STROKE-BOWEL DYSFUNCTION

SUMMARY

1. Incidence of bowel incontinence in stroke patients 31%.

2. Patient unable to inhibit urge to defecate leading to incontinence.

3. Incontinence usually resolves within the first 2 weeks; persistence may reflect severe brain damage.

4. Decrease in bowel continence may be associated with infection, inability to transfer to toilet or to manage clothing, and communication impairment/inability to express toileting needs.

5. Incontinence management: treat underlying causes (bowel infection, diarrhea), timed-toileting schedule, training in toilet transfer and communication skills.

6. Constipation management: adequate fluid intake/hydration, diet modification (increase dietary fiber), bowel management (stool softeners, stool stimulants, suppositories), allow commode/bathroom privileges.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].