Bowel motions in critically ill patients: a pilot observational study
Stephanie Bishop1, Helen Young, Donna Goldsmith
1Department of Intensive Care, Austin Hospital, Melbourne, VIC. Rinaldo.bellomo@austin.org.au.
Summary
Mechanically ventilated patients commonly experience non-defecation or diarrhea, with formed stools being rare. Medications like lactulose and ondansetron may influence bowel movements, while morphine is linked to non-defecation.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Clinical Nutrition
Background:
- Limited data exists on bowel function in mechanically ventilated patients.
- Hypothesized that stools are often unformed, with frequent diarrhea and non-defecation.
Purpose of the Study:
- To investigate factors influencing bowel motions and stool characteristics.
- To determine the prevalence of diarrhea and non-defecation in critically ill patients.
Main Methods:
- Pilot prospective observational study in a tertiary intensive care unit.
- Monitored 44 mechanically ventilated patients for over 24 hours.
- Collected data on bowel motion frequency, stool appearance (Bristol Stool Chart), and medication use.
Main Results:
- Non-defecation occurred on 61.3% of days; loose stools on 36.9%; diarrhea on 12.0%.
- Formed stools were rare (1.8%). Lactulose and ondansetron associated with bowel motions; morphine with non-defecation.
- Enteral nutrition linked to looser stools; morphine to less loose stools. Lactulose affected stool volume.
Conclusions:
- Non-defecation is the most common state in mechanically ventilated patients.
- Diarrhea is also prevalent, while formed stools are infrequent.
- Medications and nutrition impact bowel function in this population.
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