Iranian Journal of Psychiatry and Behavioral Sciences

Published by: Kowsar

Concomitant Clozapine and Opium Usage Induced Constipation Leads to Fecal Impaction: A Case Report

Mohammad Tabarestani 1 , Alireza Salehi 1 , Mahdi Hadizadeh Moghadam 2 and Iradj Maleki 2 , *
Authors Information
1 Medical Students’ Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
2 Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
Article information
  • Iranian Journal of Psychiatry and Behavioral Sciences: September 2018, 12 (3); e55054
  • Published Online: July 31, 2018
  • Article Type: Case Report
  • Received: June 15, 2017
  • Revised: January 6, 2018
  • Accepted: March 2, 2018
  • DOI: 10.5812/ijpbs.55054

To Cite: Tabarestani M, Salehi A, Hadizadeh Moghadam M, Maleki I. Concomitant Clozapine and Opium Usage Induced Constipation Leads to Fecal Impaction: A Case Report, Iran J Psychiatry Behav Sci. 2018 ; 12(3):e55054. doi: 10.5812/ijpbs.55054.

Abstract
Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Introduction
2. Case Presentation
3. Discussion
Footnotes
References
  • 1. Read NW, Celik AF, Katsinelos P. Constipation and incontinence in the elderly. J Clin Gastroenterol. 1995;20(1):61-70. [PubMed: 7884183].
  • 2. Wald A. Management and prevention of fecal impaction. Curr Gastroenterol Rep. 2008;10(5):499-501. [PubMed: 18799126].
  • 3. Araghizadeh F. Fecal impaction. Clin Colon Rectal Surg. 2005;18(2):116-9. doi: 10.1055/s-2005-870893. [PubMed: 20011351]. [PubMed Central: PMC2780143].
  • 4. Grinvalsky HT, Bowerman CI. Stercoraceous ulcers of the colon: relatively neglected medical and surgical problem. J Am Med Assoc. 1959;171:1941-6. [PubMed: 13829424].
  • 5. Wrenn K. Fecal impaction. N Engl J Med. 1989;321(10):658-62. doi: 10.1056/NEJM198909073211007. [PubMed: 2671728].
  • 6. Muller-Lissner S. General geriatrics and gastroenterology: constipation and faecal incontinence. Best Pract Res Clin Gastroenterol. 2002;16(1):115-33. doi: 10.1053/bega.2002.0269. [PubMed: 11977932].
  • 7. Yucel AF, Akdogan RA, Gucer H. A giant abdominal mass: fecaloma. Clin Gastroenterol Hepatol. 2012;10(2):e9-e10. doi: 10.1016/j.cgh.2011.06.030. [PubMed: 21749849].
  • 8. Halawi HM, Maasri KA, Mourad FH, Barada KA. Faecal impaction: in-hospital complications and their predictors in a retrospective study on 130 patients. Colorectal Dis. 2012;14(2):231-6. doi: 10.1111/j.1463-1318.2011.02769.x. [PubMed: 21848667].
  • 9. Alvir JM, Lieberman JA, Safferman AZ, Schwimmer JL, Schaaf JA. Clozapine-induced agranulocytosis. Incidence and risk factors in the United States. N Engl J Med. 1993;329(3):162-7. doi: 10.1056/NEJM199307153290303. [PubMed: 8515788].
  • 10. Habibisaravi R, Navaeinia S, Farnia S, Zarghami M. Alcohol, Cannabinoids, and Opioids Abuse and Dependence Among Psychiatric Inpatients. Iran J Psychiatry Behav Sci. 2015;9(1). e229. doi: 10.17795/ijpbs229. [PubMed: 26251662]. [PubMed Central: PMC4525451].
  • 11. Faltus F. Clozapine in the maintenance therapy of schizophrenia. Act Nerv Super (Praha). 1974;16(3):205-6. [PubMed: 4153598].
  • 12. Chengappa KN, Pollock BG, Parepally H, Levine J, Kirshner MA, Brar JS, et al. Anticholinergic differences among patients receiving standard clinical doses of olanzapine or clozapine. J Clin Psychopharmacol. 2000;20(3):311-6. [PubMed: 10831017].
  • 13. Oke V, Schmidt F, Bhattarai B, Basunia M, Agu C, Kaur A, et al. Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis - a case report. Int Med Case Rep J. 2015;8:189-92. doi: 10.2147/IMCRJ.S86716. [PubMed: 26392790]. [PubMed Central: PMC4573205].
  • 14. Levin TT, Barrett J, Mendelowitz A. Death from clozapine-induced constipation: case report and literature review. Psychosomatics. 2002;43(1):71-3. doi: 10.1176/appi.psy.43.1.71. [PubMed: 11927763].
  • 15. Bickerstaff LK, Harris SC, Leggett RS, Cheah KC. Pain insensitivity in schizophrenic patients. A surgical dilemma. Arch Surg. 1988;123(1):49-51. [PubMed: 3337657].
  • 16. Rogers DP, Shramko JK. Therapeutic options in the treatment of clozapine-induced sialorrhea. Pharmacotherapy. 2000;20(9):1092-5. [PubMed: 10999502].
  • 17. Gaftanyuk O, Trestman RL. Scolpolamine patch for clozapine-induced sialorrhea. Psychiatr Serv. 2004;55(3):318. doi: 10.1176/appi.ps.55.3.318. [PubMed: 15001737].
  • 18. Praharaj SK, Arora M, Gandotra S. Clozapine-induced sialorrhea: pathophysiology and management strategies. Psychopharmacology (Berl). 2006;185(3):265-73. doi: 10.1007/s00213-005-0248-4. [PubMed: 16514524].
  • 19. Fosnes GS, Lydersen S, Farup PG. Drugs and constipation in elderly in nursing homes: what is the relation? Gastroenterol Res Pract. 2012;2012:290231. doi: 10.1155/2012/290231. [PubMed: 22505881]. [PubMed Central: PMC3299275].
  • 20. Nelson AD, Camilleri M. Opioid-induced constipation: advances and clinical guidance. Ther Adv Chronic Dis. 2016;7(2):121-34. doi: 10.1177/2040622315627801. [PubMed: 26977281]. [PubMed Central: PMC4772344].
  • 21. Khansari M, Sohrabi M, Zamani F. The Useage of Opioids and their Adverse Effects in Gastrointestinal Practice: A Review. Middle East J Dig Dis. 2013;5(1):5-16. [PubMed: 24829664]. [PubMed Central: PMC3990131].
  • 22. De Luca A, Coupar IM. Insights into opioid action in the intestinal tract. Pharmacol Ther. 1996;69(2):103-15. [PubMed: 8984506].
  • 23. Madan P, Bhayana S, Chandra P, Hughes JI. Lower gastrointestinal bleeding: association with Sevelamer use. World J Gastroenterol. 2008;14(16):2615-6. [PubMed: 18442219]. [PubMed Central: PMC2708383].
  • 24. Gurll N, Steer M. Diagnostic and therapeutic considerations for fecal impaction. Dis Colon Rectum. 1975;18(6):507-11. [PubMed: 1081034].
  • 25. Creason N, Sparks D. Fecal impaction: a review. Nurs Diagn. 2000;11(1):15-23. [PubMed: 10847055].
  • 26. Arana-Arri E, Cortes H, Cabriada V, Lekerika N, Garcia-Verdugo A, Shengelia-Shapiro L. Giant faecaloma causing perforation of the rectum presented as a subcutaneous emphysema, pneumoperitoneum and pneumomediastinum: a case report. Eur J Emerg Med. 2007;14(6):351-3. doi: 10.1097/MEJ.0b013e3282004952. [PubMed: 17968202].
  • 27. Mahajna A, Krausz MM. Ileocolic intussusception in an adult patient due to a cecal fecalith. Isr Med Assoc J. 2009;11(1):58-9. [PubMed: 19344016].
  • 28. Tiongco FP, Tsang TK, Pollack J. Use of oral GoLytely solution in relief of refractory fecal impaction. Dig Dis Sci. 1997;42(7):1454-7. [PubMed: 9246046].
  • 29. Obokhare I. Fecal impaction: a cause for concern? Clin Colon Rectal Surg. 2012;25(1):53-8. doi: 10.1055/s-0032-1301760. [PubMed: 23449376]. [PubMed Central: PMC3348734].
  • 30. Ratnapala DN, Borrowdale RC, Lambrianides AL. On-table technique for removing faecalomas from the rectal stump before restoration of intestinal continuity. ANZ J Surg. 2008;78(7):623. doi: 10.1111/j.1445-2197.2008.04593.x. [PubMed: 18593430].
  • 31. Candy DC, Edwards D, Geraint M. Treatment of faecal impaction with polyethelene glycol plus electrolytes (PGE + E) followed by a double-blind comparison of PEG + E versus lactulose as maintenance therapy. J Pediatr Gastroenterol Nutr. 2006;43(1):65-70. doi: 10.1097/01.mpg.0000228097.58960.e6. [PubMed: 16819379].
  • 32. Eitan A, Bickel A, Katz IM. Fecal impaction in adults: report of 30 cases of seed bezoars in the rectum. Dis Colon Rectum. 2006;49(11):1768-71. doi: 10.1007/s10350-006-0713-0. [PubMed: 17036204].
  • 33. Onders RP, Mittendorf EA. Utility of laparoscopy in chronic abdominal pain. Surgery. 2003;134(4):549-52. discussion 552-4. doi: 10.1016/S0039. [PubMed: 14605614].
  • 34. Lohlun J, Margolis M, Gorecki P, Schein M. Fecal impaction causing megarectum-producing colorectal catastrophes. A report of two cases. Dig Surg. 2000;17(2):196-8. doi: 10.1159/000018833. [PubMed: 10781993].
  • 35. Beck DE. Bowel preparation for colonoscopy. Clin Colon Rectal Surg. 2010;23(1):10-3. doi: 10.1055/s-0030-1247851. [PubMed: 21286285]. [PubMed Central: PMC2850161].
  • 36. Roy AK, Ghildiyal JP. Impaction of feces in a loop of sigmoid colon: a rare cause of incarceration of inguinal hernia in children. Int J Surg. 2008;6(6):e7-8. doi: 10.1016/j.ijsu.2006.08.005. [PubMed: 19059140].
  • 37. Schwartz J, Rabinowitz H, Rozenfeld V, Leibovitz A, Stelian J, Habot B. Rectovaginal fistula associated with fecal impaction. J Am Geriatr Soc. 1992;40(6):641. [PubMed: 1587988].
  • 38. Di Palma JA, Smith JR, Cleveland M. Overnight efficacy of polyethylene glycol laxative. Am J Gastroenterol. 2002;97(7):1776-9. doi: 10.1111/j.1572-0241.2002.05840.x. [PubMed: 12135034].
  • 39. Read NW, Abouzekry L, Read MG, Howell P, Ottewell D, Donnelly TC. Anorectal function in elderly patients with fecal impaction. Gastroenterology. 1985;89(5):959-66. [PubMed: 4043676].
  • 40. Youssef NN, Peters JM, Henderson W, Shultz-Peters S, Lockhart DK, Di Lorenzo C. Dose response of PEG 3350 for the treatment of childhood fecal impaction. J Pediatr. 2002;141(3):410-4. doi: 10.1067/mpd.2002.126603. [PubMed: 12219064].
  • 41. Lee-Robichaud H, Thomas K, Morgan J, Nelson RL. Lactulose versus Polyethylene Glycol for Chronic Constipation. Cochrane Database Syst Rev. 2010;(7). CD007570. doi: 10.1002/14651858.CD007570.pub2. [PubMed: 20614462].
  • 42. Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bongers ME, Liem O, et al. Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG. Pediatrics. 2009;124(6):e1108-15. doi: 10.1542/peds.2009-0022. [PubMed: 19948614].
  • 43. Puet TA, Phen L, Hurst DL. Pulsed irrigation enhanced evacuation: new method for treating fecal impaction. Arch Phys Med Rehabil. 1991;72(11):935-6. [PubMed: 1929815].
  • 44. Zhao W, Ke M. Report of an unusual case with severe fecal impaction responding to medication therapy. J Neurogastroenterol Motil. 2010;16(2):199-202. doi: 10.5056/jnm.2010.16.2.199. [PubMed: 20535352]. [PubMed Central: PMC2879854].
  • 45. Brocklehurst JC, Kirkland JL, Martin J, Ashford J. Constipation in long-stay elderly patients: its treatment and prevention by lactulose, poloxalkol-dihydroxyanthroquinolone and phosphate enemas. Gerontology. 1983;29(3):181-4. doi: 10.1159/000213112. [PubMed: 6852545].
  • 46. Gau JT, Acharya U, Marx T, Verne GN, Carlsen W. Megacolon and stercoral proctitis after frequent fecal impactions: report of an unusual case and review of the literature. J Am Med Dir Assoc. 2007;8(5):338-41. doi: 10.1016/j.jamda.2007.01.004. [PubMed: 17570316].
  • 47. Claffey KB, Patton ML, Haith LR Jr, Germain TJ, Kerstein MD. Barium and fecal impaction: an unusual case of bilateral hydronephrosis. Am Surg. 1995;61(8):709-13. [PubMed: 7618811].
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:

Author(s):

Article(s):

Create Citiation Alert
via Google Reader

Readers' Comments