic laxative might prove beneficial in the management of functional constipation (FC) as compared to the existing therapies. Objective: To evaluate and compare the effectiveness, safety, and compliance of duphalac® bulk with other available therapeutic options for the management of constipation. Methods: In this retrospective study, electronic medical records (EMRs) of adult patients suffering from FC who were prescribed various dietary fibers or their combinations between May 2021 to September 2021 and visiting healthcare setups/clinics were reviewed. The patients were divided into four groups (2:1:1:1): Group I-duphalac® bulk; Group II-isabgol alone; Group III-lactitol and isabgol combination; and Group IV-Polyethylene glycol (PEG) and isabgol combination. Effectiveness was determined using the constipation scoring system (CSS). Adverse events and compliance were assessed. Additionally, lipid and glycemic parameters were analyzed. Results: Out of 110 patients screened, 96 met the inclusion criteria and participated in the study. Majority of the patients (42.7%) received duphalac® bulk, followed by lactitol and isabgol combination (19.7%), PEG and isabgol combination (18.7%), and isabgol (18.7%). A significant reduction in overall mean CSS was observed among all the groups; however, the maximum decrease (3.49, p&lt;0.001) was found in Group I as compared to Groups II (3.28, p&lt;0.001), III (2.58, p=0.001), and IV (2.50, p=0.002). All treatments were well tolerated. Improvements in glycemic and lipid parameters were observed in all groups. Conclusion: duphalac® bulk was well tolerated with significant symptomatic improvement in patients suffering from FC. Keywords: Constipation scoring system, Duphalac® bulk, Functional constipation, Glycemic control, Lipid profile

Evaluation of Management of Functional Constipation in Children among South Indian Population – Cross Sectional Study

Functional constipation is a common bowel disorder in the communitywhich affects one in six children. The overall prevalence of constipation was 14.7%and 4.6% for FC while only 1.8% of respondents reported laxative use every day.The aim of this study is to evaluate the current trend of diagnosing and treatment of functional constipation among children. After getting informed consent, we reviewed the prescription of these patients, and data was collected using a semi-structured pre-validated questionnaire. Data were entered in Microsoft excel 2010 and statistical analyses were done using SPSS 17. The total number of cases included in the study was 138. Of which majority of cases are in the age group of below 5 years with a female preponderance. Almost all the cases reported laxatives use for the relief of constipation along with few dietary modifications. Lactulose and PEG played a major role in FC.Dietary habits and physical activity also played an important role as FC children reported low fruit and vegetable consumption, high fast-food consumption, and low levels of physical activity.

Reported Prevalence and Nutritional Management of Functional Constipation among Young Children from Healthcare Professionals in Eight Countries across Asia, Europe and Latin America.

Background: The prevalence of functional constipation (FC) among children varies widely. A survey among healthcare professionals (HCPs) was conducted to better understand the HCP-reported prevalence and (nutritional) management of FC in children 12–36 months old. Methods: An anonymous e-survey using SurveyMonkey was disseminated via emails or WhatsApp among HCPs in eight countries/regions. Results: Data from 2199 respondents were analyzed. The majority of the respondents (65.9%) were from Russia, followed by other countries (Indonesia (11.0%), Malaysia (6.0%)), Mexico, KSA (5.1% (5.7%), Turkey (3.0%), Hong Kong (2.2%), Singapore (1.1%)). In total, 80% of the respondents (n = 1759) were pediatricians. The prevalence of FC in toddlers was reported at less than 5% by 43% of the respondents. Overall, 40% of the respondents reported using ROME IV criteria in > 70% of the cases to diagnose FC, while 11% never uses Rome IV. History of painful defecation and defecations < 2 x/week are the two most important criteria for diagnosing FC. In total, 33% of the respondents reported changing the standard formula to a specific nutritional solution, accompanied by parental reassurance. Conclusion: The most reported prevalence of FC in toddlers in this survey was less than five percent. ROME IV criteria are frequently used for establishing the diagnosis. Nutritional management is preferred over pharmacological treatment in managing FC.

Management of Functional Constipation in Children

Management of Functional Constipation in Children

Implementation of a Clinical Decision Support (CDS) Tool for the Management of Functional Constipation in Pediatric Primary Care.

Constipation is common in general pediatrics and often results in potentially unnecessary referrals to pediatric gastroenterology. We hypothesized that a clinical decision-making tool would support primary care providers to manage pediatric constipation, improve workflow, and prevent unnecessary subspecialty care. In this pilot quality improvement initiative, a multidisciplinary team completed a root cause analysis related to challenges with the care of pediatric constipation. The results informed the development of interventions including a Clinical Decision Support tool and patient educational materials embedded within an existing order-set in the electronic health record, which we implemented in our primary care network. The use of the updated order-set continues to increase monthly, and there is reported improved workflow and increased confidence by providers. These interventions demonstrated that it is feasible to implement tools to support primary care clinicians in their management of pediatric patients with constipation.

Physical Therapy Management of Functional Constipation in Adults: A 2021 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association's Academy of Pelvic Health Physical Therapy

Background: Functional constipation, diagnosed by physicians utilizing the Rome criteria, is a nonpathologic bowel condition resulting in difficulty with defecation. Adults with functional constipation experience infrequent defecation and may strain and/or use manual maneuvers to produce a bowel movement. Physical therapy should be offered as part of conservative intervention. The goals of this guideline were to describe the available evidence and create a reference document of evidence for physical therapists managing adults with functional constipation symptoms. Methods: A systematic search of the literature was performed for articles published between 1990 and 2019 related to physical therapy interventions for adult functional constipation. A summary of details including benefits, risks, harms, and costs related to each intervention category is provided. Results: Strong evidence suggests that physical therapists should offer biofeedback interventions to their patients with functional constipation, including either electromyographic, rectal balloon catheter, or anorectal manometry biofeedback. Moderate evidence supports the use of manual therapy, whereas weak evidence was found to support the use of electrical stimulation to manage adult functional constipation. Finally, although we were not able to grade the evidence for the use of patient education and therapeutic exercise in the physical therapy management of functional constipation, we did provide a summary of these interventions in the literature. Discussion/Conclusions: Our findings suggest that physical therapists can confidently include biofeedback interventions into the plan of care for adults with functional constipation, as they are supported by strong evidence. Manual therapy also provided a degree of evidence suitable to recommend its use.

Physical Therapy Management of Functional Constipation in Adults Executive Summary: A 2021 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association's Academy of Pelvic Health Physical Therapy

Physical Therapy Management of Functional Constipation in Adults Executive Summary: A 2021 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association's Academy of Pelvic Health Physical Therapy

Effectiveness of Polyethylene Glycol 3350 versus Lactulose in Management of Functional Constipation in Children

Constipation is one of the common problems in childhood. Recently, Polyethylene Glycol (PEG 3350) has been suggested as a good alternative laxative to Lactulose as a treatment option in pediatric constipation. The current study aimed to compare the efficacy of two laxatives (PEG 3350 and Lactulose) in the management of functional constipation and evaluate the side effects.

Probiotics and Functional Gastrointestinal Disorders in Pediatric Age: A Narrative Review.

Assessment and management of pain are essential components of pediatric care. Pain in pediatric age is characterized by relevant health and socio-economic consequences due to parental concern, medicalization, and long-term physical and psychological impact in children. Pathophysiological mechanisms of nociception include several pathways in which also individual perception and gut-brain axis seem to be involved. In this narrative review, we analyze the rational and the current clinical findings of probiotic use in the management of functional gastrointestinal disorders (FGID) in pediatric age, with special focus on infantile colic, irritable bowel syndrome, constipation, and gastroesophageal reflux. Some specific probiotics showed a significant reduction in crying and fussing compared to placebo in breastfed infants with colic, although their exact mechanism of action in this disorder remains poorly understood. In irritable bowel syndrome, a limited number of studies showed that specific strains of probiotics can improve abdominal pain/discomfort and bloating/gassiness, although data are still scarce. As for constipation, whilst some strains appear to reduce the number of hard stools in constipated children, the evidence is not adequate to support the use of probiotics in the management of functional constipation. Similarly, although some probiotic strains could promote gastric emptying with a potential improvement of functional symptoms related to gastroesophageal reflux, current evidence is insufficient to provide any specific recommendation for the prevention or treatment of gastroesophageal reflux. In conclusion, probiotics have been proposed as part of management of pain in functional gastrointestinal disorders in pediatric age, but mechanisms are still poorly understood and evidence to guide clinical practice is currently inadequate.

Observation on the Efficacy of Shouhui Tongbian Capsule in the Treatment of Functional Constipation and Study on Its Regulatory Effect on Intestinal Flora.

Functional constipation is relatively common in both adults and children, exhibiting similar symptoms. However, there are significant differences in the epidemiology, symptomatology, pathophysiology, diagnostic tests, and treatment management of functional constipation by age. The treatment of functional constipation is generally based on lifestyle interventions, pelvic floor interventions, and pharmacotherapy. Pharmacological treatment is popular as the most direct and effective modality, especially the herbal preparations (e.g., Shouhui Tongbian capsule), which are popular for their lower toxic side effects and less physiological reactions. In our clinical study, patients with functional constipation who took Shouhui Tongbian capsules for a longer period of time showed significantly better improvement than those who took them for a shorter period of time (P < 0.001). Relative to the duration of the disease, the improvement effect was higher in patients with short duration of the disease than in patients with long duration of the disease (P < 0.001). What's more, Shouhui Tongbian capsule had a regulating effect on intestinal flora, and the regulating effect was stronger in patients with a shorter disease duration.

The magnitude and management of functional constipation at pediatric gastroenterology clinics: A survey study of various countries.

There have been no large-scale epidemiological study of functional constipation of pediatric gastroenterology services. This survey was undertaken to investigate the prevalence of functional constipation and magnitude of related problems in hospital settings of various countries as well as the practice of pediatric gastroenterologists in management of these conditions. The survey was conducted by sending questionnaires to members of Societies for Pediatric Gastroenterology Hepatology and Nutrition of various continents. A total of 274 pediatric gastroenterologists from 41 countries participated in this study. Functional constipation accounted for overall 30% of patients attending pediatric gastroenterology outpatient clinics. In comparison with non-western countries, respondents from western countries reported significantly higher median annual numbers of new patients with intractable functional constipation (10 [4,25] vs 5 [2,10], P < 0.001), dyssynergic defecation (3 [0,15] vs 1 [0,4], P < 0.001), and colonic inertia (2 [0,5] vs 0 [0,1], P < 0.001). The use of high dose polyethylene glycol for fecal disimpaction was significantly more commonly among respondents from western countries, whereas rectal enema was significantly more favored in non-western countries. Respondents from different continents reported significant discrepancies in choices of investigations and management of patients with dyssynergic defecation and colonic inertia. Functional constipation is a major problem for pediatric gastroenterology outpatient services worldwide. There were significant variations in the investigations of choice and therapeutic management of functional constipation, intractable functional constipation, and related problems among pediatric gastroenterologists of different geographic regions.

Management of Functional Constipation in Pediatrics Based on Nurse Educational Intervention

Back ground: Constipation is a prevalent problem in pediatric patients and one of the ten most common pathological conditions visited by general pediatricians (1). It accounts for up to 25 percent of referrals to a pediatric gastroenterologist. Therefore, this study was done to evaluate the effects of a nurse-based education program on reducing the symptoms of chronic functional constipation in children (2). Methods: This clinical trial study was conducted on 95 children (48 control and 47 intervention group), aged 3 to 14 years old, and selected randomly out of the patients referred to Imam Reza Clinic affiliated to Shiraz University of Medical Sciences in 2014. The control group only received the usual treatment prescribed by the physician; however, the intervention group received a comprehensive nursing program. Then, having completed Rome III Criteria Form immediately after the intervention for one month, two months, and three months, we collected the required data. The significance level in this study was 0.05. Results: The mean age of the samples was 78.30±32.52 months in the intervention group and 74.60±32.26 months in the control group. Also, the average weight of children in the intervention group was 23302.17±12034.96 grams and in the control group 21376.09±9351.80 grams. 18% of the samples from the intervention group and 22% of the control group were males. With a follow-up of 3 months, the percentage of changes in the intervention group in items 1 (two or fewer defecation in the toilet per week) and 4 (history of painful or hard bowel movement) was 48.9% and 74.5%, respectively, and in the control group 22.9% and 52.1%, respectively. Therefore, positive changes in the intervention group were better than the control group. The difference between these two variables was statistically significant (p-value 0.05), despite changes in the percentage of items in different periods of 1, 2, and 3 months. Conclusion: The findings of this study indicate that nursing education programs have a desirable effect on the reduction of some symptoms of chronic functional constipation based on Rome III criteria in children aged 3-14 years.

A randomized, comparative, open clinical trial for evaluating the efficacy of PP/JLN/107/09-10 Syrup in the management of Functional Constipation

Context: Functional constipation which has no underlying organic causes is difficult to be allopathic treatment for long term due to its side effects and undeniable effect, thus a natural balanced and compatible formulation needs to be validated. Objectives: Current study aimed to assess a poly-herbal formulation in management of functional constipation. Material and Methods: This study was 28 days, two armed, randomized, open labeled, prospective clinical study. 60 clinically confirmed cases of functional constipation patients randomized to receive orally either 2 teaspoonful of PP/JLN/107/09-10 Syrup or 1 teaspoonful of 5- 6 gm of Isabgol powder. Results were analyzed as per Rome II criteria and other associated symptoms like headache, acidity, belching, barborgysmy, flatulence and abdominal dis tension or bloating which are recorded on VAS score. Results: PP/JLN/107/09-10 scored over Isabgol on four out of six parameters of Rome II Criteria viz., frequency of bowel movement, straining at defecation, lumpy I har dstool formation, feeling of incomplete evacuation, feeling of ano-rectal blockage and manual maneuvers (p less than 0.001). Trial drugs showed comparable effects (p &gt; 0.05) in reducing the mean scores of associated symptoms like headache, acidity, belching, borgorgysmy, flatulence and abdominal distension. However, trial drug was found to perform statistically significant result in more number of parameters in comparison to Isabgol. Conclusion: PP/JLN/107/09-10 was found to be effective and safe in reliving functional constipation.

The Use of Botulinum Toxin as an Adjuvant in Managing Children with Chronic Constipation and Obstructed Defecation

Abstract Background: Pediatric chronic constipation and obstructed defecation is a challenging problem, with bad impact on quality of life affecting both the child and family. It is a complex disorder of multifactorial etiology and pathophysi-ology. Many symptoms-based systems have been instructed for clarifying definitions for chronic constipation and obstruct-ed defecation such as ROME IV criteria, PACCT criteria, NICE guideline. Most protocols of management of functional constipation usually include; disimpaction enemas, feeding regulations, bowel diaries and laxatives. Aim of Study: To evaluate the effectiveness of adding anal Botox injection to those already following management plan for pediatric age group suffering from chronic constipation and obstructed defecation. Patients and Methods: The current study included 40 children with functional constipation, and obstructed defeca-tion. The study started in April 2017 and completed the patients follow-up in November 2019. Bowel management program was applied with Botulinum toxin injection. Patients were followed-up at 2 months, and 6 months using Rintala Scores. Results: The study included 45% female members and 55% male ones, with age range between 3-12 years. Improve-ment was achieved in 22.5% of children after 2 months of the management, all patients were followed-up at least for 6 months period, with a mean follow-up of 11.35 months. Rintala scores at initial presentation, 2 months and 6 months follow-up showed improvement. Overall, across all the study subjects, females did better and showed more improvement. Conclusion: This study has confirmed that BT injection did not add any significant effect, to children with obstructed defecation and chronic FC.

The Effectiveness of Acupuncture in Management of Functional Constipation: A Systematic Review and Meta-Analysis.

Objective The purpose of this study was to assess the effectiveness and safety of acupuncture for functional constipation (FC). Methods A rigorous literature search was performed in English (PubMed, Web of Science, the Cochrane Library, and EMBASE) and Chinese (China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang database, and China Science and Technology Journal (VIP)) electronic databases from their inception to October 2019. Included randomized controlled trials (RCTs) compared acupuncture therapy with sham acupuncture or pharmacological therapies. The outcome measures were evaluated, including the primary outcome of complete spontaneous bowel movement (CSBM) and secondary outcomes of Bristol Stool Form Scale (BSFS), constipation symptoms scores (CSS), responder rate, the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, and safety evaluation. Meta-analysis was performed by using RevMan5.3. Results The merged data of 28 RCTs with 3525 participants indicated that acupuncture may be efficient for FC by increasing CSBMs (p < 0.00001; MD = 0.84 [95% CI, 0.65 to 1.03]; I2 = 0%) and improving constipation symptoms (p=0.03; SMD = −0.4 [95% CI, −0.78 to −0.03]; I2 = 74%), stool formation (p < 0.00001; MD = 0.24 [95% CI, 0.15 to 0.34]; I2 = 0%), quality of life (p < 0.00001; N = 1, MD = −0.33 [95% CI, −0.45 to −0.21]), and responder rates (p=0.02; RR = 2.16; [95% CI, 1.1 to 4.24]; I2 = 69%) compared with the effects of sham treatment. No increased risk of adverse events was observed (p=0.44; RR = 1.18; [95% CI, 0.77 to 1.81]; I2 = 0%). With regard to medication comparisons, the pooled data indicated that acupuncture was more effective in increasing CSBMs (p=0.004; MD = 0.53 [95% CI, 0.17 to 0.88]; I2 = 88%) and improving patients' quality of life (p < 0.00001; SMD = −0.73 [95% CI, −1.02 to −0.44]; I2 = 64%), with high heterogeneity. However, there were no significant differences in responder rate (p=0.12; RR = 1.31; [95% CI, 0.94 to 1.82]; I2 = 53%), BSFS (p=0.5; MD = 0.17 [95% CI, −0.33 to 0.68]; I2 = 93%), or CSS (p=0.05; SMD = −0.62 [95% CI, −1.23 to −0.01]; I2 = 89%). Regarding safety evaluation, acupuncture was safer than medications (p < 0.0001; RR = 0.3; [95% CI, 0.18 to 0.52]; I2 = 30%). Conclusions Current evidence suggests that acupuncture is an efficient and safe treatment for FC. Acupuncture increased stool frequency, improved stool formation, alleviated constipation symptoms, and improved quality of life. However, the evidence quality was relatively low and the relationship between acupuncture and drugs is not clear. More high-quality trials are recommended in the future. PROSPERO registration number: CRD42019143347.