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Constipation after acute stroke is linked to damage in the left insular cortex. This study found left-sided insular infarction significantly increases constipation risk in stroke patients.

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Area of Science:

  • Neurology
  • Gastroenterology
  • Autonomic Nervous System

Background:

  • Constipation is a common gastrointestinal motility issue following acute ischemic stroke, often linked to autonomic nervous system dysfunction.
  • The insular cortex plays a role in autonomic regulation, with damage to the left insula potentially leading to constipation.

Purpose of the Study:

  • To investigate the association between constipation and left-sided insular infarction in patients diagnosed with acute stroke.
  • To identify key factors contributing to constipation post-stroke.

Main Methods:

  • Retrospective analysis of acute stroke patients diagnosed with middle cerebral artery territory infarction (January 2015 - December 2018).
  • Constipation defined as fewer than three bowel movements weekly or laxative prescription within two weeks of stroke onset.
  • Evaluation of clinical characteristics and associated factors for constipation.

Main Results:

  • Out of 892 patients, 32.8% experienced constipation.
  • Constipation was more frequent in patients with insular (57.7%) and left-sided infarction (62.5%) compared to those without.
  • Left-sided insular infarction showed the highest incidence of constipation (69.2%).

Conclusions:

  • Left-sided infarction and insular cortex involvement are independent risk factors for constipation in acute stroke patients.
  • Higher baseline National Institutes of Health Stroke Score is also associated with increased constipation risk.