Bowel Elimination

• Infants have small stomachs and less secretion of digestive enzymes and are unable to control defecation due to lack of neuromuscular control
• Older adults lose muscle tone in the perineal floor and anal sphincter

• Regular intake of food increases peristalsis
• Fiber increases peristalsis
• Gas producing foods increases peristalsis

increase in fluid intake=softened stool

during emotional stress peristalsis increases and digestive process quickens. Diarrhea and gaseous distention.

• A busy work schedule sometimes prevents the individual from responding appropriately to the urge to defecate, disrupting regular habits and causing possible alterations such as constipation.
• Hospitalized clients are not always able to maintain privacy during defecation. embarrassment may prompt clients to ignore the urge to defecate, which begins a vicious cycle of constipation and discomfort.

• Fetus gets bigger and increases pressure on rectum.
• Fetus can create a temporary obstruction which impairs passage of feces.
• Constant straining = permanent hemorrhoids

• The temporary cessation of peristalsis... usually after surgery.
• lasts 24-48 hours

Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. ignoring urge to defecate

dilated, engorged veins in the lining of the rectum. They are either external or internal. External hemorrhoids are clearly visible as protrusions of skin. If the underlying vein is hardened, there is usually a purplish discoloration

• An ileostomy bypasses the entire large intestine. As a result, stools are frequent and liquid. The same is true for a colostomy of the ascending colon.
• A colostomy of the transverse colon generally results in a more solid, formed stool.
• The sigmoid colostomy releases near-normal stool.

Two large temporary stomas constructed in the transverse colon. Proximal end drains stool while distal end drains mucus. usually performed in a medical emegency

• consists of one stoma formed from the proximal end of the bowel with the distal portion of the GI tract either removed or sewn closed (called Hartmann's pouch) and left in the abdominal cavity.
• usually for pts with colorectal cancer

Unlike the loop colostomy, the bowel is surgically severed and the 2 ends are brought out through the abdomen. The proximal stoma is functioning and the distal is non-functioning.

liver disease, obstructions in bile duct, certain anemias, and could indicate that pt just had blood transfusion

obstructive liver disease, liver or biliary carcinomas, bone tumors, healing fractures

• abnormalities in the pancreas
• cholecystitis (inflammation of gall bladder)
• necrotic bowel (death of tissue in bowel)
• diabetic ketoacidosis

• cancer of GI tract
• inflamation of GI tract
• inflamation of liver or biliary tract

the entire colon through endoscopy

views sigmoid colon

many angles of the body using a scanner analyzed by a computer

small intestine to be studied

regular meals, hot drinks, fiber, increasing exercise, or in severe case give them suppository 30 min b4 the time they want to have a bowel mvmt.

• tap water
• large volume (500-1000 mL)
• distends the colon and encourages peristalsis
• Disadvantage: can cause electrolyte imbalance

• 9% normal saline
• distends colon and stimulates peristalsis
• *not as big of a electrolyte imbalance as hypotonic

a very strong solution pulls fluid out of tissues and into bowels (sodium phosphate)

• soap irritates mucosa and distends colon
• use only castile soap

• Oily like substance seeps into stool and provides lubrication to move
• you want the pt to hold it for 1-3 hours
• can also be used for pts with parasites
• also used for impaction

provide relief from gaseous distention

• draws potassium out of cells and into bowels
• used with pt who has a high K+ level