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To evaluate the diagnostic value of plain abdominal radiography in stroke patients with bowel dysfunction.
A total of 59 stroke patients were recruited and assigned into constipation or non-constipation group. Patients were interviewed to obtain clinical information, constipation score, and Bristol stool form scale. The total and segmental colon transit time (CTT) was measured using radio-opaque markers (Kolomark). The degree of stool retention was evaluated by plain abdominal radiography and scored by two different methods (Starreveld score and Leech score). The relationship between the clinical aspects, CTT, and stool retention score using plain abdominal radiography was determined.
Average constipation score was 4.59±2.16. Average Bristol stool form scale was 3.86±1.13. The total and segmental CTTs showed significant differences between the constipation and non-constipation groups. There was statistically significant (p<0.05) correlation between the total CTT and constipation score or between Starreveld score and Leech score. Each segmental CTT showed significant correlation (p<0.05) between segmental stool retention scores.
The stool retention score showed significant correlation with constipation score as well as total and segmental CTT. Thus, plain abdominal radiography is a simple and convenient method for the evaluation of bowel dysfunction in stroke patients.
Citations
To investigate factors related to bowel function and colon motility in acute stroke patients.
Fifty-one stroke patients (29 males, mean age 63.4±13.6 years, onset 13.4±4.8 days) were recruited and divided into two groups: constipation (n=25) and non-constipation (n=26) groups. We evaluated the amount of intake, voiding function, concomitant swallowing problem and colon transit time (CTT) using radio-opaque markers for ascending, descending and rectosigmoid colons. The Adapted Patient Evaluation Conference System (APEC), Korean version of Modified Bathel Index (K-MBI) and Motricity Index (MI) were evaluated.
The constipation group showed significantly prolonged CTT of ascending, descending and entire colon (p<0.05) and more severe swallowing problems (p=0.048). The APEC scale (2.65±1.44 vs 1.52±0.92, p=0.001), K-MBI scores (59.4±14.4 vs 28.0±24.3, p<0.001) and MI scores (69.1±22.3 vs 46.8±25.9, p=0.001) of the constipation group were significantly lower compared to the non-constipation group.
Our study demonstrated that bowel function in acute stroke patients was associated with functional status and swallowing function, indicating the need for intensive functional training in post-stroke constipation patients.
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