Cornwall Partnership NHS Foundation Trust, Truro, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth, Truro, UK
Indermeet Sawhney
Hertfordshire Partnership University NHS Foundation Trust, Hatfield, UK
Bhathika Perera
Department of Psychiatry, University College London, London, UK
Delia Wainwright
Devon Partnership NHS Trust, Exeter, UK
Paul Bassett
Statsconsultancy, Amersham, UK
Briony Caffrey
Cornwall Partnership NHS Foundation Trust, Truro, UK
Maire O'Dwyer
School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Republic of Ireland
Kirsten Lamb
Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth, Truro, UK
Coventry and Warwickshire Partnership NHS Trust, Birmingham, UK
Katy Oak
Royal Cornwall Hospitals Trust, Truro, UK
Sharon Eustice
Cornwall Partnership NHS Foundation Trust, Truro, UK
Nick Newton
Cornwall Partnership NHS Foundation Trust, Truro, UK
James Sterritt
Cornwall Partnership NHS Foundation Trust, Truro, UK
Ruth Bishop
Cornwall Partnership NHS Foundation Trust, Truro, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth, Truro, UK
Cornwall Partnership NHS Foundation Trust, Truro, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth, Truro, UK
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.
