Bowel Elimination
Regular elimination of bowel waste products is essential for
normal body functioning. The large intestine which extends
from the ileocecal valve to the anus is the primary organ of
bowel elimination. Functions of the large intestine include
absorption of water, formation of feces, and expulsion of feces
from the body. Peristaltic contractions move contents through
the colon.
Alterations in bowel elimination are often early signs or
symptoms of problems within either the gastrointestinal (GI) or
other body systems. Because bowel function depends on the
balance of several factors, elimination patterns and habits vary
among individuals.
Factors affecting bowel elimination
Many factors influence the process of bowel elimination.
Knowledge of these factors helps to anticipate measures
required to maintain a normal elimination pattern.
Age: Age influences bowel elimination. Infants have a smaller
stomach capacity, less secretion of digestive enzymes, and more
rapid intestinal peristalsis. The ability to control defecation does
not occur until 2 to 3 years of age. Older adults may have
decreased chewing ability. Peristalsis declines and esophageal
emptying slows. This impairs absorption by the intestinal
mucosa. Muscle tone in the perineal floor and anal sphincter
weakens and may cause difficulty in controlling defecation.
Diet: Regular daily food intake helps maintain a regular pattern
of peristalsis in the colon. Fiber in the diet provides the bulk in
the fecal material. Foods with laxative effect include fruits and
vegetables, bran, chocolate, alcohol, coffee. Some foods may
also produce gas, which distends the intestinal walls and
, increase colonic motility. Gas-producing foods are onions,
cabbage, beans, cauliflower. In choosing a diet for promoting
normal elimination, consider the frequency of defecation,
characteristics of feces, and types of foods that impair or
promote defecation. A well-balanced diet with whole grains,
legumes, fresh fruits and vegetables eaten regularly promotes
normal elimination. Fiber adds bulk to the stool, eliminates
excess fluids and promotes more frequent and regular
movements. With increasing fiber it is important to drink
enough fluids. When the patient has diarrhe , low residue foods,
such as white rice, potatoes, bread, b nan , and cooked cereals,
are recommended until the diarrhea is controlled.
Fluid intake: While individual fluid needs vary with the person,
a fluid intake of 2-3 L per day is recommended. Fluid liquefies
intestinal contents by absorbing into the fiber from the diet and
creating a larger, softer stool mass. This increases peristalsis and
promotes movement of stool through the colon. Physical activity
promotes peristalsis.
Psychological factors: Prolonged emotional stress impairs the
function of almost all body systems. During emotional stress,
the digestive process is accelerated, and peristalsis is increased.
Personal elimination habits influence bowel function. A busy
work schedule sometimes prevents the individual from
responding appropriately to the urge to defecate, disrupting
regular habits and causing possible alterations such as
constipation.
Squatting is the normal position during defecation and warrants
privacy. For the patient immobilized in bed, defecation is often
difficult. If the patientÕs condition permits, raise the head of the
bed to assist the patient to a more normal sitting position on a
bedpan, enhancing the ability to defecate.
A number of conditions such as hemorrhoids, rectal surgery, anal
fissures (which are painful linear splits in the perianal area), and
abdominal surgery result in discomfort. In these instances, the
Regular elimination of bowel waste products is essential for
normal body functioning. The large intestine which extends
from the ileocecal valve to the anus is the primary organ of
bowel elimination. Functions of the large intestine include
absorption of water, formation of feces, and expulsion of feces
from the body. Peristaltic contractions move contents through
the colon.
Alterations in bowel elimination are often early signs or
symptoms of problems within either the gastrointestinal (GI) or
other body systems. Because bowel function depends on the
balance of several factors, elimination patterns and habits vary
among individuals.
Factors affecting bowel elimination
Many factors influence the process of bowel elimination.
Knowledge of these factors helps to anticipate measures
required to maintain a normal elimination pattern.
Age: Age influences bowel elimination. Infants have a smaller
stomach capacity, less secretion of digestive enzymes, and more
rapid intestinal peristalsis. The ability to control defecation does
not occur until 2 to 3 years of age. Older adults may have
decreased chewing ability. Peristalsis declines and esophageal
emptying slows. This impairs absorption by the intestinal
mucosa. Muscle tone in the perineal floor and anal sphincter
weakens and may cause difficulty in controlling defecation.
Diet: Regular daily food intake helps maintain a regular pattern
of peristalsis in the colon. Fiber in the diet provides the bulk in
the fecal material. Foods with laxative effect include fruits and
vegetables, bran, chocolate, alcohol, coffee. Some foods may
also produce gas, which distends the intestinal walls and
, increase colonic motility. Gas-producing foods are onions,
cabbage, beans, cauliflower. In choosing a diet for promoting
normal elimination, consider the frequency of defecation,
characteristics of feces, and types of foods that impair or
promote defecation. A well-balanced diet with whole grains,
legumes, fresh fruits and vegetables eaten regularly promotes
normal elimination. Fiber adds bulk to the stool, eliminates
excess fluids and promotes more frequent and regular
movements. With increasing fiber it is important to drink
enough fluids. When the patient has diarrhe , low residue foods,
such as white rice, potatoes, bread, b nan , and cooked cereals,
are recommended until the diarrhea is controlled.
Fluid intake: While individual fluid needs vary with the person,
a fluid intake of 2-3 L per day is recommended. Fluid liquefies
intestinal contents by absorbing into the fiber from the diet and
creating a larger, softer stool mass. This increases peristalsis and
promotes movement of stool through the colon. Physical activity
promotes peristalsis.
Psychological factors: Prolonged emotional stress impairs the
function of almost all body systems. During emotional stress,
the digestive process is accelerated, and peristalsis is increased.
Personal elimination habits influence bowel function. A busy
work schedule sometimes prevents the individual from
responding appropriately to the urge to defecate, disrupting
regular habits and causing possible alterations such as
constipation.
Squatting is the normal position during defecation and warrants
privacy. For the patient immobilized in bed, defecation is often
difficult. If the patientÕs condition permits, raise the head of the
bed to assist the patient to a more normal sitting position on a
bedpan, enhancing the ability to defecate.
A number of conditions such as hemorrhoids, rectal surgery, anal
fissures (which are painful linear splits in the perianal area), and
abdominal surgery result in discomfort. In these instances, the
