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BM Elimination

Normal feces 75% H2O and 25% solids; soft, but formed
Adult produces 7-10 L of flatus a day. Includes CO2, methane, H+, O2, and Nitrogen.
Bulk-forming foods- grains (bran, oats), fruits (prunes, figs) and vegetables- absorb fluids and increase stool mass-stimulating peristalsis
Gas-producing foods- onions, cauliflower, cabbage, beans, bananas, apples--stimulate peristalsis
Spicy foods & Sugar- cause diarrhea and gas
Lactose intolerance- is seen with patients that can’t digest foods like milk and milk products. Can be cause of diarrhea
should drink 6-8 glasses of fluid a day (non caffeinated)—preferably 2000-3000 mL/day, especially if constipation problems
Chocolate & alcohol can have a laxative effect.
Cheese, pasta (better to use whole grain), eggs, lean meat can cause constipation
Activity Activity-stimulate peristalsis- Bedridden clients risk for constipation, as well as clients with muscle weakness
Psychological factors- anxiety increases peristalsis-depression causes constipation (↓ peristalsis)
Defecation habits- most people go after breakfast-if client ignores urge, H20 is absorbed, eventually making stool hard-When
Medications- some cause diarrhea- laxatives help with elimination
Diagnostic procedures may have enemas before, or laxative prep (colonoscopy)
Anesthesia/Surgery if involves intestines, no bowel sounds for 24-48 hours-ileus; general anesthesia slows or blocks peristalsis
Pathologic conditions spinal and head injuries decrease elimination-immobility decreases elimination , poorly functioning anal sphincters
Pain-suppresses urge to defecate hemorrhoids, episiotomy, excoriation, fungal infection, etc.
Blood in the stool (melena or hematochezia): Very important that your remember that black stool is indicative of UPPER and Red blood lower
Black, tarry stool can result from aspirin, Pepto Bismol, GI bleed.
Gray-green stool can result from antibiotics
Chalky-flecked stools antacids, barium enema, barium swallow.
Brown Normally adults
Yellow Infants Newborns may also be green, black
Red Bleeding from Lower GI eating beets
Pale diet high in milk low in meats not absorbing fats
Orange or green intestinal infection
Amount varies with diet- ~100-400g/day
Odor Aromatic—affected by diet & individual’s own bacterial flora
“bad” odor- infection or blood
Constituents undigested roughage, sloughed dead bacteria & epithelial cells, fats, protein, bile pigments, inorganic matter
pus infection
mucus inflammatory
parasites (worms, ova), blood
Eructation burping, belching, mostly from swallowed air
Sources of Flatus Action of bacteria on chyme in large intestine (also source of odor of flatus) Swallowed air Gas that diffuses between the bloodstream & intestine
Distention stretches intestines, causing bloating, usually from foods, abdominal surgery, or narcotics.
Direct Visualization —”Going in with the light”; requires clear liquids, laxative prep day before, and NPO day of test.
Indirect Visualization X-rays, barium enemas
Lab tests parasites (may look like rice in stool), organisms, incomplete digestion
Simethicone used to coalesce gas (Gaviscon, Gas-Ex, Mylicon)
meds promote defecation (Metamucil, Fiber-Con, MOM, docusate, senna, mineral oil, Epsom salts)
control diarrhea by promoting absorption of excess fluid and/or slowing motility (Imodium, Lomotil, Paregoric)
Laxatives & Cathartics soften stool & promote peristalsis & can assist in return of normal pattern if used correctly—if chronic use, client can become laxative dependent, & normal signals no longer present for defecation without meds.
Bulemics use laxatives to purge to lose weight. Can cause ↓ absorption of nutrients, diarrhea, dehydration, electrolyte imbalance, and even death.
Constipation: Less than 3 stools per week Dry Hard stool Is this a change???? One of the most important questions
Symptom not disease infrequent BM’s, difficulty or inability to defecate; hard stool.
Straining Little water is left to soften the stool because of the absorption leading to hard dry stool
Hemorrhoids (swollen & inflamed veins in anus & rectum) can develop during late pregnancy d/t to ↑ abd pressure & straining from constipation, causing discomfort with defecation. Can also occur in children & adults with frequent or chronic constipation
Acute constipation often caused by organic process (tumor or bowel obstruction, as from surgical adhesions in abd)
Chronic constipation has functional causes that impede normal passage of stool
Retention Introduces oil or medication into the rectum & sigmoid colon for lubrication of stool
Carminative and return-flow Used primarily to expel flatus
Cleansing Prevents escape of feces during surgery Prepare intestines for certain diagnostic tests Removes feces in instances of constipation or impaction
Partial loss of control of flatus & minor soiling
Major lack of control of feces of normal consistency
Created by: ED.