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

Conclusion

Critically ill patients have a high frequency of constipation, and opioid use is a significant risk factor for constipation. Once enteral access has been established, routine use of stimulant and/or osmotic laxatives in this patient population should be considered. Laxative doses should be held only if adverse effects such as diarrhea develop. Since senna was the most frequently used laxative of the stimulant or osmotic class, and its use was significantly associated with occurrence of a bowel movement, we recommend it. Docusate is commonly administered in constipated patients; however, it was ineffective in producing bowel movements in this study. Further studies are warranted to investigate both factors that may increase or decrease the frequency of constipation in critically ill patients and factors that may prevent or ameliorate constipation-associated complications and costs.

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