New-Onset Fecal Incontinence After Stroke

Abstract

Background and Purpose-Fecal incontinence (FI) is a common complication after stroke, yet epidemiological research into this distressing condition is limited. The purpose of this study was to describe the prevalence, natural history, associations, and impact of new-onset FI after stroke. Methods-Stroke patients in the community-based South London Stroke Register (January 1995 to 2000) without preexisting FI were characterized regarding bowel continence at 7 to 10 days, 3 months, and 1 and 3 years after stroke. FI was defined as any degree of bowel leakage. Results-Prevalence of poststroke FI was 30% (7 to 10 days), 11% (3 months), 11% (1 year), and 15% (3 years). One third of patients with FI at 3 months were continent by 1 year; conversely, 63% incontinent at 1 year had been continent at 3 months. Characteristics of 91 patients with FI and 755 without FI at 3 months were compared using multiple logistic regression. Acute stroke associations of neglect (adjusted odds ratio [OR], 1.9; 95% CI, 1.0 to 3.5) and initial urinary incontinence (OR, 6.2; 95% CI, 3.2 to 11.9) were no longer significant after adjustment for clinical factors at 3 months. Final independent associations were anticholinergic drug use (OR, 3.1; 95% CI, 1.1 to 10.2) and needing help with toilet use (OR, 3.5; 95% CI, 1.4 to 17.3). FI at 3 months increased the risk of long-term placement (28% vs 6%) and death within 1 year (20% vs 8%). Conclusions-New-onset FI in stroke survivors is common but may be transient.

Chronic constipation in hemiplegic patients

“…The 5.5% prevalence of de novo fecal incontinence at least 3 months after a CVA in patients of this study, is consistent with previous reports [33] . The largely transient and early manifestation of fecal incontinence after stroke appears to be related more to impaired consciousness, immobility and inadequate nurse assistance than to the neurological damage per se.…”

“…Fecal incontinence has been reported to occur in about 30% of patients in the first few weeks immediately after stroke and between 3%-11% at 3 months and thereafter [33,34] . The 5.5% prevalence of de novo fecal incontinence at least 3 months after a CVA in patients of this study, is consistent with previous reports [33] .…”

Comprehensive Overview of Nursing and Interdisciplinary Rehabilitation Care of the Stroke Patient

“…113 Prevalence of fecal incontinence among stroke survivors ranges between 30% and 40% while the patient is in the hospital, 18% at discharge, and between 7% and 9% at 6 months after stroke. 293 During the rehabilitation phase, patients are evaluated to identify and address potential contributing factors (eg, diet, drug side effects, rectal muscle weakness); however, the strongest independent risk factor for fecal incontinence at 3 months after stroke is needing help getting to the toilet. Unfortunately, management of poststroke fecal incontinence has not yet been well investigated.…”

“…289,293 Generally, effective intervention involves medications and assurance of appropriate fiber and fluid intake and bowel habits. 294 Bulk-forming laxatives, bisacodyl suppositories, stool softeners, osmotic agents, and/or stimulant laxatives may be indicated or contraindicated depending on the individual patient.…”

Isolated Urinary, Fecal, and Double Incontinence: Prevalence and Degree of Soiling in Stroke Survivors

“…(13) (14) (15) More recently it has been reported that 15% of stroke survivors still report fecal incontinence 3 years after their stroke and being incontinent increases the risk of long-term care placement and death. (11) This paper only investigated the prevalence of fecal incontinence in a stroke population and was unable to make comparisons with a non-stroke population.…”