Bowel Elimination
Chapter 30
MSN Milad Azar
Introduction
Defecation (bowel elimination) is the act of expelling feces
(stool) from the body.
Peristalsis means the rhythmic contractions of intestinal
smooth muscle that facilitate defecation. Peristalsis moves
fiber, water, and nutritional wastes along the ascending,
transverse, descending, and sigmoid colon toward the
rectum. Peristalsis becomes even more active during eating;
this increased peristaltic activity is termed the gastrocolic
reflex.
Structure of Bowel System - GI
The digestive system is made up of the gastrointestinal tract—also called the GI tract or digestive tract, and the liver, pancreas,
and gallbladder.
The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The hollow organs that make
up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine, and anus.
The liver, pancreas, and gallbladder are the solid organs of the digestive system.
The small intestine has three parts. The first part is called the duodenum. The jejunum is in the middle and the ileum is at the end.
The large intestine includes the appendix, cecum, colon, and rectum. The appendix is a finger-shaped pouch attached to the
cecum. The cecum is the first part of the large intestine. The colon is next. The rectum is the end of the large intestine.
How to Examine the Abdomen
Problems
Temporary or chronic problems with bowel elimination and intestinal function such as:
1. Constipation: is an elimination problem characterized by dry, hard stool that is difficult to pass. How many types?
2. Fecal impaction: occurs when a large, hardened mass of stool interferes with defecation, making it impossible for the client to
pass feces voluntarily, caused by unrelieved constipation, retained barium from an intestinal x-ray,
dehydration, and weakness of abdominal muscles.
3. Flatulence: (excessive accumulation of intestinal gas) results from swallowing air while eating or
sluggish peristalsis.
4. Diarrhea: is the urgent passage of watery stool and commonly is accompanied by abdominal cramping.
5. Fecal incontinence: is the inability to control the elimination of stool. How to do this procedure?
If these conditions are a component of a serious disorder, nurses and physicians collaborate to address them. Nurses may treat
alterations within the scope of nursing practice independently.
What are the sign and symptoms of each problems?
MEASURES TO PROMOTE BOWEL ELIMINATION
Nurses commonly use two interventions, Inserting suppositories and
administering enemas—to promote elimination when it does not occur
naturally or when the bowel must be cleansed for other purposes, such as
preparation for surgery and endoscopic or x-ray examinations.
What are the types of Enema?
Peristalsis is the involuntary contraction and relaxation of longitudinal and
circular muscles throughout the digestive tract, How many times per min.?
Colostomy Care
A client with an ostomy (surgically created opening to the bowel or other structure)
requires additional care for promoting bowel elimination.
Two examples of intestinal ostomies are:
1. ileostomy (surgically created opening to the ileum)
2. colostomy (surgically created opening to a portion of the colon)
Materials enter and exit through a stoma (entrance to the opening). Most persons
with an ostomy, also called ostomates, wear an appliance (bag or collection device
over the stoma) to collect stool. Depending on the type and location of the ostomy,
client care may involve providing peristomal care, applying an appliance, draining a
continent ileostomy.
Nursing Implementation
While assessing and caring for clients with altered bowel elimination, the
nurse may identify one or more of the following nursing diagnoses:
• Constipation
• Risk for Constipation
• Perceived Constipation
• Diarrhea
• Bowel Incontinence
• Toileting Self-Care Deficit
• Situational Low Self-Esteem
Homework
Write one page to know those diseases
• Pancreatitis
• Gall Bladder problems
• Lymph node infection
• Appendicitis
