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A nurse-led educational intervention for relieving idiopathic constipation: a retrospective study

27 October 2022
Volume 31 · Issue 19



Constipation is a common condition. Although numerous articles emphasise the importance of conservative interventions, none have set out a complete educational programme.


To describe the results of an evidence-based, nurse-led educational intervention for functional constipation in adults.


A retrospective study of patient records with an analysis of Wexner constipation scores and Bristol stool charts was carried out before and after a nurse-led educational programme on nutrition and bowel habits.


Twenty-nine patients were enrolled (19 women and 10 men), with a median age of 61 (53–71) years, a mean BMI of 24.4±3.88 kg/m2 and comparable baseline Wexner and Bristol scores. A statistically significant improvement in Wexner scores (P<0.001) and a clinically relevant but not statistically significant (P=0.682) improvement in Bristol scores were observed.


The results suggest this investigation should be repeated on a larger scale. An educational intervention could be included in all consultations on any issue that could affect bowel activity.

Constipation is a common gastrointestinal condition characterised by infrequent defecation, difficulty in passing stools or both. It can occur for a multitude of reasons, with geographical, linguistic, cultural and educational differences influencing its definition (Barberio et al, 2021). These discrepancies can make the evaluation and standardisation of prevalence data from cross-sectional surveys difficult.

The Rome Foundation coined the term ‘functional constipation’ to help standardise the diagnosis of persistent constipation in the absence of a physiological problem. Over the past two decades, the Rome criteria have been increasingly used in cross-sectional research to assess the prevalence of functional constipation worldwide (Simren et al, 2017). Such uniformity is crucial, given that assessing the incidence of constipation using alternative or informal criteria can result in a 40% difference in prevalence estimates (Werth et al, 2019).

Functional constipation (FC), also known as idiopathic constipation, accounts for approximately 95% of constipation cases in the adult population (Vriesman et al, 2020). It is defined as the simultaneous presence of two or more signs for at least 3 months, including straining in more than one in four defecations; lumpy or hard stools in more than one in four defecations; a sensation of incomplete evacuation in more than one in four defecations; a sensation of anorectal obstruction/blockage in more than one in four defecations; and using manual manoeuvres to facilitate more than one in four defecations (eg digital evacuation and pelvic floor support); and/or fewer than three defecations per week.

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