Constipation and its implications in the critically ill patient † †An abstract of a part of this paper has been presented at the European Society of Intensive Care Medicine in Rome, October 2000 (published in Intensive Care Medicine: Mostafa SM and Ritchie G. Failure to wean critically ill patients from mechanical ventilation due to constipation (A). Intensive Care Medicine 2000, 26 (Suppl. 3): S336), and at the Intensive Care Society meeting in London, December 2000 (published in the British Journal of An

Abstract

Constipation has implications for the critically ill.

Laxative effects of fermented rice extract in rats with loperamide-induced constipation

“…This highly prevalent functional gastrointestinal disorder affects 3–15% of the general population (2,3). Constipation may also cause abdominal distension, vomiting, restlessness, gut obstruction and perforation, and may even be associated with aspiration or fatal pulmonary embolism (4). At present, constipation disproportionately affects older adults, with prevalences of 50% among the community-dwelling elderly and 74% in nursing-home residents (5).…”

Agarwood Induced Laxative EffectsviaAcetylcholine Receptors on Loperamide-Induced Constipation in Mice

“…Constipation is not only discomforting but can cause abdominal distension, vomiting, restlessness, gut obstruction, and perforation, and can cause aspiration or fatal pulmonary embolism. 1) Nowadays, 20 to 30% of people over the age of 60 use a laxative more than once a week.…”

Constipation in critically ill patients: much more than we imagine

“…A number of factors increase the frequency of constipation among patients admitted to intensive care, such as shock, the use of sedatives and opioid agents, electrolyte disturbances and changes in diet. (1,2) The incidence of constipation in the intensive care setting varies widely among studies, and it can range from 5 to 83%. (1-5) Such variation is directly related to the lack of a precise definition.…”

“…(1,2) The incidence of constipation in the intensive care setting varies widely among studies, and it can range from 5 to 83%. (1-5) Such variation is directly related to the lack of a precise definition. In the guidelines of the American Gastroenterological Association, constipation is defined as fewer than 3 bowel movements per week, feelings of incomplete evacuation, hard stools, difficulty passing stools or the need for manual maneuvers for rectal emptying.…”

“…Published studies on the topic mainly use the frequency of bowel movements during hospitalization or the time between admission to the intensive care unit (ICU) and the first bowel movement as the primary factors that define constipation among critically ill patients. (1,2,4,5,7,8) …”