[Severe obstipation in the mentally ill and disabled]

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Patient Care

Background:

• Severe constipation (obstipation) is common in disabled and mentally ill patients.
• These patients often present with abdominal distension and fecal impaction, frequently requiring inpatient care.
• Diagnostic challenges arise due to lack of cooperation, especially with intestinal obstruction.

Purpose of the Study:

• To analyze data from 94 disabled patients with severe obstipation.
• To evaluate treatment outcomes, including surgical interventions for refractory constipation and bowel obstruction.

Main Methods:

• Retrospective analysis of 94 disabled patients with severe constipation.
• Categorization of patients into those admitted for constipation/obstruction and those treated for other diagnoses requiring constipation intervention.
• Review of surgical procedures performed for ileus or untreatable constipation.

Main Results:

• 16 operations were performed on 14 patients, including polypectomy, rectopexy, cecostomy, left hemicolectomy, and subtotal colectomy.
• Cecostomies were found to be ineffective as definitive treatment.
• Colonic resection led to daily bowel movements in patients.

Conclusions:

• Severe constipation in disabled patients presents significant management challenges.
• Surgical intervention, specifically colonic resection, offers a definitive solution for chronic constipation in this population.
• Further research into optimal management strategies for obstipation in disabled patients is warranted.