Management of Constipation in Hospitalized Patients

Area of Science:

• Gastroenterology
• Hospital Medicine
• Pharmacology

Background:

• Constipation is a prevalent issue in hospital settings, often overlooked and inadequately treated.
• Opioid-induced constipation (OIC) is a significant contributor to constipation among hospitalized patients.
• Opioids cause constipation via agonistic effects on enteric µ-opioid receptors, impacting gut motility.

Purpose of the Study:

• To offer insights into the identification and management of constipation within inpatient environments.
• To specifically address the challenges and strategies related to opioid-induced constipation.

Main Methods:

• Routine constipation assessment upon hospital admission.
• Utilizing symptom assessment, patient history (including medication use), and physical examination.
• Employing patient assessment tools to gauge the impact of constipation.

Main Results:

• Effective management involves initial steps like ensuring hydration, electrolyte balance, and patient mobilization.
• Treatment options encompass laxatives, enemas, intestinal secretagogues, peripherally acting µ-opioid receptor antagonists, and manual disimpaction.
• Surgical intervention serves as a salvage therapy for severe, refractory constipation cases.

Conclusions:

• Early and thorough assessment of constipation is crucial for hospitalized patients.
• A multi-faceted approach, including lifestyle modifications and pharmacotherapy, is essential for managing OIC.
• Timely intervention can prevent serious complications associated with undertreated constipation.