Pharmacologic Management of Constipation in the Critically Ill Patient

Asad E. Patanwala, Pharm.D.; Jacob Abarca, Pharm.D., M.S.; Yvonne Huckleberry, Pharm.D.; Brian L. Erstad, Pharm.D., FCCP

Disclosures

Pharmacotherapy. 2006;26(7):896-902. 

In This Article

Limitations

We did not account for patients who were receiving treatment with numerous laxatives. Our bivariate and logistic regression analyses may have been influenced by patients who were receiving numerous laxatives simultaneously. To accommodate for this possibility and for sample limitations, we combined patients who received stimulants and/or osmotic laxatives in one category for our logistic regression.

In our study, oral or enteral nutrition did not influence occurrence of a bowel movement during the first 96 hours of MICU admission; this may have been due to study design limitations. For example, although we recorded the type of enteral feeding formulas used, our study did not have the power to detect differences in our primary outcome based on the specific enteral formula (e.g., fiber vs no fiber) administered. In addition, patient nutrition information before admission was not recorded, nor was in-hospital use of potentially constipating agents (although the use of drugs such as anticholinergic agents is uncommon in our critically ill patients).

Given our sample size, the regression analysis included only a limited number of confounding variables that could influence occurrence of a bowel movement in our critically ill patients. Thus, we selectively chose the variables considered the most contributory to our outcome variable. It is important to note that our results are limited by the accuracy of documentation in the medical record.

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