ABSTRACT
The incidence of megacolon is elevated in neuropsychiatric patients. Siegmund was the first, in 1935, to report on the development of megacolon and megasigmoid as the result of chronic atropine therapy of patients with postencephalitic parkinsonism and the associated risk of stercoraceous ulcers and ileus or even sudden death. The etiology of increased frequency of megacolon among neuropsychiatric patients is assumed to be nonuniform, and to include organic defects of centers of the autonomous nervous system in the diencephalon and/or hypothalamous, pharmacodynamic, psychogenic and neurogenic influences on the autonomic nervous system, akinesia and increased obstipation among psychiatric patients, insufficient pressure in the abdominal wall especially in the mentally retarded, with frequently associated weakness of the connective tissue. In cases of long-term therapy with psychotropic drugs the anticholinergic side effects with the risk of megacolon and resulting ileus, sometimes with fatal outcome should be borne into mind.
Subject(s)
Cholinergic Antagonists/adverse effects , Intellectual Disability/drug therapy , Megacolon/chemically induced , Nervous System Diseases/drug therapy , Psychotic Disorders/drug therapy , Psychotropic Drugs/adverse effects , Cholinergic Antagonists/administration & dosage , Humans , Intellectual Disability/psychology , Intestinal Obstruction/chemically induced , Intestinal Obstruction/psychology , Long-Term Care , Megacolon/psychology , Nervous System Diseases/psychology , Psychotic Disorders/psychology , Psychotropic Drugs/administration & dosage , Risk FactorsABSTRACT
Appropriate communication with clients is essential when dealing with pets that have conditions associated with loss of autonomic function. These conditions include fecal and urinary incontinence, megaesophagus, and feline constipation. These conditions require a strong commitment to long-term caretaking with frequent frustrations on behalf of the client. Evaluation of the owner's personality types as well as the entire home situation is essential in assisting clients with their decision on how to deal with the problems. Each case should be evaluated based on multiple factors. Ideally, the veterinarian needs to go beyond offering medical advice and should help facilitate the decision-making process based on the ability of the client to deal with the care of a pet with a chronic problem. Different approaches to dealing with these often difficult situations will be discussed.
