Chapter 35: Bowel Elimination; Factors Influencing Bowel Elimination

Question 1

Factors Influencing Bowel Elimination

Answer 1

Age
Diet
Position during Defecation
Pregnancy
Diagnostic Tests
Fluid Intake
Activity
Psychological Factors
Personal Habits
Pain
Medications
Surgery and Anesthesia

Question 2

Age:
Infants
Adolescents
Older Adults

Answer 2

• Infants- smaller stomach, less secretion of digestive enzymes, rapid intestinal peristalsis, no control until 2-3 years old
• Adolescents- rapid growth, increased metabolic rate, growth of large intestine and increased secretion of gastric acids to dissolve food fibers
• Older Adults- decreased chewing ability, partially chewed food is not digested as easily, peristalsis declines, muscle tone in perineal floor and anal sphincter weaken causing difficulty in controlling defecation

Question 3

Diet

Answer 3

Regular daily food intake
High-fiber foods-promote peristalsis
Low-fiber foods- slow peristalsis
Gas-producing foods- stimulate peristalsis
Lactose intolerance- leads to diarrhea and cramping
Gluten intolerance- pain, bloating, diarrhea or constipation

Question 4

Position During Defecation

Answer 4

• Sitting position- leaning forward, exert intraabdominal pressure, and contract thigh muscles
• Immobility- Difficulty sitting down, or rising from seat
• Modifications include elevated toilet seat and chair arms
• Immobilized patients require bedpan while lying down cannot contract muscles to defecate

Question 5

Pregnancy

Answer 5

• Pressure on rectum

- Constipation commonly occurs

Question 6

Diagnostic Tests

Answer 6

• Bowel preparations

- Blood Tests

Question 7

Fluid Intake

Answer 7

• Warm beverages and fruit juice softens stool
• Caffeinated drinks stimulate peristalsis
• Adequate fluid intake body absorbs fluid into fecal mass and increases bulk for easier passage

Question 8

Activity

Answer 8

• Immobilization depresses colon motility

- Regular physical exercise promotes peristalsis

Question 9

Psychological Factors

Answer 9

• Stress, anxiety, fear- initiates parasympathetic impulses, causing the acceleration peristalsis leads to diarrhea
• Emotional depression- decreases peristalsis and leads to constipation

Question 10

Personal Habits

Answer 10

• Failing to respond to the need to defecate and lack of privacy interfere with normal elimination
• Hospitalized patients often share toilet facilities or use bedpans or bedside commodes- leads to ignoring the urge to defecate

Question 11

Pain

Answer 11

Hemorrhoids, rectal surgery, and abdominal surgery cause a patient to suppress defecation because of pain leads to constipation

Question 12

Medications

Answer 12

Laxatives- soften stool
Antidiarrheal- agents slow peristalsis
-Opiates and anticholinergic drugs- depress peristalsis and cause constipation
Antibiotics- alter normal flora and produce diarrhea
Iron- cause stool to be black

Question 13

Surgery and Anesthesia

Answer 13

Anesthetics- slowing or halting of peristalsis

Surgery involving bowel manipulation- temporarily stop peristalsis