This document discusses various gastrointestinal disorders including constipation, impaction, diarrhea, incontinence, flatulence, and hemorrhoids. It provides information on causes, signs and symptoms, and management for each condition. Nursing considerations are outlined and include maintaining regular bowel habits, providing privacy, administering enemas or suppositories when needed, and supporting patients through bowel retraining programs. Surgical procedures like ostomies may also be used to treat severe cases of fecal incontinence.
3. It is the term is used to describe an
infrequent bowel movements or irregularity
of defecation ,abnormal hardening of stool
that makes their passage difficult and painful.
4. Causes
◦ Irregular bowel habits and ignoring the urge to
defecate
◦ Chronic diseases
◦ Low fiber diet and high in animal fat
◦ less fluid intake
◦ Anxiety, depression, cognitive impairment
◦ Immobilization or lack of exercise
◦ Laxative misuse
◦ Illnesses (neurological illnesses & organic illnesses)
◦ Medications
5. Signs and symptoms
◦ Decreased frequency of defecation
◦ Hard, dry, formed stools
◦ Straining at stool; painful defecation
◦ Feeling of fullness, discomfort in rectum, abdomen
◦ Anorexia or nausea
◦ Headache
6. Medical management
◦ Treat the under lying cause
◦ Increase fiber and fluid intake
◦ Routine exercises
◦ Biofeedback
◦ Use of laxatives
Nursing management
◦ Maintain a regular pattern of elimination
◦ Dietary pattern
◦ Exercises
◦ Privacy
◦ Psychological support
◦ Posture
◦ Laxative administration
◦ Administration of suppositories or enema
7. It is the accumulation of hardened feces in
the rectum, as a result of which the person is
unable to voluntarily evacuate the stool.
◦ Mass or collection of hardened feces in folds of
rectum
◦ Passage of liquid fecal seepage and no normal stool
Usual causes
◦ Poor defecation habits
◦ Untreated or un relieved Constipation
8. Signs and symptoms
◦ Feeling of fullness in rectum and abdomen
◦ An urge for defecation and inability to pass stool
◦ Generalized malaise
◦ Loss of appetite
◦ Nausea/vomiting
◦ Abdominal distension
Management
◦ Laxatives , enema or manual removal of the
stool(digital evacuation)
9. Defined as frequent passage of loose,
fluid unformed stools due to increased
gastro intestinal motility
◦ Manifested by frequent evacuation of watery stool
◦ Besides the intense urge to defecate, there may
be abdominal cramps, nausea & painful burning
sensations at the anus
10. Causes
◦ Intestinal infections (enteritis)
◦ Nervous tension (emotional or psychogenic diarrhea
……excessive stimulation of parasympathetic
nervous system
◦ Medications ( antibiotics &iron supplements)
◦ Abuse of cathartics
◦ Mechanical causes : incomplete obstruction
….stenosis,adhesions and tumors
◦ Other causes :Malabsorption syndrome, irritable
colon, narcotic withdrawal. Etc.
11. Management
◦ Replace the fluid and electrolytes
◦ Treat the cause
◦ Drug therapy
Antibiotics/antimicrobials
Antimotility agents (loperamide)
Nursing care
◦ Replacements of fluid and electrolytes ( potassium)
◦ Small frequent diet.. Avoid spicy foods
◦ Use of bedpan and commodes
◦ Skin care
◦ Adequate rest
◦ Psychological support
◦ Medications
◦ Healthy eating habits
12.
13. The loss of voluntary ability to control fecal and
gaseous discharges through the anal sphincter
Types :
◦ Partial :inability to control flatus or to prevent minor
soiling
◦ Major : inability to control feces of normal consistency
Causes
◦ Neuromuscular disease
◦ Spinal cord trauma
◦ Tumors
Treated with surgery
◦ Repair of sphincter
◦ Fecal incontinence pouch
◦ Bowel diversion or colostomy
14. Flatulence is the presence of excessive flatus in
the intestines and leads to stretching and
inflation of the intestines (intestinal distensions)
Causes
◦ Action of bacteria on the Chyme in L.intestine
◦ Swallowed air
◦ Gas that diffuses between the blood stream and the
intestine
◦ Foods (cabbage, onions)
Signs
◦ Gastric distension
Management :insertion of rectal tube
15. Hemorrhoids are dilated, engorged vein in
the lining of the rectum
◦ External or internal
16. External
Clearly visible as protrusions of skin
If underlying vein is hardened or purple colored
Pain
Need to be excised
Internal
An outer mucus membrane
Causes :
Increased venous pressure due to straining
Pregnancy
Heart failure
Chronic liver diseases
Treatment
Hemorrhoidectomy
24. Decreasing flatulence
◦ Avoid gas-producing foods
◦ Exercise
◦ Movement in bed ( position)
◦ Ambulation
◦ Probiotics
Administering enemas
Rectal suppositories
Bowel wash
Digital removal of a fecal impaction
Bowel training programs
◦ Based on factors within client's control
◦ Goal of establishing normal defecation pattern
25. Bowel training programs
◦ Major phases
Determine client's usual habits and factors that help or
hinder defecation
Design plan with client
Determine fluid, fiber, hot drinks, exercise
Maintain routine for 2–3 weeks
Cathartic suppositories
Prompt response to urges
Privacy
Effective physical positioning
Provide positive feedback for successful defecation
Offer support; encourage client to have patience with the
process
26. Fecal incontinence pouch
◦ Collect and contain large amounts of liquid feces
Artificial sphincter
Ostomy
◦ Is a term for a surgically formed opening from the
inside of an organ to the out side ( eg: ileostomy or
colostomy)
◦ Stoma ( the part of the ostomy that is attached to
the skin, is formed by suturing the mucosa to the
skin)
◦ skin care