Stroke: Bowel Dysfunction in Patients Admitted for Rehabilitation§

Tânia M.N. de M Engler*, 1, 2, Cinthia C Dourado 2, Thais G Amâncio 3, Luciano Farage 4, Paulo A. de Mello 4, Marcele P.C Padula 5
1 Graduate Program in Health Sciences, Universidade de Brasília (UnB), Brazil
2 Neurological rehabilitation program in the SARAH Network of Rehabilitation Hospitals, Brasília (DF), Brazil
3 Secretaria de Estado de Saúde do Distrito Federal, Brasília (DF), Brazil
4 Faculty of Medicine, Universidade de Brasília-UnB-Brasília (DF), Brazil
5 Faculty of Medical Sciences of Santa Casa São Paulo-São Paulo (SP), Brazil

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© Engler et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the SMHS quadra 301 Bloco, 70335-901-Brasília, DF, Brasil; Tel: (+5561) 33191357; E-mail:
§ Study taken place in the Neurological rehabilitation program in the SARAH Network of Rehabilitation Hospitals, Unit SARAH-Center, Brasilia (DF), Brazil.


Aim :

to assess the prevalence of diminished frequency of bowel movements, lumpy or hard stools, intestinal constipation, straining, incomplete evacuation, incontinence (bowel dysfunctions) in patients with brain injury resulting from cerebrovascular accident, either self-reported or reported by their caregivers; to describe the type and frequency of such dysfunctions; and the prevalence of laxative use both before and after stroke.

Method :

cross-sectional study with 98 hospitalized patients admitted for rehabilitation between December 2009 and May 2010.

Results :

the prevalence of bowel dysfunctions before stroke was 23.96% whereas after the lesion it was 55.21% (p<0.0001). As reported by patients/caregivers, the chances of developing bowel dysfunctions increase sevenfold after stroke, 95% CI (2.44-24.26). The most frequent dysfunctions before stroke were intestinal constipation (73.91%) and diminished frequency of bowel movements (17.39%). After stroke, constipation remains to be the most frequent dysfunction reported (50%), followed by diminished frequency of bowel movements (26.79%), incomplete evacuation (12.50%), and lack of privacy (5.36%). The use of laxatives was 19,15% after the lesion, but not statisticaly significant (p=0.0736).

Conclusion :

Bowel dysfunctions increases significantly after stroke. Therefore, further studies are needed to better understand and characterize such dysfunctions, which are scarcely described in the literature.

Keywords: Constipation, fecal incontinence, rehabilitation centers, stroke.