Bowel Management in the ICU: What We Know

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 conc...

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Main Authors: Giulia Caroti, Rebecca Zagni
Format: Article
Language:English
Published: Firenze University Press 2025-03-01
Series:Infermieristica Journal
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Online Access:https://riviste.fupress.net/index.php/if/article/view/3285
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author Giulia Caroti
Rebecca Zagni
author_facet Giulia Caroti
Rebecca Zagni
author_sort Giulia Caroti
collection DOAJ
description 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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spelling doaj-art-9ec0a36afa0f4609b1b60b846682655a2025-08-20T02:38:52ZengFirenze University PressInfermieristica Journal2785-70182025-03-014110.36253/if-3285Bowel Management in the ICU: What We KnowGiulia Caroti0Rebecca Zagni1Emergency and Traumatic Intensive and Sub-intensive Care Unit, University Hospital of Careggi, Florence, ItalyDepartment of Technical Health Care Professions Dietetics Unit, Santo Stefano Hospital, Prato, Italy 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. https://riviste.fupress.net/index.php/if/article/view/3285ConstipationDiarrheaBowel ProtocolIntensive Care Unit
spellingShingle Giulia Caroti
Rebecca Zagni
Bowel Management in the ICU: What We Know
Infermieristica Journal
Constipation
Diarrhea
Bowel Protocol
Intensive Care Unit
title Bowel Management in the ICU: What We Know
title_full Bowel Management in the ICU: What We Know
title_fullStr Bowel Management in the ICU: What We Know
title_full_unstemmed Bowel Management in the ICU: What We Know
title_short Bowel Management in the ICU: What We Know
title_sort bowel management in the icu what we know
topic Constipation
Diarrhea
Bowel Protocol
Intensive Care Unit
url https://riviste.fupress.net/index.php/if/article/view/3285
work_keys_str_mv AT giuliacaroti bowelmanagementintheicuwhatweknow
AT rebeccazagni bowelmanagementintheicuwhatweknow