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Management of Constipation

Constipation is difficulty in passing stools or incomplete or infrequent passage of hard stool. Constipation is usually not a serious condition but should be treated to promote comfort.

constipationConstipation sometimes occurs in individuals following stroke. The chance of constipation occurring increases after stroke if an individual has a decrease in activity level, decrease in muscle tone, or is unable to eat foods that are high in fiber. Some medications may also cause constipation. Constipation means different things to different people. For many people it simply means infrequent stools. For others, however, constipation means hard stools, difficulty passing stools (straining), or a sense of incomplete emptying after a bowel movement.

Sometimes a person may think constipation is present when it is not. Some individuals feel the need to have a bowel movement everyday, but this is not necessary. There is no right number of bowel movements to have in a week. Normal bowel movements for some people may be three times a week or three times a day.

As a caregiver of an individual with stroke, there are many things you can do to encourage the prevention of constipation.

-Provide a diet high in fiber. Fiber is found in beans, bran, whole grains, fresh fruits and vegetables. 20-30 grams of fiber are needed every day. You should increase the amount of fiber in your diet slowly so that your stomach can adjust to the change. Avoid foods that are high in fats and sugars.

-Provide plenty of liquids, especially water. Eight, 8 ounce glasses of liquid are needed every day. Try to avoid liquids with caffeine or alcohol in them. These liquids tend to dry out the body.

-Encourage daily exercise as much as able, even if the person with stroke is only able to lift their legs up and down in a sitting position.

-Try to set aside 15 to 20 minutes every day for an undisturbed visit to the toilet, usually after the first meal of the day, or according to the individual's usual bowel habits.

Laxatives are medications used to help pass stool from the bowel. Regular use of these medications should be avoided as much as possible. Using laxatives too often can make the body dependent on laxatives for the bowels to move. If the person with stroke goes three days without a bowel movement, the following recipe can be tried to relieve constipation.
Prune Juice, Bran and Applesauce Recipe

Mix together 1 cup prune juice, 1 tablespoon unprocessed bran and add applesauce to desired consistency. Start with 1 ounce of mixture every day with breakfast. If needed, you may increase weekly by 1 ounce of mixture to a total amount of 3 ounces 3 times a day. If using the above recipe does not relieve the constipation, contact your health care provider for instructions to treat the constipation.

Additional Information:

The following are some web sites to provide you with more information about preventing constipation.

National Digestive Diseases Information Clearinghouse

Preventing Constipation


References:

Fenstermacher, K., & Hudson, B. (2000). Practice guidelines for family nurse practitioners.Philadelphia: Saunders

Chronic constipation: Tips on treatment. (2011). Retrieved from http://www.webmd.com

Constipation. (2011). Retrieved from http://www.medicinenet.com

Mosby. (1998). Mosby’s Medical, Nursing, and Allied Health Dictionary (5th ed.). St. Louis: Mosby.

Uphold, C., & Graham, M. (1998). Clinical guidelines in family practice (3rd ed.) Gainesville: Barmarrae Books.

Developed in 2001 by Gerri Rupp, MSN, RN, CNP at The University of Toledo for the Caring~Web©

Revised 2010, 2012

Last Updated: 6/17/14