Constipation in Intensive Care Unit: Pathophysiology, Definition, Prognostic Value, and Management

Abstract

Gastrointestinal symptoms are frequently experienced by intensive care unit (ICU) patients. The pathophysiology of gut motility is complex and influenced by usual ICU injuries or therapeutics. Definition of constipation remains different among studies because of lack of homogeneous definition criteria. The estimation is also more difficult in the ICU setting. This may partly explain the differences in reported incidence in previous works on the field. Prognostic value of constipation is also a matter of debate and it is still impossible to state whether constipation is an autonomous morbid disease or a surrogate of patient’s severity. Nevertheless, many works have evidenced an association between constipation and length of mechanical ventilation and length of stay in ICU. There is no consensus on management and the identification of the pathophysiological mechanisms may guide the therapeutic. The specific drugs to use as well as the timing of ignition and therapeutic goals remain to be defined.