Constipation in the critically ill child

Abstract

Constipation is a common but understudied complication in the critically ill child. Its diagnosis is frequently delayed because it is not usually considered to be such a severe complication for these patients. However, constipation has been associated with worse outcomes in critically ill adults and children. There are only few studies in critically ill children focused on epidemiology and risk factors and there are no studies about diagnostic criteria, diagnostic tests or treatments in this population. The lack of studies in this field within critically ill children contrasts with the increasing number of studies in critically ill adults during these past two decades. Constipation clinical findings in children admitted to a pediatric intensive care unit are very similar to those observed in children with functional constipation. However, these critically ill children cannot meet the diagnostic criteria for functional constipation. As there is no a standard definition, carrying out studies about this topic is quite difficult. The treatment of constipation in critically ill children includes pharmacologic and non-pharmacologic therapies but there is also little evidence about this. Polyethylene glycol and lactulose are the preferred therapeutic options but there is a broad range of different possibilities. A new research area has emerged for treatments in opioid-induced constipation.