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Alteration in Bowel elimination - Coggle Diagram
Alteration in Bowel elimination
Alterations of Motility: Constipation
Large intestine disturbances in movement, ranging from constipation to diarrhea, are brought on by the common illness known as IBS.
Causes: Failure to respond to defecate, inadequate fiber in diet and water intake, weakened abdominal muscles, pregnancy, hemorrhoids, inactivity
Associated with other neurologic diseases: spinal cord injury, Parkinson's disease, MS, hypothyroidism. Drug: opioids, anticholinergic, calcium, diuretics, iron supplements.
Clinical manifestations: difficulty passing stools, straining during bowel movement, hard stools and abdominal bloating
Treatment: adequate fluid intake, moderate exercise, laxative and enema
Alterations of Neuromuscular Function: Neurogenic Bowel
The pathophysiologic mechanisms
Disruption in normal sensory or motor nerve signals innervating upper and lower GI tract
S/S chronic constipation, fecal incontinence, upset stomach, flatus incontinence,
Parkinson's disease and diabetic neuropathy can both cause neurogenic bowel
Other causes: Spinal cord injury, stroke, post-op complications, tumors
Diagnosis: MRI or CT scan, ultrasound, anorectal manometry
To regain control of bowel movement: exercise, dietary changes, laxative regiment, scheduled bowel movement routines, sphincter manipulation training, electrical muscle stimulation
Alterations of Patency: Diverticulitis
Etiology: increased in intraluminal pressure, increased colonic wall resistance, diminished colonic mobility
Prevalence among women under 50 and over 70 years of age
Pathophysiology: Pressure in the GI wall causes bulging pouches to build up, called diverticulum. This causes a cutoff in blood supply and the accumulation of bacteria. The inflammatory response causing abdominal pain.
Bulging pouches in the GI wall and muscle occurs in the sigmoid colon
Physical findings: c/o abdominal pain in the left lower abdomen, mild nausea, gas, diarrhea, constipation, rectal bleed, low-grade fever, rebound tenderness
Diagnostic tests: CBC, fecal occult blood test, ESR, barium studies, XRAY, CT scan with IV and oral dye, flexible colonoscopy, biopsy
Risk factors: smoking, low fiber-diet, sedentary lifestyle, constipation, obesity
Medical management and therapy: NPO (bowel rest), IV fluid hydration (lactate ringer or normal saline), antibiotics (metronidazole), pain medication (morphine), surgery (colon resection), temporary colostomy