Use of opioids in critical care units causes constipation which can lead to adverse outcomes including delayed feeding and later discharge from the ICU. Researchers from London, UK, and Chicago, IL, have found that methylnaltrexone (MNTX), a peripheral opioid antagonist, may restore bowel function in critically ill patients. Their retrospective study appears in the March issue of Mayo Clinic Proceedings. "We found MNTX to be very effective in producing laxation when compared with conventional laxatives in our critically ill patients. MNTX was well tolerated and did not demonstrate any signs of reversing the effects of centrally mediated analgesia or precipitate withdrawal," says lead author Parind B. Patel, MBBS, FRCA, Critical Care Medicine, Hammersmith Hospital, London. MNTX was developed at the University of Chicago by Dr. Jonathan Moss. Researchers reviewed 88 nonsurgical critical care patients in their ICU during a 10-week period. 15 of the patients suffered from opioid induced constipation (OIC) within 72 hours of admission to the ICU. 7 were managed with MNTX and 8 were managed with conventional therapy consisting of sodium picosulfate and glycerin suppositories. The most striking result was the immediate effect of MNTX. Laxation occurred within 24 hours in 6 of the 7 patients, compared with none of the 8 patients in the conventional therapy group. MNTX was ineffective in one patient with a large intra-abdominal hematoma. When this patient was excluded from the analysis, the MNTX-treated patients laxated within 7.8 hours vs. 96.0 hours for patients who received conventional treatment. "We observed a clinically significant improvement in feeding and decreased gastric residual volumes in our patients with MNTX treatment," notes Dr. Patel. "Although our study was too small to demonstrate statistical significance, the improvement in enteral feeding suggests that further study is merited. The reduction in residual volumes following MNTX was dramatic and facilitated early target enteral feeding. There is a trend toward improved outcome, but our study was too small to document this statistically." The lack of suitable therapy has hampered study of bowel function in the ICU. "Our findings demonstrate a potential role for MNTX in managing OIC in critically ill patients and suggest that a larger controlled study in the ICU environment is merited," Dr. Patel concludes. Source: Eurekalert << Old Drug Reveals How the Body Uses Natural Immunity to Figh... Robotic Surgery is Less Invasive Way to Treat HPV-Related O... >> Recommended Reading Constipation Constipation, or difficulty passing stool, is a common digestive complaint and is a symptom of gastrointestinal abnormalities and preventing constipation is done by treating underlying disease. READ MORE Constipation-Symptom Evaluation Constipation can occur due to a number of factors from faulty bowel habits, digestive tract problems, and generalized muscle conditions and systemic diseases. READ MORE Fiber Up Your Meals A high fiber diet and good water intake are essential for a stress free body. High-fiber foods prevent overeating and is also the key to maintaining a healthy weight. READ MORE Nutritional Guard - Bottle Gourd Oozing with health and cosmetic benefits, the bottle gourd is a blessing in disguise many are unaware of. READ MORE Clinical Trials - Different Phases of the trial Clinical trials serve as a vital component for improving the treatment of medical conditions as they lead to higher standards of patient care. READ MORE Colo-rectal cancer - Management Treatment for Colorectal Cancers may involve surgery,chemotherapy, radiation therapy or biological therapy. Some people require a combination of treatments. READ MORE Drug Toxicity Drug toxicity is an adverse reaction of the body towards a drug that results as a side effect of a drug, reaction to a drug or drug abuse. READ MORE Irritable Bowel Syndrome Irritable bowel syndrome (IBS) causes recurrent abdominal pain or discomfort and a fluctuating disturbance in defecation. IBS is not life threatening. READ MORE The Better Flour - Refined Or Whole Wheat Flour! Whole wheat flour is rapidly gaining exposure for its rich nutritional value and being considered healthy, as opposed to all-purpose flour, maida. READ MORE Most Popular on Medindia Noscaphene (Noscapine) Post-Nasal Drip Drug Side Effects Calculator More News on: Drug ToxicityConstipationPilesClinical Trials - Different Phases of the trialColo-rectal cancer - ManagementSignature Drug ToxicityPiles Treatment OptionsIrritable Bowel SyndromeFiber Up Your MealsThe Better Flour - Refined Or Whole Wheat Flour!