title: Poststroke constipation in the rehabilitation ward: incidence, clinical course and associated factors.
abstract: BACKGROUND
  Constipation is a common poststroke complication. This study was designed to document the incidence and clinical course of poststroke constipation in a rehabilitation ward, as well as identify the factors independently associated with the condition.
  
  
  METHODS
  This retrospective study involved patients who were admitted to the rehabilitation ward of our institute due to an acute stroke between 1 August 2010 and 31 July 2011. The main outcome measured was the incidence of poststroke constipation, defined as the use of laxative after stroke, fulfilment of the Rome II diagnostic criteria for functional constipation and/or stool impaction. The variables examined were basic demographic data, presence of impairment, degree of disability (evaluated using the Barthel index), walking ability, medications taken and medical complications.
  
  
  RESULTS
  Out of the 155 patients who met the inclusion criteria, 123 (79.4%) had poststroke constipation. All 123 patients used oral laxatives; 56 received additional rectal medications and 13 discontinued their use of laxatives at discharge. Patients with poststroke constipation were more likely to have major medical complications (p = 0.04). Those who used rectal medications had a higher risk of major medical complications than those who used only oral laxatives (p < 0.01). Infratentorial lesions were an independent predictor of poststroke constipation (p = 0.003). More severe disability increased the severity of constipation, as indicated by the use of rectal medication.
  
  
  CONCLUSIONS
  Poststroke constipation is a common complication during inpatient rehabilitation. Healthcare providers should be aware of the incidence of poststroke constipation. Further studies are required to establish standard guidelines for screening and managing bowel function in patients with stroke.
authors.affiliation: Department of Rehabilitation, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Dapi Road, Niaosong Division, Kaohsiung City 83301, Taiwan. hung0702@adm.cgmh.org.tw.
authors.forename: Chun-Ju
authors.initials: CJ
authors.lastname: Lin
authors.forename: Jen-Wen
authors.initials: JW
authors.lastname: Hung
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Cho
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Tseng
authors.forename: Hsuan-Yu
authors.initials: HY
authors.lastname: Chen
authors.forename: Fang-Chia
authors.initials: FC
authors.lastname: Lin
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Li
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003248:Constipation / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012846:Singapore; D020521:Stroke / Q000150:complications* / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
chemical_list: D054368:Laxatives