Despite recent recommendations from an expert panel of pediatric specialists, a surprisingly high number of children with sickle cell disease are not being prescribed laxatives or stool softeners after being treated with opioids, according to a study published in the April issue of Pediatric Blood and Cancer.
"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 lead author Sarah O'Brien, of 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," she added.
For the study, the researchers analyzed the medical records of 6,093 sickle cell disease patients under the age of 18 who received opioids after being admitted to the hospital. Of that group, only two-thirds were prescribed concomitant laxatives or stool softeners.
O'Brien and her colleagues found that younger patients were less likely to receive constipation medication, presumably due to their inability to effectively communicate their symptoms. She noted that physicians need to do a better job of following the 2008 recommendations, which were authored by the Child Health Corporation of America quality improvement collaborative.
