Robertson, Janet Margaret and Baines, Susannah May Johnston and Emerson, Eric Broughton and Hatton, Christopher Rowan (2018) Constipation management in people with intellectual disability : A systematic review. Journal of Applied Research in Intellectual Disabilities, 31 (5). pp. 709-724. ISSN 1360-2322
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Abstract
Background Constipation can lead to serious health issues and death. This systematic review summarizes international research pertaining to the management of constipation in people with intellectual disability. Method Studies published from 1990 to 2017 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests and cross-citations. Studies were reviewed narratively in relation to identified themes. Results Eighteen studies were reviewed in relation to three themes: laxative receipt; interventions (dietary fibre, abdominal massage and macrogol); and staff issues (knowledge and training). Laxative polypharmacy was common. Studies report positive results for dietary fibre and abdominal massage although study quality was limited. Conclusion 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.