Cha pt er 19

Bowel Elimination
The gastr ointes tinal tr act

 The GI tract is
part of the
digestive
system. Bowel
elimination is
the excretion of
wastes from the
GI tract.
 2 parts:
 The small intestines
 The large intestine (large bowel or
colon)
GI syst em c ont
 Chyme is the partially
digested foods and
fluids.
 Feces refer to the
semi-solid mass of
waste products in the
colon that are
expelled through the
anus.
WHY IS IT CALLED
FECES?

 Feces comes from

the Latin word
"faex," which
means "dregs."
Dregs means the
most undesirable
part.
WHAT IS FECES?
WHAT ARE FECES MADE
OF?
perist alsis

 Feces move
through the
intestines by
peristalsis. It is
the alternating
contraction and
relaxation of the
intestinal muscles.
Defecat io n (bowe l
move me nt)
 Is the process of
excreting feces from
the rectum through
the anus. Stool
refers to excreted
feces.
 How o fte n and wh en?
 In a healthy person, it
should take between 24
and 36 hours to digest
food. Many people like to
defecate after breakfast.
 How
long?

 A healthy piece of
feces is about one
foot long.
No rmal bowe l
move me nts
 The frequency of bowel movements
varies from person to person.
 Observations include : color,
amount, consistency, odor, shape,
frequency, complaints of pain or
discomforts.
Ba bies

 Breast-fed infants have yellow stools.

Factors a ffectin g
bowel eli min atio n
 Privacy
 Habits
 Diet
 Fluids
 Activity
 Drugs
 Age
 Disability
WHAT DOES IT MEAN IF
THERE IS UNDIGESTED
FOOD IN THE FECES?
 Examples of foods
that are not
digested well by the
human body
include corn,
peanuts, peas,
carrots, cereals,
and beans.
 Research also
suggests that the
more a food is
cooked, the more
difficult it is for the
body to digest it. This
is generally true of
most foods. The
higher the
temperature that the
food is cooked, the
longer it will stay in
the digestive system,
and the more difficult
it will be for the body
to digest.
Th e sm ell
WHAT MAKES FECES
SMELL SO BAD?

 The bacteria
WHAT DO THE BACTERIA
INSIDE OF FECES LOOK
LIKE?

 The bacteria inside of feces can take

many different shapes and
appearances. Here is a picture of a
common type of bacteria found in
feces known as fecal coliform
bacteria:
CAN I REDUCE THE BAD
SMELL OF MY FECES?
Yes! !!
WHAT COLORS CAN FECES BE?
BROWNISH-YELLOW

 because they are also made up of an

orange-yellow substance called
bilirubin
YELLOW?

 One condition that can cause yellow

poop is an infection known as giardia.
 Hyperbilirubinemia is when too much
of a substance known as bilirubin is
present in the circulating blood.
 Feces can be black if dried blood is present in
it from a bleed.
 Red if active bleeding
 Red food coloring can cause bright red poop.
 Sometimes brightly colored foods pass through
the body almost unchanged, and the poop may
be speckled with bright red spots.
 Feces can be blue or green in children with
certain illnesses or if they eat food with a lot of
green or blue food coloring.
 Babies can also get green feces when they are
given food for the first time.
 Adults can also have green poop
 Feces can even
appear white if one
drinks a substance
known as barium
sulfate.
IS IT TRUE THAT SOME PEOPLE GET
SEXUALLY EXCITED BY FECES?

 This is true, and is referred to in

psychiatry as coprophilia. Coprophilia
is an abnormal attraction to and
interest in filth and feces (poop).
Sometimes, the interest and attraction
to filth and poop takes on a sexual
component and leads to sexual
excitement.
HOW ARE FECES EXAMINED TO
DIAGNOSE MEDICAL PROBLEMS?

 To diagnose various medical problems,

feces are often examined
Co mmon pro ble ms

 Constipation
 Fecal impaction
 Diarrhea
 Fecal
incontinence
 flatulence
Co nstip atio n

 The passage of dry, dry stool.

Imp action
 Can be removed with a gloved finger. Called
digital removal.
 The vagus nerve can be stimulated causing
slowed heart rate.
Fecal I mp actions, c ont

 Liquid feces can seep from the anus

 Abdominal discomfort, nausea, cramping
and rectal pain are common
 Indigestion is not common.
Dia rrh ea

 Dispose of
stools promptly.
This prevents
odors and the
spread of
microbes.
Fecal I ncontin ence

 The inability to
control the
passage of
feces and gas
through the
anus.
Fla tule nce
 Excessive formation of gas
 Air
 Bacterial action
 Foods
 Constipatio0n
 Surgeries
 drugs
Bo wel t rain ing

 Two goals
1. to gain control of bowel
movements
2. to develop a regular pattern of
elimination – to prevent
impaction,
constipation, and fecal
incontinence.
En ema s
 The introduction of
fluid into the rectum
and lower colon.
 It can clean the
bowel.
 The Sims'’ position or
the left side-lying
position is preferred.
 500 to 1000 cc
 Oil r etentio n
 Relieve constipation and fecal
impactions. The oil is retained for 30
to 60 minutes.
En ema s
 A nurse must be available to answer questions
and to supervise you.
Re cta l t ubes
 Its purpose is to
relieve flatulence and
intestinal distention.
 Usually left in place
for 20 – 30 minutes.
ost omy

 An ostomy is a surgically created artificial

opening.
 The opening is called a stoma.
 The person wears a pouch over the
stoma to collect feces and flatus or urine.
 Colostomy
 Ileostomy
 Urostomy
Pe rso n w ith a n o st omy
Co lo st omy

 A colostomy is a surgically created

opening (stomy) between the colon (colo)
and abdominal wall.
 colo st omy

 The person wears a pouch over the

stoma to collect feces and flatus.
 The pouch is emptied when feces
are present – they are usually
changed every to 7 days.
colo st omy