Understanding constipation in stroke patients with dysphagia: incidence, risk factors, and management strategies—a scoping review
摘要
Constipation and dysphagia are common complications among stroke survivors, impacting quality of life, recovery, and rehabilitation outcomes. Dysphagia can lead to decreased fluid and fibre intake, which, combined with reduced mobility, increases the risk of constipation. While each condition has been studied independently, there is limited research focusing on their co-occurrence and management in post-stroke populations.
AimsThis scoping review aims to examine the incidence, risk factors, and management strategies for constipation in stroke patients with dysphagia, synthesizing current knowledge to inform clinical practice and future research.
MethodsUsing the Arksey and O’Malley framework and PRISMA-ScR guidelines, we conducted a comprehensive search of MEDLINE, EMBASE, PsychInfo and CINAHL databases for peer-reviewed studies published between 2003 and December 2024. Studies were eligible if they included adult stroke patients with both constipation and dysphagia and reported on incidence, risk factors, or management strategies.
ResultsSeven studies, including retrospective and prospective cohorts, were reviewed. The incidence of constipation varied widely (4.4 to 70%), with higher rates in dysphagia patients. Key risk factors included dysphagia severity, decreased fluid and fibre intake, low functional independence, and comorbid conditions. Management strategies, including modified diets, hydration support, and interdisciplinary interventions, were discussed. However, variations in diagnostic criteria and study designs limited comparability.
ConclusionsConstipation is a significant concern in stroke patients with dysphagia, highlighting the need for interdisciplinary care approaches that address fluid, dietary, and mobility challenges. Further research into the relative contribution of dysphagia to post-stroke constipation is needed, as well as how best to manage same, and the impact of constipation on patients’ quality of life.