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British Journal of Anaesthesia, 2003, Vol. 91, No. 6 815-819
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Constipation and its implications in the critically ill patient{dagger}

S. M. Mostafa*,1, S. Bhandari2, G. Ritchie1, N. Gratton1 and R. Wenstone1

1 Intensive Therapy Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK. 2 Pinderfields General Hospital, Wakefield, UK

*Corresponding author. E-mail: Fred.Mostafa@rlbuht.nhs.uk
{dagger}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 Anaesthesia: Mostafa SM, Bhandari S, Ritchie G. Constipation and its implications in the critically ill: A National Survey of United Kingdom Intensive Care Units (A). British Journal of Anaesthesia 2001; 87: 343P).

Background. Motility of the lower gut has been little studied in intensive care patients.

Method. We prospectively studied constipation in an intensive care unit of a university hospital, and conducted a national survey to assess the generalizability of our findings.

Results. Constipation occurred in 83% of the patients. More constipated patients (42.5%) failed to wean from mechanical ventilation than non-constipated patients (0%), P<0.05. The median length of stay in intensive care and the proportion of patients who failed to feed enterally were greater in constipated than non-constipated patients (10 vs 6.5 days and 27.5 vs 12.5%, respectively (NS)). The survey found similar observations in other units. Delays in weaning from mechanical ventilation and enteral feeding were reported by 28 and 48% of the units surveyed, respectively.

Conclusions. Constipation has implications for the critically ill.

Br J Anaesth 2003; 91: 815–19


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