Constipation management in people with intellectual disability: A systematic review

Abstract

The main management response to constipation in people with intellectual disability is laxative use despite limited effectiveness. An improved evidence base is required to support the suggestion that an individualized, integrated bowel management programme may reduce constipation and associated health conditions in people with intellectual disability.

Prevalence and patterns of antipsychotic use and their associations with mental health and problem behaviours among older adults with intellectual disabilities

“…The anticholinergic burden and its associated side effect of constipation associated with this type of psychotropic polypharmacy may also contribute to the development of problem behaviours. For example, previous studies have identified that pain from constipation may present as distress or behavioural problems such as aggression and self‐injury in adults with intellectual disability who may not be able to communicate symptoms (Christensen et al., ; Robertson, Baines, Emerson, & Hatton, ). However, given that neither reporting constipation nor pain was associated with displaying problem behaviours in the IDS‐TILDA wave 2 sample, this relationship warrants further investigation (O'Dwyer et al., ).…”

Constipation in autistic people and people with learning disabilities

“…A systematic review of 31 studies published between 1990 and 2016 found that people with an LD were more likely to suffer from constipation than people without an LD. 8 The review found that, across studies, prevalence was high, with 21 studies reporting rates of over 33% and 14 studies reporting rates of 50% or more. Over 12 months, laxative prescriptions were received by 25.7% of people with an LD compared with 0.1% of people without an LD.…”

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

“…e most common complications arising from chronic constipation are hemorrhoids, anal fissures, and rectal bleeding. More serious complications include fecal incontinence (where overflow incontinence may confuse the diagnosis of chronic constipation), fecaloma, pelvic organ prolapse, fecal impaction, bowel obstruction necessitating surgery, and bowel perforation and stercoral peritonitis where extremely impacted feces can compress the colonic wall, causing an ischemic ulcer and subsequent perforation, culminating in stercoral peritonitis and sometimes death [25]. Fecaloma is a not uncommon complication of constipation, which is a stone that is formed by a high colonic stool burden and coprostasis.…”

“…e current literature does not provide a clear guideline on how to treat constipation in adults with IDD. Most of studies found in the literature address treatment of constipation in the pediatric age group [25].…”