Chronic constipation in people with intellectual disabilities in the community: cross-sectional study
Wainwright, Delia Caffrey, Briony Lamb, Kirsten Wilcock, Mike
Wainwright, Delia
Caffrey, Briony
Lamb, Kirsten
Wilcock, Mike
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Affiliation
Cornwall Partnership NHS Foundation Trust; University of Plymouth; Hertfordshire Partnership University NHS Foundation Trust; University College London; Devon Partnership NHS Trust; Statsconsultancy, Amersham, UK; Trinity College, Dublin; Royal Cornwall Hospitals Trust; Coventry and Warwickshire Partnership NHS Trust
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Publication date
2024-03-01
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Abstract
Background: One-third to half of people with intellectual disabilities suffer from chronic constipation (defined as two or fewer bowel movements weekly or taking regular laxatives three or more times weekly), a cause of significant morbidity and premature mortality. Research on risk factors associated with constipation is limited.
Aims: To enumerate risk factors associated with constipation in this population.
Method: A questionnaire was developed on possible risk factors for constipation. The questionnaire was sent to carers of people with intellectual disabilities on the case-loads of four specialist intellectual disability services in England. Data analysis focused on descriptively summarising responses and comparing those reported with and without constipation.
Results: Of the 181 people with intellectual disabilities whose carers returned the questionnaire, 42% reported chronic constipation. Constipation was significantly associated with more severe intellectual disability, dysphagia, cerebral palsy, poor mobility, polypharmacy including antipsychotics and antiseizure medication, and the need for greater toileting support. There were no associations with age or gender.
Conclusions: People with intellectual disabilities may be more vulnerable to chronic constipation if they are more severely intellectually disabled. The associations of constipation with dysphagia, cerebral palsy, poor mobility and the need for greater toileting support suggests people with intellectual disabilities with significant physical disabilities are more at risk. People with the above disabilities need closer monitoring of their bowel health. Reducing medication to the minimum necessary may reduce the risk of constipation and is a modifiable risk factor that it is important to monitor. By screening patients using the constipation questionnaire, individualised bowel care plans could be implemented.
Citation
Laugharne R, Sawhney I, Perera B, Wainwright D, Bassett P, Caffrey B, O'Dwyer M, Lamb K, Wilcock M, Roy A, Oak K, Eustice S, Newton N, Sterritt J, Bishop R, Shankar R. Chronic constipation in people with intellectual disabilities in the community: cross-sectional study. BJPsych Open. 2024 Mar 1;10(2):e55. doi: 10.1192/bjo.2024.12. PMID: 38425039; PMCID: PMC10951845.
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Article