A Primary Care Approach to Constipation in Adults with Intellectual and Developmental Disabilities

Abstract

Constipation is a condition that is very prevalent and is reported in up to 40 percent of individuals with intellectual and developmental disabilities (IDD). Constipation in this patient population is most commonly secondary to neuromuscular abnormalities, immobility, suboptimal diet, and medication side effects. History taking is frequently limited in adults with IDD due to communication barriers, often leading to a missed diagnosis of constipation. Inadequately treated constipation may lead to adverse effects including behavioral disturbances, fecal impaction, intestinal obstruction, and even death from intestinal perforation and sepsis. As a result, a high index of suspicion must exist for this patient population. Treatment in these patients requires an individualized approach, to reduce the constipation and its associated health complications.

Psychiatric diagnostic dilemmas among people with intellectual and developmental disabilities

“…For example, constipation and GERD were reported at high rates in the current study (70 and 52% respectively). People with IDD (including ID and ASD) may display altered mood and behaviour as a result of medical problems, including medication side effects (Charlot et al ., 2011; de Winter et al ., 2011; Mathew et al ., 2021). Additionally, identifying medical concerns and medication side effects can be challenging when assessing a person with IDD.…”

Abdominal Compartment Syndrome Secondary to Constipation in an Adult Patient With Cerebral Palsy

“…Constipation is a commonly encountered clinical problem with a global prevalence estimated to be about 18.9% in a systematic review [ 1 ]. In individuals with intellectual and developmental disabilities, it is estimated to have a higher prevalence of about 40% [ 2 ]. In daily practice, most cases of constipation are commonly treated with dietary modifications and medical therapy [ 3 ].…”