Constipation is defined as the feeling of going to the toilet less than 3 times a week, having difficulty defecating or not being able to empty completely. Constipation is present in 15% of the general population. It is more common in the elderly and women. Walking less than 500 meters a day and having less than 35 grams of fiber in the diet increase the risk of constipation (1). Constipation is a common problem in stroke patients.
What causes constipation in stroke patients?
Stroke itself does not directly cause constipation. However, constipation is observed with a frequency of about 50% in stroke patients (2). The reason for this may be that they do not take enough liquid and fibrous food, stay sedentary and spend most of the day in bed, and some medications they use. In people who do not take enough fluids, the body absorbs a large amount of water from the intestines for the water it needs, so the volume of the remaining stool becomes smaller and hard. If the constipation is severe, a stool blocker may form, preventing intestinal transit.
Drinking plenty of water and taking certain hours to use the toilet are the first treatment approaches. Adequate time and privacy must be provided for the toilet. Eating fiber-rich vegetables, fruits, legumes and grains is beneficial. The more active you are, the lower the risk of constipation. Constipation in stroke patients can only be significantly improved with nurse education and lifestyle changes that help bowel movements (3). If constipation persists, stool softeners, drugs that increase stool volume, laxatives, or enemas may be tried.
Fecal incontinence (fecal incontinence) in stroke patients
Although fecal incontinence, called fecal incontinence, is 30% in the first week after stroke, it has been reported in 11% of patients after 1 year. There may be reasons such as damage to the part of the brain that controls the intestines, not being able to reach the toilet on time, and diarrhea. These patients need more care and have a higher risk of death (4). Groin floor exercises help strengthen muscles. Bowel training, that is, going to the toilet regularly at certain times can reduce leaks. If there is excessive incontinence, drugs that prolong and solidify the passage of stool can be used. If leaks cannot be completely prevented, diapers or other products that can increase the quality of life can be used.