Clinical characteristics of people with intellectual disability admitted to hospital with constipation: identifying possible specific high-risk factors.
Adults with moderate-to-profound ID, epilepsy, and antiseizure meds are the group most likely to be hospitalized for constipation—so screen early and adjust laxatives.
01Research in Context
What this study did
Doctors looked at every adult with intellectual disability who entered a UK hospital for constipation.
They wrote down age, level of ID, other health problems, and every drug the person took.
The goal was to spot patterns that could warn us before someone needs a hospital bed.
What they found
Most patients had moderate or profound ID.
Epilepsy and antiseizure drugs showed up far more than in the general ID population.
These three red flags—deep ID, epilepsy, and seizure meds—were the clearest signals.
How this fits with other research
Hermans et al. (2014) already told us that 8 out of the adults over 50 with ID have more than one health problem.
van der Miesen et al. (2024) zooms in and says constipation is one of those hidden problems that can land them in the hospital.
Nøttestad et al. (2003) and Patton et al. (2020) both warned that antiseizure and psychotropic drugs stay high after people leave institutions.
The new study shows one concrete harm of those drugs—severe constipation—so the warnings now have a specific target for action.
Why it matters
If your client has moderate-to-profound ID plus epilepsy, add a quick bowel check to every visit. Ask about stool pattern, bump up fluids and fiber, and talk to the doctor about laxative dose before trouble starts. A five-minute screen can save a week in the hospital.
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02At a glance
03Original abstract
BACKGROUND: People with intellectual disabilities (ID) die on an average 20 years earlier to the general population. They have higher rates of multimorbidity and polypharmacy. Around 25% of people with ID report chronic constipation. The England Learning Disabilities Mortality Review found that nearly 25% of deaths identified constipation as a long-term health problem. However, the likely risk factors for constipation related harm are poorly enumerated. We sought to identify possible specific high-risk factors by examining the clinical characteristics of people with ID admitted to hospital with constipation. METHODS: Data of people with ID admitted with constipation in two general hospitals covering a population of 1.3 million from 2017 to 2022 were reported using the STROBE guideline for cohort studies. Collected data included age, gender, intellectual disability severity, recorded medication, presenting complaint and co-morbidities. The medication anticholinergic burden was calculated using the anticholinergic burden scale. Continuous variables were summarised by mean and standard deviation if normally distributed, with categorical variables summarised by the number and percentage in each category. RESULTS: Of 46 admissions (males 52%), 57% had moderate to profound ID, 37% had epilepsy, 41% prescribed antiseizure medication (ASM) and 45% were on laxatives. Average age was 46 years. The anticholinergic burden score mean was 2.3 and median, one. CONCLUSIONS: We can hypothesise that people with more severe ID, suffering from epilepsy and on ASM may be more at risk of developing severe constipation. Some admissions may be avoided with earlier use of laxatives in the community.
Journal of intellectual disability research : JIDR, 2024 · doi:10.1111/jir.13108