Constipation in specialized palliative care: factors related to constipation when applying different definitions

Area of Science:

• Palliative Care Medicine
• Gastroenterology
• Oncology

Background:

• Constipation is a common issue in palliative care, often attributed to opioid therapy.
• However, other contributing factors to constipation in this patient population are under-researched.

Purpose of the Study:

• To identify factors associated with constipation in palliative care patients.
• To compare these factors across different constipation types and in patients without constipation.

Main Methods:

• A cross-sectional study involving 485 patients from 38 palliative care units in Sweden.
• Data collected via a 26-item questionnaire, analyzing three constipation groups: infrequent defecation only (MC ONLY), perceived constipation only (PC ONLY), and both (MC & PC).
• Logistic regression analysis was employed to determine odds ratios.

Main Results:

• Patients with infrequent defecation (MC ONLY) showed higher odds of hospitalization, bed restriction, needing assistance with toileting, and poor fluid intake.
• Patients experiencing perceived constipation (PC ONLY) had increased odds of poor appetite, hemorrhoids, hard stools, higher opioid use, lower laxative use, and dissatisfaction with constipation information.
• Patients with both infrequent defecation and perceived constipation (MC & PC) had higher odds of having a cancer diagnosis.

Conclusions:

• Several factors beyond opioid treatment are significantly associated with constipation in palliative care.
• These include hard stools, cancer diagnosis, information dissatisfaction, low fluid intake, hemorrhoids, bed restriction, hospitalization, and need for personal assistance for toileting.