Nursing Guide to Bowels & Common Bowel Disturbances

The bowels are made up of the small intestines which include the duodenum, jejunum and ileum, and the large intestines which include the cecum, ascending colon, transverse colon, descending colon, rectum and anus.

There are many common disturbances of the bowels that we will see in our patients from diarrhea, constipation, hemorrhoids, and impactions. Understanding how to treat these disturbances is very important to nursing to prevent further complications down the road in your patient's health.

Diarrhea is classified as the brisk movement of fecal matter through the intestines which interferes with the absorptions of electrolytes and water. Signs and symptoms of diarrhea may include nausea, vomiting, abdominal cramping, dehydration, fatigue, weakness, electrolyte imbalances, emaciation, fecal incontinence, hyperactive bowel sounds and irritation to the anus or buttocks.

Contributing factors of diarrhea; infection (bacterial, viral, parasitic), anxiety, stress, medications, allergies and/or food intolerances.

Constipation is classified as fever then three bowel movements in a week's time or when the patient complains of not moving their bowels according to their normal movements. Signs and symptoms of constipation may include nausea, abdominal distension, hypoactive bowel sounds, and reports from your patients of no bowel movements.

Contributing factors of constipation; improper nutritional intake low fiber diet, suppressing the impulse to defecate, dehydration, post surgical procedures, obstructions, laxative abuse, immobility, and medications.

Constipation can turn serious due to complications that can be suffered due to the constipation for example mega colon, aggravated hemorrhoids, fecal impactions, bowel obstructions, and electrolyte imbalance.

Hemorrhoids are classified as an enlarged vein from around the anus area; these enlarged veins can be external or internal. Hemorrhoids usually look like a cluster of grapes or tissue that protrudes from the anus opening. Signs and symptoms of hemorrhoids include burning, itching, pain and bleeding during bowel movements.

Fecal impactions are classified as fecal matter that is trapped in the bowel system. Signs and symptoms include liquid fecal seepage, desire to move bowels, nausea or vomiting, rectal pain, anorexia, hypoactive bowel sounds, absence of formed stool, palpable on rectal exam and abdominal distension.

Flatulence is classified as gas that is propelled through the colon faster than it can be absorbed. This gas can lead to excessive flatulence which then leads to the inflation and stretching of the colon. Signs and symptoms of flatulence include cramping, abdominal pain, abdominal distension and peristalsis.

Contributing factors of flatulence; diffusion of gas from blood vessels to intestines, swallowed air, certain food intake, action of bacteria in the intestines, abdominal surgery and narcotics.