Navigation Links
Sickle cell patients should be better monitored for constipation prevention
Date:6/16/2010

Not all patients with sickle cell disease receive laxatives after being treated with narcotics, despite recommendations from a collaborative panel of pediatric experts. These are the findings from a Nationwide Children's Hospital study examining patients from 29 pediatric hospitals, and appearing in Pediatric Blood & Cancer.

Narcotic-related adverse events are the most common adverse drug events in hospitalized children and constipation is a frequent narcotic-associated adverse drug event. In 2008, an expert panel of 14 freestanding children's hospitals met as part of the Reducing Narcotic-Related Adverse Drug Events in Children improvement collaborative and recommended that laxatives and stool softeners be proactively used when narcotics are prescribed.

Sickle cell disease patients are commonly prescribed narcotics to help manage vaso-occlusive pain crises, painful events that occur when blood flow is blocked to an area because the sickled cells have become stuck in small blood vessels. There are few studies discussing the impact of constipation on sickle cell disease and no studies have addressed the use of laxatives in these hospitalized patients.

"Besides causing discomfort to the patient, the development of constipation can negatively affect other aspects of inpatient care in patients with sickle cell disease," said Sarah O'Brien, MD, MSc, the study's lead author and principal investigator in the Center for Innovation in Pediatric Practice in The Research Institute at Nationwide Children's Hospital. "The abdomen is a well-known site of sickle cell pain. Abdominal pain due to constipation may be misinterpreted as a worsening vaso-occlusive crisis with subsequent higher doses of narcotics and therefore worsening constipation."

Dr. O'Brien, a hematologist in Hematology/Oncology and Blood & Marrow Transplantation at Nationwide Children's, and her colleagues used the Pediatric Health Information System, a multi-institutional, geographically diverse database to collect information on pediatric inpatients with sickle cell disease who received a narcotic medication during a 12-month period. They then investigated which of these patients received medications used to prevent and treat constipation during their hospitalization.

The study showed that one-third of sickle cell disease patients receiving narcotics were not prescribed concomitant laxatives or stool softeners as recommended by the Child Health Corporation of America quality improvement collaborative.

"We also discovered unexpected variability in the use of constipation medication," said Dr. O'Brien, also an assistant professor of Pediatrics at The Ohio State University College of Medicine. "While one would expect a diagnosis of constipation and increased length of stay to impact the use of laxatives, we also discovered that unrelated variables such as patient age, type of admission and hospital sickle cell disease patient volumes were associated with constipation medication use."

Older children were more likely to receive laxatives. Dr. O'Brien says that perhaps this is because they are better able to articulate symptoms of constipation. Patients with medical admissions were four times more likely to receive laxatives than patients with primarily surgical admission.

"Our findings demonstrate that increased attention needs to be paid to constipation prophylaxis in sickle cell patients, particularly in younger children and surgical admissions," said Dr. O'Brien.


'/>"/>

Contact: Mary Ellen Peacock
MaryEllen.Peacock@NationwideChildrens.org
614-355-0495
Nationwide Children's Hospital
Source:Eurekalert

Related medicine news :

1. Stroke prevention study in children with sickle cell anemia, iron overload stopped early
2. NHLBI to hold workshop on health consequences of sickle cell trait
3. New study suggests sickle cell disease may affect brain function in adults
4. Sickle Cell Disease Tied to Cognitive Difficulties
5. Low blood oxygen may lead to heart defects in children with sickle cell disease
6. Sickle Cell Disease Patients Seek Acute Pain Care Repeatedly
7. Cholesterol-Lowering Drug Shows Promise Against Serious Infections in Sickle Cell Disease
8. Statins Show Promise Against Sickle Cell
9. Blood stem-cell transplant regimen reverses sickle cell disease in adults
10. Bone Marrow Transplants May Cure Sickle Cell in Adults
11. New approach to sickle-cell disease shows promise in mice
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/26/2017)... ... 2017 , ... A global center of excellence specializing in ... of the art center will provide advanced surgical care (heart surgery), management of ... patients longer lives. , North American Veterinary Heart Center, the “Heart Center,” will ...
(Date:7/26/2017)... ... July 26, 2017 , ... BioPlus Specialty Pharmacy ... version of the HCV Treatment Path app (version 4.4.0) to keep health care ... infection. All of the latest HCV medications are included in this app, including ...
(Date:7/25/2017)... ... July 25, 2017 , ... ... of their partnership to provide the Pharmacist eCare Plan to Computer-Rx ... the country with the ability to develop the Pharmacist eCare Plan, a shared ...
(Date:7/25/2017)... ... July 25, 2017 , ... Dr. ... Dr. Negrette has more than a decade of experience in psychiatry, treating clients ... individuals fighting addictions, eating disorders, psychotic and manic conditions, as well as those ...
(Date:7/24/2017)... , ... July 24, 2017 ... ... Director,      (407) 916-7235, kklaproth(at)robinsmorton(dot)com , Robins & Morton, Perkins ... to celebrate the structural topping out of the new Destination Medical Building ...
Breaking Medicine News(10 mins):
(Date:7/19/2017)... , July 19, 2017  Mako Medical Laboratories partnered ... the Military Family Assistance Fund (MFA) to bring 140 ... to visit with their families one last time before ... coordinate the travel and logistics needed for these soldiers. ... soldiers and their families. We just wish we could ...
(Date:7/14/2017)... VEGAS , July 13, 2017 It should ... United States is in the midst of a ... Control , since 1999, the number of overdose deaths from ... "resulting in over half a million dead from 2001 to ... codeine, oxycodone, and hydrocodone has similarly quadrupled, drawing a compelling ...
(Date:7/12/2017)... 12, 2017 CarpalAID is a revolutionary new product that ... Carpal tunnel syndrome affects more than 8 million people ... rate of men. The common methods of treating CTS are painful ... hand braces or gloves. ... CarpalAID is a clear patch worn on the ...
Breaking Medicine Technology: