Gastrointestinal complications and their relationship with functional performance in stroke survivors

Abstract

Background: Gastrointestinal (GI) complications can retard or limit a patient's rehabilitation and functional recovery. Thus, if not recognized and prevented early, they can be a significant determinant of morbidity and mortality in patients with stroke. Objective: The study was designed to determine the frequencies of GI symptoms in stroke survivors and to evaluate their relationships with functional performance. Methodology: Consecutive patients with diagnosis of stroke in medical wards and neurology clinic at the Aminu Kano Teaching Hospital and apparently healthy age and sex matched volunteers were recruited. A structured, pre-tested, close-ended questionnaire inquiring about common GI symptoms and demographic and stroke characteristics such as type, number and hemispheric side of stroke was administered in each case and control. Functional performance was assessed using the Barthel index. Results: A total of 150 patients and 150 control subjects were recruited for the study. The mean age of the patients was 58.1 ± 13 and that of the control subjects was 58.0 ± 12 and the difference was not statistically significant (P = 0.9846). There were 113 (80.7%) ischemic stroke and 27 (19.3%) hemorrhagic stroke. The most common GI symptoms were constipation (16.7%), dysphagia (12.1%) and masticatory difficulty (10.0%). There was no statistically significant difference in the occurrence of GI symptoms with respect to side of stroke. Constipation, dysphagia, masticatory difficulty, incomplete evacuation, abdominal pain, malnutrition, vomiting, bloating were found to be associated with low functional performance. Conclusion: Constipation, dysphagia and masticatory difficulty were the most common GI complications. They appear to be independent of the side or type of stroke, but are associated with low functional performance of the stroke survivors.