Q: What generally defines constipation in ICU?


Answer: Constipation in ICU is generally defined as ‘failure of the bowel to open for three consecutive days’. Some papers have used four days cut off time too, but in general no bowel movement beyond three days is defined as constipation. Sounds very simple, but constipation carries enormous domino effect in ICU, and should be address with due attention. Constipation can cause abdominal distension, vomiting, restlessness, gut obstruction, intra-abdominal hypertension and possible perforation. Cases have been reported of its association with pulmonary embolism. And, its association with increase LOS and failure to wean from ventilator is well documented.