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IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
IBS, Constipation & Diarrhea
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IBS, Constipation & Diarrhea

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IBS, constipation and diarrhea - disorders of the gastrointestinal tract

IBS, constipation and diarrhea - disorders of the gastrointestinal tract

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  • From time to time people become irregular in terms of bowel movements, which is why it’s important to look into constipation remedies that can ease the stress of irregularity. Constipation can lead to some serious risks in the digestive tract, as it is not good for waste to sit in the large intestine for a long period of time. Flushing out the system and being regular is important to the overall homeostasis that is required for every person living today. If you’re not sure what to do when nothing is coming out, it’s important not to strain, as it could rupture blood vessels near the sphincter.
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  • 1. MARIA G. NELSON BATCH 17 - PCN IRRITABLE BOWEL SYNDROME
  • 2. What is IBS? <ul><li>Also known as spastic colon, spastic colitis, mucous colitis and irritable colon </li></ul><ul><li>Most common functional disorder of the GIT </li></ul><ul><li>Causes increased motility of the small or large intestine </li></ul><ul><li>Affects the intestine’s structure, but cause is unknown </li></ul><ul><li>Does not lead to or cause ulcerative colitis or cancer </li></ul>
  • 3. Signs and Symptoms <ul><li>Causes alternately tense and flaccid bowel segments </li></ul><ul><li>Symptoms vary in intensity and pattern </li></ul><ul><li>Aggravated by foods, alcohol ingestion, stress and fatigue </li></ul><ul><li>Resulting symptoms include: </li></ul><ul><ul><li>Nausea </li></ul></ul><ul><ul><li>Abdominal pain </li></ul></ul><ul><ul><li>Cramps </li></ul></ul><ul><ul><li>Flatulence (gas) </li></ul></ul><ul><ul><li>Altered bowel function (constipation or diarrhea) </li></ul></ul><ul><ul><li>Hypersecretion of colonic mucus </li></ul></ul>
  • 4. Diagnosis <ul><li>Upper GI series </li></ul><ul><li>Barium enema </li></ul><ul><li>Colonoscopy appropriate for older adults </li></ul><ul><ul><li>Tests that eliminate other pathologies with similar symptoms </li></ul></ul><ul><li>Nursing Alert! </li></ul><ul><ul><li>Rectal Bleeding and fever are not associated symptoms of IBS. The person with these symptoms should report to a physician for evaluation. </li></ul></ul>
  • 5. Treatment <ul><li>Lifestyle changes </li></ul><ul><li>Counseling </li></ul><ul><li>Biofeedback and relaxation training </li></ul><ul><li>High-fiber diet and agents that add bulk like Metamucil and Effersyllium </li></ul><ul><li>Adequate oral fluids and regular meal patterns </li></ul><ul><li>Limitation of dairy products if lactose intolerant </li></ul><ul><li>Medications for symptomatic relief </li></ul>
  • 6. Types of Medications <ul><li>Sedatives or tranquilizers such as alprazolam (Xanax) </li></ul><ul><ul><li>Help quiet the bowel’s activity </li></ul></ul><ul><ul><li>Provide relaxation </li></ul></ul><ul><li>Antispasmodic agents like dicylclomine hydrochloride (Bentyl) and hyoscyamine (Donnatal) </li></ul><ul><ul><li>Relieve pain and cramping symptoms </li></ul></ul><ul><ul><li>Common side effects: </li></ul></ul><ul><ul><ul><li>Dry mouth </li></ul></ul></ul><ul><ul><ul><li>Blurred vision </li></ul></ul></ul><ul><ul><ul><li>dizziness </li></ul></ul></ul><ul><li>Antidiarrheal agents like loperamide (Imodium) to maintain normal activity </li></ul>
  • 7. Nursing Considerations <ul><li>Consistency </li></ul><ul><li>Follow prescribed treatment plan. </li></ul><ul><li>Keep a log or diary to track progress or identify changes. </li></ul>
  • 8. MARIA G. NELSON BATCH 17 CONSTIPATION
  • 9. What is Constipation? <ul><li>Infrequent, hard bowel movements accompanied by mucus </li></ul><ul><li>May be acute or chronic </li></ul><ul><li>Fecal impaction </li></ul><ul><ul><li>Loose, watery stool and mucus traveling around the constipated stool </li></ul></ul><ul><li>Prolonged constipation </li></ul><ul><ul><li>Sign of serious difficulty – intestinal obstruction or paralytic ileus </li></ul></ul><ul><ul><li>Immediate action needed! </li></ul></ul>
  • 10. Causes <ul><li>Dehydration </li></ul><ul><li>Cancer </li></ul><ul><li>Chemical dependency </li></ul><ul><li>Mechanical obstruction </li></ul><ul><li>Psychosomatic disorder </li></ul>
  • 11. Treatment <ul><li>Enemas for removal of feces and flatus </li></ul><ul><li>Diagnostic test or surgery </li></ul><ul><ul><li>To alleviate symptoms of constipation or distension </li></ul></ul><ul><ul><li>To administer specific medications or fluids </li></ul></ul><ul><li>Digital removal of fecal impaction for severely constipated or paralyzed clients </li></ul><ul><ul><li>Done only when stool softeners and enemas fail </li></ul></ul><ul><li>Fecal impaction as a possible complication of barium enema or barium swallow </li></ul>
  • 12. Nursing Considerations <ul><li>Warn client not to strain while defecating. </li></ul><ul><li>Client should quit worrying – compounds the problem </li></ul><ul><li>Lots of fluids – drink prune juice </li></ul><ul><li>Increase dietary bulk </li></ul><ul><li>Exercise </li></ul><ul><li>Regular schedule for defecation </li></ul><ul><ul><li>Postponing urge to defecate desensitizes the bowel to the presence of feces </li></ul></ul>
  • 13. Constipation in Older Adults <ul><li>Multiple medications may decrease peristalsis, cause water loss and interfere with intestinal absorption. </li></ul><ul><li>Limited mobility or exercise </li></ul><ul><li>Low intake of dietary fiber </li></ul><ul><li>Difficulty with chewing, swallowing or ingesting </li></ul><ul><li>Daily stool softeners suggested but regular laxatives should be avoided. </li></ul><ul><li>Caution: Loose watery stools may not be diarrhea – could be severe constipation with leakage of H2O around blockage. </li></ul><ul><ul><li>Assess for fecal impaction. </li></ul></ul>
  • 14. MARIA G. NELSON BATCH 17 DIARRHEA
  • 15. What is Diarrhea? <ul><li>Liquid or semi-liquid stools, often light colored </li></ul><ul><li>May be foul smelling, contain mucus, pus, blood or fats </li></ul><ul><li>Often accompanied by flatus and severe, painful abdominal cramps or spasms (tenesmus) that defecation relieves </li></ul><ul><li>Complications of severe or chronic diarrhea include: </li></ul><ul><ul><li>Dehydration </li></ul></ul><ul><ul><li>Electrolyte disturbances </li></ul></ul><ul><ul><li>Cardiac dysrhytmias </li></ul></ul><ul><ul><li>Hypovolemic shock </li></ul></ul>
  • 16. Signs and Symptoms <ul><li>Bacterial invasion by S. dysenteriae or Salmonella </li></ul><ul><li>Clostridium botulinum </li></ul><ul><ul><li>Anaerobic bacterium often the cause of nosocomial diarrhea </li></ul></ul><ul><ul><li>Infection that occurs in acutely ill patients who have received countless courses of antibiotics </li></ul></ul><ul><li>Inflammatory bowel disease (IBD) </li></ul><ul><ul><li>Often cause of diarrhea </li></ul></ul><ul><li>Medications </li></ul><ul><ul><li>Can cause diarrhea that stops when treatment stops </li></ul></ul>
  • 17. Diagnosis <ul><li>Evaluation of possible causes before client self-medicates </li></ul><ul><li>If it awakens the client from normal sleep – indicates intestinal pathology; bacterial infection, IBS or IBD should be ruled out. </li></ul><ul><li>Stool tests including cultures, occult blood tests, and O &amp; P smears are performed. </li></ul><ul><li>Hematology studies indicate infection of inflammatory processes. </li></ul><ul><li>Lower GI barium exams to rule out pathologic causes </li></ul>
  • 18. Treatment <ul><li>Elimination of the cause </li></ul><ul><li>IV fluids and electrolytes </li></ul><ul><li>Medications </li></ul>
  • 19. Medications for Diarrhea <ul><li>All contraindicated in poisoning unless poison is removed from GIT) </li></ul><ul><ul><li>Motility reduction: loperamide (Imodium), diphenoxylate (Lomotil) </li></ul></ul><ul><ul><ul><li>Potential for drug dependence; may cause dizziness, constipation and drying of mucous membranes </li></ul></ul></ul><ul><ul><ul><li>Lomotil cannot be used when pregnant </li></ul></ul></ul><ul><ul><li>Bile salt-binding agent: cholestyramine (Questran) </li></ul></ul><ul><ul><ul><li>May cause constipation, nausea, bloating, abdominal pain, rash </li></ul></ul></ul><ul><ul><ul><li>Cannot be mixed with other medications because it blocks their absorption </li></ul></ul></ul><ul><ul><li>Antibiotics: to treat bacterial/microbial diarrhea </li></ul></ul>
  • 20. Nursing Considerations <ul><li>Assess client’s fluid I&amp;O and weight. </li></ul><ul><li>Monitor for s/s of electrolyte disturbances and electrolyte levels – can disrupt electrolyte balance </li></ul><ul><li>Record exact time, amount and character (TAC) of each stool. </li></ul><ul><li>Restrict client’s diet to clear liquids. </li></ul><ul><li>Reintroduce food and fluids slowly to observe for improvement or worsening. </li></ul><ul><li>Client teaching that includes prevention of food contamination with S. aureus and Salmonella , often sources of diarrhea. </li></ul>

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