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:10/13/2017)... ... October 13, 2017 , ... “America On The Brink”: the ... “America On The Brink” is the creation of published author, William Nowers. Captain ... As a WWII veteran, he spent thirty years in the Navy. Following his ...
(Date:10/12/2017)... ... October 12, 2017 , ... The ... demand of today’s consumer and regulatory authorities worldwide. From Children’s to Adults 50+, ... to meet the highest standard. , These products are also: Gluten Free, ...
(Date:10/12/2017)... ... October 12, 2017 , ... Information about the ... to develop to enable prevention of a major side effect of chemotherapy in ... in pediatric patients. For cisplatin, hearing loss is FDA listed on-label as a ...
(Date:10/12/2017)... ... October 12, 2017 , ... On Saturday, October 21, the Health & Wellness ... Moonlight to raise money for the American Heart Association Heart Walk. Teams of up ... work together to keep their treadmills moving for 5 hours. Treadmills will start at ...
(Date:10/12/2017)... ... October 12, 2017 , ... Vohra Chief ... advancements to physician colleagues, skilled nursing facility medical directors and other clinicians at ... of Wound Care." , "At many of these conferences we get to educate ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... West Pharmaceutical Services, Inc. (NYSE: ... drug administration, today announced that it will release third-quarter ... October 26, 2017, and will follow with a conference ... 9:00 a.m. Eastern Time. To participate on the call, ... ID is 94093362. ...
(Date:10/10/2017)... Oct. 10, 2017  NDS received FDA 510(k) clearance in May ... battery-powered display stand specifically designed for endoscopy environments. An innovative secondary ... a clinical solution to support the improvement of patient outcomes, procedural ... ... ...
(Date:10/4/2017)... Mass. , Oct. 4, 2017  According to the Centers for ... the end of October . PhysicianOne Urgent Care is helping communities across ... Westchester, NY , by offering no-cost* flu shots through the ... as mandated by certain health insurance regulations. ... The best time to get a flu shot is by the ...
Breaking Medicine Technology: