Protocolo de controle de constipação intestinal em pacientes adultos em cuidados paliativos

Abstract

INTRODUCTION: Constipation is one of the most frequent symptoms among adult patients receiving palliative care, particularly in the hospital setting, and is associated with significant discomfort, risk of complications, and negative impact on quality of life. Despite its high prevalence, considerable variability exists in diagnostic and therapeutic approaches, often marked by the absence of standardized institutional protocols. OBJECTIVE: This study aimed to develop an institutional protocol for the evaluation and management of constipation in adult patients receiving palliative care admitted to the Hospital de Clínicas of the Federal University of Uberlândia/Ebserh (HC-UFU/Ebserh). METHODS: A narrative literature review was conducted, focusing on randomized clinical trials, systematic reviews, and relevant clinical guidelines, addressing pathophysiological aspects, clinical assessment, alarm signs, indicated diagnostic tests, and pharmacological and non-pharmacological therapeutic strategies. RESULTS: A protocol was developed establishing a stepwise approach that prioritizes the exclusion of mechanical bowel obstruction, rational use of laxatives, systematic clinical reassessment, and multiprofessional care. According to the most recent evidence, systematizing the management of constipation through a multiprofessional protocol not only standardizes clinical practices but also enhances patient safety, optimizes symptom control, and contributes to improving the quality of palliative care in the hospital setting. CONCLUSION: A protocol for the evaluation and management of constipation in adult patients receiving palliative care was developed, based on the best available scientific evidence and adapted to institutional practice, promoting quality and safety of care.