INCIDENCE, PREDICTORS AND MANAGEMENT OF CONSTIPATION IN PATIENTS WITH STROKE

Abstract

BACKGROUND: CONSTIPATION IS ONE OF THE MOST COMMON COMPLICATIONS AFTER STROKE. AIMS: TO DEVELOP A FEASIBLE EVIDENCE-BASED BOWEL MANAGEMENT PROGRAMME. PHASE 1 STUDY IDENTIFIED INCIDENCE AND PREDICTORS OF CONSTIPATION. PHASE 2 STUDY EVALUATED FEASIBILITY OF THE NEW BOWEL MANAGEMENT PROGRAMME. METHODS: PHASE 1 WAS A PROSPECTIVE MATCHED COHORT STUDY COMPARING STROKE PATIENTS WITH ORTHOPAEDIC PATIENTS. PHASE 2 WAS A SINGLE QUASI-EXPERIMENTAL POST-TEST STUDY EVALUATING FEASIBILITY OF THE PROGRAMME. RESULTS: THE INCIDENCE OF CONSTIPATION WAS HIGH FOR BOTH STROKE AND ORTHOPAEDIC PATIENTS. MOBILITY GAINS (RR 0.741, P<0.001) AND USE OF PROPHYLACTIC LAXATIVES (RR 0.331, P<0.01) WERE PROTECTIVE AGAINST CONSTIPATION. BEDPAN USE (RR 2.058, P<0.05) AND LONGER HOSPITAL STAY (RR 1.032, P<0.05) INCREASED THE RISK OF DEVELOPING CONSTIPATION. THE ADHERENCE RATES TO THE BOWEL MANAGEMENT PROGRAMME RANGED FROM 70% TO 100%. NO PATIENTS EXPERIENCED ADVERSE EFFECTS. CONCLUSION: CONSTIPATION IS COMMON IN STROKE