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Poststroke Constipation Is Associated With Impaired Rectal Sensation
Abstract
Objectives Constipation is prevalent in individuals after stroke. However, the pathophysiological mechanisms of poststroke constipation remain unclear. This study was designed (i) to investigate the difference in anorectal motility and rectal sensation among stroke patients with constipation, stroke patients without constipation, and healthy controls (HC), (ii) to evaluate the impact of stroke sites on constipation and rectal sensation, (iii) to explore the role of autonomic functions, and (iv) to determine the independent risk factors for poststroke constipation. Methods Seventy-one stroke patients and 24 HC were recruited. General information, clinical characteristics, and relevant questionnaires were collected. Meanwhile, an anorectal manometry test was performed to assess functions of anorectal motility and rectal sensation, and an electrocardiogram was recorded to evaluate autonomic functions. Results (i) Constipation patients exhibited increased rectal sensation thresholds, compared with patients without constipation or HC (P Discussion Poststroke constipation is characterized by elevated thresholds for rectal sensation, rather than altered anorectal motility. Patients with brainstem lesions are predisposed to constipation possibly because of the disruption of afferent pathway from the rectum to the brain. Moreover, the desire of defecation threshold and the physical activity level are factors independently associated with poststroke constipation.
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“Constipation after stroke is common and is driven by a combination of reduced mobility, impaired cortical control of defecatory reflexes, medication effects, and autonomic imbalance (Cheng et al., 2020; Li et al., 2017; Yi et al., 2011).”
From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Cheng et al., 2020
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References 29 · Cited by 26
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Metadata
- Authors
- Cheng, J., Li, L., Xu, F., Xu, Y., Lin, L., & Chen, J. D. Z.
- Affiliations
- Nanjing University of Chinese Medicine (CN)
- Ningbo University (CN)
- Jiangsu Province Hospital (CN)
- Johns Hopkins University (US)
- Corresponding author
- Li, Liangda
- Lin, Lin
- Chen, Jiande D. Z.
- Venue
- American Journal of Gastroenterology
- Published
- 2019-12-05
- Volume
- 115
- Issue
- 1
- Pages
- 105-114
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W2991706011
- Cited by
- 26
- References
- 29
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 1 · 2023: 6 · 2022: 5 · 2021: 2 · 2020: 4
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
- Keywords
- rectal sensation, anorectal motility, anorectal manometry, brainstem lesions, autonomic function, sympathetic activity, parasympathetic activity, physical activity, risk factors, stroke severity
- MeSH terms
- Aged, China, Constipation, Defecation, Female, Follow-Up Studies, Humans, Hypesthesia, Magnetic Resonance Imaging, Male, Manometry, Middle Aged, Pressure, Rectum, Retrospective Studies, Sensation, Tomography, X-Ray Computed, Prevalence, Stroke
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