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Poststroke Constipation Is Associated With Impaired Rectal Sensation.

Jiafei Cheng1,2,3, Liangda Li4, Feng Xu5

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Poststroke constipation is linked to higher rectal sensation thresholds, not changes in anorectal motility. Brainstem lesions and impaired defecation desire/physical activity are key risk factors.

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Area of Science:

  • Neurology
  • Gastroenterology
  • Clinical Medicine

Background:

  • Constipation is a common issue following stroke, but its underlying causes are not fully understood.
  • Investigating the mechanisms of poststroke constipation is crucial for improving patient care.

Purpose of the Study:

  • To compare anorectal function and rectal sensation in stroke patients with and without constipation against healthy controls.
  • To assess the influence of stroke location and autonomic function on constipation.
  • To identify independent risk factors for constipation after stroke.

Main Methods:

  • Recruited 71 stroke patients and 24 healthy controls.
  • Utilized anorectal manometry for motility and sensation assessment.
  • Collected clinical data and performed electrocardiography for autonomic function evaluation.

Main Results:

  • Stroke patients with constipation showed significantly higher rectal sensation thresholds compared to those without constipation and healthy controls.
  • Brainstem lesions were associated with a higher prevalence of constipation and altered sensation thresholds.
  • Rectal sensation thresholds correlated with autonomic activity (sympathetic and vagal) and clinical factors like spontaneous bowel movements.
  • Defecation desire threshold and physical activity level emerged as independent risk factors for poststroke constipation.

Conclusions:

  • Poststroke constipation is primarily associated with altered rectal sensation, not anorectal motility.
  • Brainstem lesions may predispose individuals to constipation due to disrupted rectal-brain pathways.
  • Reduced desire for defecation and lower physical activity are significant independent risk factors for constipation post-stroke.