Defecation Process and Management

Defecation Process and Management

• Defecation begins with colonic contractions propelling stool toward the anus.
• Stool reaching the rectum relaxes sphincters, signaling the need to defecate.
• Normal defecation frequency is 1-3 times daily.
• Normal stool characteristics include a soft, brown, formed consistency, cylindrical shape, aromatic odor, and may contain small undigested roughage.
• Ignoring the urge to defecate causes the external sphincter muscle to constrict.
• This temporarily suppresses the urge but it returns after a few hours.
• Repeated inhibition leads to rectal expansion, reduced sensitivity to the need to defecate, and constipation.
• Ignoring the urge to defecate can also lead to a loss of sensitivity in the rectum to the need to expel stool.

Assisting with Bowel Elimination

• Positioning: A sitting position may be challenging for those with muscle weakness or mobility issues; ensure comfort and proper alignment. Positioning on a bedpan involves raising the head of the bed to 30 degrees for comfort and ease of elimination.
• Ambulation: Encourage ambulation to the washroom if feasible.
• Choice of Facilities: Offer options like a bedpan, commode, or toilet to respect patient dignity and autonomy.
• Post-Elimination Care: Assess stool and skin condition, dispose of stool appropriately, and provide perineal care after elimination.
• Sitting Position: If a seated position is difficult for the patient due to weakness or mobility issues, ensure comfort and correct positioning.
• Bedpan Positioning: Raising the head of the bed (HOB) to 30 degrees can promote comfort during bedpan use.
• Choice of Options for Bowel Elimination: Options such as a bedpan, commode, or toilet should be offered to patients to promote autonomy and dignity.
• Post-Elimination Actions: Post-elimination, assess the stool and patient skin, dispose of stool correctly, and give perineal care.

Incontinence Products and Associated Risks

• Incontinence Products: Garment protectors (adult briefs, protective underwear, incontinence pads, bed pads, waterproof covers) are used for urinary and/or bowel incontinence.
• Incontinence Management: Encourage regular toileting to minimize reliance on incontinence products.
• Skin Risks: Incontinence products can lead to skin integrity loss and pressure injuries, increasing falls and the risk of infections (e.g., UTIs).
• Psychological Risks: Incontinence can negatively affect self-esteem, body image, and social interactions; leading to embarrassment, frustration, anger, fear, social isolation, depression, and guilt.
• Incontinence Product Use: Use incontinence products appropriately to avoid associated complications.
• Skin Care: Ensure proper skin care and perineal hygiene to prevent complications.
• Risks: Loss of dignity, self-esteem, and negative body image can result from incontinence. Feelings like embarrassment, frustration, anger, and fear can arise as well. Social isolation and a restriction of activities might occur. Depression and guilt can be effects of incontinence.
• Associated Risks: Falls are a risk associated with incontinence.

Explore the intricate process of defecation, from colonic contractions to stool characteristics. This quiz covers the normal frequency, the importance of responding to urges, and effective strategies for assisting with bowel elimination, including positioning and ambulation.