Increasing Dietary Fibre for Patients in an Acute Hospital Ward

Development of a constipation risk assessment scale

“…The literature would suggest that a fluid intake in excess of 2 l/day is desirable to prevent constipation (O'Connor, 1995;Benton et al, 1997;Anti et al, 1998;Wilson, 1999;Richmond and Wright, 2004), yet it is unacceptable to ask patients to quantify fluid intake in l/day. As each glass/cup of fluid equals approximately 250 mls with values ranging from 200 to 300 mls, it was more appropriate to estimate fluid intake by enquiring of the number of cups/glasses consumed daily.…”

Evaluation of a constipation risk assessment scale

“…The constipation risk assessment scale consisted of five categories relating to the risk factors associated with the development of constipation which were well documented in the literature 3 –9 . Risk factors included: (i) inadequate diet/fibre intake; (ii) inadequate fluid intake; (iii) inadequate activity; (iv) some medications; and (v) frequency and type of bowel motion.…”

“…All patients who described themselves as constipated after 5–6 days’ admission were surveyed during each audit. Patients defined constipation accord‐ing to difficulty with defecation, passing small hard stools at irregular intervals and a sensation of incomplete evacuation 5 …”

Review of the literature on constipation to enable development of a constipation risk assessment scale

“…If fluid intake is inadequate in individuals consuming a high fibre diet then dietary fibre can have a negative effect on bowel function (Hope, 1983;Hope and Down, 1986;Wrenn, 1989;Beverley and Travis, 1992). As fluid intake is difficult to maximise in elderly individuals (O'Connor, 1995;Hyde et al, 1999) and as hydration status is difficult to measure accurately is a hospital environment with varying extraneous variables and influences (such as constantly changing staff, varying environmental temperatures), it is possible that fluid intake was not increased to the point that would be required for dietary fibre intake and therefore bowel function was not improved by dietary fibre intake.…”