IntroductionAs the digestive organ of the human body, the gastrointestinal tract maintains nutrient metabolism and is also actively involved in various stress responses following trauma, burns, or infection. Since it is the initial organ of multiple organ dysfunction syndrome (MODS) in critically ill patients [1], it has recently gained increasing attention. However, scientists generally pay more attention to upper gastrointestinal problems in critically ill patients, while lower gastrointestinal problems such as failure to void are frequently ignored. In the intensive care unit (ICU), prolonged bed rest, sedation and analgesia, use of vasoactive drugs, mechanical ventilation, and changes in feeding mode slow down intestinal peristalsis, leading to constipation.Reports have suggested that the incidence of constipation in ICU patients is as high as 83% [2]. Moreover, constipation is associated with various adverse outcomes such as prolonged mechanical ventilation time and increased ICU length of stay (LOS) [2-4]. Additionally, because defecation is infrequent, stool accumulation and long-term retention can easily cause bacterial proliferation, intestinal flora imbalance, and endotoxin and bacterial displacement. This may induce systemic inflammatory response syndrome and even MODS [5], putting patients’ lives at risk. Currently, there is no consistent procedure concerning drugs and the timing of bowel cleansing in critically ill patients. Clinically, when patients suffer from constipation or require bowel cleansing, they are generally offered bowel cleansing treatments such as Coloxyl or senna, enemas, or laxatives [6], which are often unsuitable. If the stool is in the ascending colon or the transverse colon, the enema cannot clean the stool and clinicians cannot tell whether the patient has impaired bowel peristalsis or difficult rectal defecation. In recent years, bedside ultrasound has gradually become more widely applied in gastrointestinal assessment. Ultrasonography of the gastric antrum, ascending colon, descending colon, and rectum allows the quick assessment of gastrointestinal motility and stool shape and location, so that targeted measures can be taken.Therefore, in this study, we developed a bowel cleansing program for ICU patients using intensive care ultrasound, aiming to accurately cleanse the bowel, reduce stool accumulation, and improve patient health outcomes.