Constipation and defecation pattern the first 30 days after thoracic surgery

In clinical practice constipation is often an overlooked aspect of patient care and first gains attention when it has become a severe problem for the patients. Constipation increases the risk for postoperative complications, can prolong hospital stay, increase financial cost, and staff nursing care time.

A prospective descriptive design was used. One hundred and thirty nine patients participated in the study from February to June 2006. On admission, day of discharge, and 30 days after surgery patients normal and actual defecation pattern, stool consistency, and if they experienced problems with defecation was assessed by a structured interview. North America Nursing Diagnosis Associations (NANDA's) general definition of constipation was used as a frame of reference for this study. The Bristol Stool Scale was used to measure stool consistency. Prolonged and difficult evacuation and defecation pattern was recorded on a self-composed scale.

Fifty per cent of patients developed constipation during the first postoperative period and their normal pattern of defecation was re-established 17 days after discharge. Nearly one third of the patients reported that their daily life was affected by constipation after discharge.

The results imply that further studies are needed to prevent constipation and to help patients to cope with this side effect of surgery after discharge. The results of this study also suggest that acute and chronic constipation might be two different disorders.