Vol. 4 Núm. 1 (2025): beyond the mask
Articles

Bowel Management in the ICU: What We Know

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  • Giulia Caroti,
  • Rebecca Zagni
Giulia Caroti
Emergency and Traumatic Intensive and Sub-intensive Care Unit, University Hospital of Careggi, Florence, Italy
Rebecca Zagni
Department of Technical Health Care Professions Dietetics Unit, Santo Stefano Hospital, Prato, Italy
DOI: https://doi.org/10.36253/if-3285

Publicado 2025-03-31

Palabras clave

  • Constipation,
  • Diarrhea,
  • Bowel Protocol,
  • Intensive Care Unit

Derechos de autor 2025 Giulia Caroti, Rebecca Zagni

Creative Commons License

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.

Resumen

Introduction. Gastrointestinal dysmotility frequently occurs in critically ill patients, who often experience symptoms such as constipation and diarrhea. Within the high-tech environment of modern intensive care units (ICUs), bowel care is often overlooked and sometimes regarded as a secondary concern. Limited guidelines and low-quality evidence hinder the management of constipation and diarrhea. The aim of this study is to review and analyze the literature on bowel management in ICUs.

Method. This is a cultural paper. All articles were sourced from indexed databases and nursing journals.

Results. Constipation is defined by NANDA-I as “a decrease in the normal frequency of defecation.” In the ICU, the incidence of constipation ranges from 45% to 83%. The most commonly used laxatives are osmotic, bulk-forming, and stimulant laxatives. The World Health Organization (WHO) defines diarrhea as the passage of three or more loose or liquid stools per day. Diarrhea is common in ICUs, and its complications can prolong the length of stay in the intensive care unit. The incidence of diarrhea ranges from 29.5% to 95%. In the ICU, acute fecal incontinence and diarrhea can be managed with a bowel management system (BMS). The implementation of bowel management protocols can improve bowel care in the ICU.

Discussion and Conclusion. Studies agree that the incidence of constipation and diarrhea is high in the ICU. The use of BMS is controversial. The use of a bowel protocol allowed standardization and improving bowel care in ICU. Further studies are necessary to find robust evidence for orientating healthcare staff in bowel management in ICU.

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Citas

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