{"id":1663,"date":"2024-09-26T18:30:11","date_gmt":"2024-09-26T22:30:11","guid":{"rendered":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/bowel-elimination-2\/"},"modified":"2024-10-07T14:31:45","modified_gmt":"2024-10-07T18:31:45","slug":"bowel-elimination","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/bowel-elimination\/","title":{"raw":"7.3 Bowel Elimination","rendered":"7.3 Bowel Elimination"},"content":{"raw":"

Normal Bowel Elimination<\/h1>\r\nThe stomach breaks down ingested food by means of stomach acid and enzymes. This product is called chyme. Chyme is passed into the small intestine through [pb_glossary id=\"1029\"]peristalsis[\/pb_glossary]. Chemical digestion and absorption of nutrients is the main function of the small intestine. The large intestine continues to absorb nutrients and fluid. The resulting waste is called [pb_glossary id=\"434\"]feces[\/pb_glossary] and is stored in the colon and rectum until the urge to [pb_glossary id=\"433\"]defecate[\/pb_glossary] is felt. The HCA should monitor the client\u2019s bowel movements and note the frequency, consistency, colour, odour and any pain or discomfort experienced during bowel movements. This will assist the nurse in adjusting the client\u2019s diet or medications.\r\n
\r\n

Watch the video:<\/p>\r\n\r\n<\/header>\r\n

\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=Og5xAdC8EUI&t\r\n\r\nHow Your Digestive System Works - Emma Bryce<\/em><\/a>, from TED-Ed (2017).\r\n\r\n<\/div>\r\n<\/div>\r\n
\r\n

Watch the video:<\/p>\r\n\r\n<\/header>\r\n

\r\n\r\nhttps:\/\/www.youtube.com\/watch?v=kVjeNZA5pi4\r\n\r\nWhat is Peristalsis?<\/em><\/a> by Mister Science (2018).\r\n\r\n<\/div>\r\n<\/div>\r\n

Characteristics of Normal Bowel Movements<\/h2>\r\n

There is a range of normal when considering the frequency of bowel movements. It is important to know what is normal for your client. Some people have bowel movements daily, for others normal is every 2\u20133 days. The frequency of a person\u2019s bowel movements can be affected by many factors, such as activity, age, medications, diet, fluid intake, and elimination habits. The Bristol Stool Chart (Figure 7.3.1) can assist you in identifying the consistency of the bowel movement.<\/a><\/p>\r\n\r\n[caption id=\"attachment_180\" align=\"aligncenter\" width=\"507\"]\"\" Figure 7.3.1<\/strong> Bristol Stool Chart [Image description]<\/a>[\/caption]\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Table 7.3.1<\/strong> Characteristics of Normal Bowel Elimination<\/caption>\r\n
Characteristic:<\/strong><\/td>\r\nWhat is Normal?\u00a0<\/strong><\/td>\r\n<\/tr>\r\n
Colour<\/td>\r\nNormally brown due to presence of bile.<\/td>\r\n<\/tr>\r\n
Amount<\/td>\r\nNormal can range from 3 times a day to 3 times a week. It is important to know what is normal for an individual, so changes can be identified.<\/td>\r\n<\/tr>\r\n
Consistency<\/td>\r\nNormal is soft and formed.<\/td>\r\n<\/tr>\r\n
Odour<\/td>\r\nNormal feces have a distinct odour.<\/td>\r\n<\/tr>\r\n
Shape<\/td>\r\nShould be tube shaped, like the colon.<\/td>\r\n<\/tr>\r\n
Size<\/td>\r\nCan vary depending on diet and elimination habits.<\/td>\r\n<\/tr>\r\n
Pain or Discomfort<\/td>\r\nThere should not be pain or discomfort felt with normal elimination.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

Abnormal Bowel Elimination<\/h2>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Table 7.3.2<\/strong> Characteristics of Abnormal Bowel Elimination<\/caption>\r\n
Characteristic<\/th>\r\nAbnormal<\/th>\r\nPossible Causes<\/th>\r\n<\/tr>\r\n<\/thead>\r\n
Colour<\/td>\r\nBlack, red, green or other<\/td>\r\n\r\n
    \r\n \t
  • Black stool: Clients on iron supplements are likely to have black, tarry (sticky and unformed) stool. Bleeding higher up in the digestive tract will also cause this.<\/span><\/li>\r\n \t
  • Red stool: Bleeding in lower digestive tract, or eating beets will cause red coloured stool.<\/li>\r\n \t
  • Pale or clay coloured: Can indicate disease or infection.<\/span><\/li>\r\n \t
  • Green: may be diet related or disease\/infection.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
Amount<\/td>\r\nAny increase or decrease from the client\u2019s normal should be reported and monitored<\/td>\r\n\r\n
    \r\n \t
  • Increased:<\/strong> Can indicate infection (gastrointestinal virus or bacteria), diet related, or related to some medications.<\/li>\r\n \t
  • Decreased:<\/strong> Constipation, medications<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
Consistency\/Shape<\/td>\r\nSee Bristol Stool Chart (Figure 7.3.1) for variations in consistency\/shape<\/td>\r\nHarder consistency can indicate lack of fluids\/fibre in diet. Loose consistency can indicate infection, changes in diet, allergies or intolerances, or other disease processes. A thinner shape could indicate also indicate disease process.<\/td>\r\n<\/tr>\r\n
Odour<\/td>\r\nFoul; different from usual stool<\/td>\r\nFoul or unusual odour can be the result of changes in diet, medications or infection<\/td>\r\n<\/tr>\r\n
Size<\/td>\r\nIncrease or decrease in normal should be monitored<\/td>\r\n\r\n
    \r\n \t
  • Smaller stool: Could indicate constipation.<\/li>\r\n \t
  • Larger stool: Could indicate change in diet, or infrequent bowel movements.<\/li>\r\n<\/ul>\r\n<\/td>\r\n<\/tr>\r\n
Pain or Discomfort<\/td>\r\nAbdominal pain, cramping, rectal pain<\/td>\r\nAny pain or discomfort with defecation should be reported, as there are a variety of factors and causes.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

Assisting with Bowel Elimination<\/h1>\r\n

The Health Care Assistant plays an important role in assisting clients to maintain normal elimination patterns. By following the guidelines below, you can support independence and prevent constipation. Always ensure to check the care plan.<\/p>\r\n\r\n

\r\n

Guidelines for Assisting with Bowel Elimination<\/p>\r\n\r\n<\/header>\r\n

\r\n