High amounts of flatulence in Psych

[funnypharm]

I have worked nights on and inpatient Psych. ward for 3 years. Mostly Psychitzo effective. I have noticed a large amount of these people have extreme amounts of gas (flatulence). Now I'm not saying that I hear or smell an occasional fat. I'm saying the whole room is gassed up and travels out into the unit from over half the rooms. I have worked in Hospitals before and I know the smells from medsurge. I have never experience this type of horrible gas smells in any other field. This population has (to me) an extreme flatulence problem.

Now, please take my post in the most serious way. This is so obvious to me that I've been even trying to find information about it on the internet. All I can find is information about gut bacteria and the gut microbiome. I did read that Psych meds only work on the brain but most of our mental health actually comes from the gut.

Has this been researched? Does anyone have a personal experience or something to add to this? I would really like for this to be researched. I think there is something to this.

[KatieMI, BSN, MSN, RN]

OK, just by the logic of things...

Psych drugs CANNOT work "only in brain". If you look in any physiology book, you'll see that the D, NA, S and other receptors are everywhere in the body. We may not know precisely what exactly their role and significance might be, but they are there and they are affected by these drugs in systemic circulation. Otherwise, where systemic side effects would come from?

Night us "vagus time", time when parasympathetic authonomous system dominates. One function of this system is bowel mobility and passage (that's why we normally tend to have BM early in the morning. The masses were moved toward the anal sphincter zone at night).

Bowel biome depends on neurohormonal regulation of GI tract for survival. The receptors I mentioned above regulate motility and orchestrate synchronization of acidic/basic changes (h2 increase HCl secretion in stomach, then the highly acidic mass comes to pylorus, the secretin starts pancreas to produce highly alkaline secret... see any good pathophysiology book for details).

Putting it all together, drugs which disrupt neuroendocrine connection everywhere in the body (they may correct abnormalities in brain, but please remember that we do not have any hard evidence of that fact, and just about to get into rough details about these connections' roles and functions everywhere else in the body - the role of h2 receptors in gastric secretion and motility was discovered in 1985) and many of them have known parasympathic/antimuscarinic effects can be predicted to cause excessive flatus at nighttime among certain patients. I doubt there is any significant research about it but in theory it looks like a probability.

[vintagemother, BSN, CNA, LVN, RN]

Perhaps it's their diet? I don't recall smelling lots of flatulence when I worked in pt psych for about a year.

Some days, though, we had more complaints of heart burn, which we nurses assumed was related to the current nights meals.

But, there sure were other smells! Many pts refused to bathe.......

[Whispera, MSN, RN]

Since many psych meds can cause nausea, it follows they the nausea could lead to flatulence...

"most of our mental health comes from the gut" ??? I never heard that before.

[CarryThatWeight, BSN]

Do you mean "schizoaffective disorder?"

[Farawyn]

Are you farting and blaming it on the patients, OP?

[Mandychelle79, ASN, RN]

Our unit can be pretty odiferous. We freak pharmacy out at times when we get a unit wide order for gas-x. We often carry around a bottle of biological odor eliminator. I don't know if it's any worse than other units just more noticeable because the patients are out and about more.

[RatchedAfterMidnight, MSN, APRN]

I really don't have anything scientific to add, but I had a patient with severe anxiety and her symptom was not nausea, dizziness, etc. She would pass gas repeatedly for hours. She would stop passing gas for 2 hours after an anxiety PRN then start passing gas again. The unit was full and the smell permeated into everyone's rooms. That's all I got

[Neurotic Student]

Hah! I don't notice it more than usual but I work with the mid to high acuity patients, they seem to be less self-conscious and considerate of others in letting it go. My unit has an odor, but is usually either gas or a combination of that and body odor. A lot of schizophrenics don't upkeep their hygiene very well.

[Zedrek]

I'm fairly immune to odors after so many years working psych but I do hear them roaring pretty often. I'm thinking that they just don't care and let them rip. Probably also a mixture of their diet and medications too.

[shamrokks, ADN, ASN, RN]

I notice it too but a lot of ours are homeless or basically always institutionalize do and seem to eat a lot and almost hoard food if they can so maybe a mix of that and the meds??? Some rooms hit me like a brick wall of funk when I open the door to do a Q15 round.

[rubyagnes, BSN]

Perhaps probiotics could be implemented to help balance their flora?