Noninflammatory Bowel Disorders Overview

Bowel displacement through a weak abdominal muscle.

A hernia that cannot be pushed back into place.

Hernia cutting off blood supply to the bowel.

Abdominal pain, fever, vomiting, fast heart rate, and swollen abdomen.

Hernia occurring post-surgery due to poor incision healing.

Examining the patient for a bulge or lump at the site of the hernia, usually in the groin, umbilicus, or a healed incision.

Factors that increase the chances of developing a hernia, including male sex, advanced age, increased intra-abdominal pressure, and genetics.

A supportive device worn to prevent abdominal contents from bulging into a hernia sac when surgery isn't necessary.

Instructions for patients after hernia surgery, including avoiding heavy lifting, coughing, and straining, and managing constipation.

Important to prevent constipation by increasing fiber and fluids to reduce straining and pressure on the surgical site.

A common disorder that affects the large intestine, causing symptoms like diarrhea, constipation, bloating, and abdominal pain.

The cause of IBS is not fully understood, but it's believed to be influenced by a combination of environmental, immunological, genetic, hormonal, and stress factors.

Certain factors can worsen IBS symptoms, including dairy products, caffeinated beverages, infectious agents, food intolerances, stress, and anxiety.

IBS is diagnosed primarily based on the presence of typical symptoms, such as recurrent abdominal pain, changes in bowel frequency and stool appearance.

Common criteria for diagnosing IBS include recurrent abdominal pain occurring at least 3 days a month for the past 3 months, accompanied by two or more of the following: improvement with bowel movements, onset with changes in stool frequency, and onset with changes in stool appearance.

Common IBS symptoms include cramping abdominal pain, changes in bowel frequency, bloating, gas, and the feeling of incomplete defecation.

A diet rich in fiber and fluids is recommended for IBS. Avoid trigger foods like dairy, wheat, corn, fried foods, alcohol, spicy foods, and aspartame.

Factors that increase your risk of developing IBS include being female, experiencing stress, eating large fatty meals, consuming caffeine and alcohol.

A test used to detect malabsorption, impaired digestion, or bacterial overgrowth in the gut. It measures the amount of hydrogen gas in the breath after ingesting a test sugar.

The hydrogen breath test can help rule out IBS, as IBS doesn't typically cause bacterial overgrowth or malabsorption.

The patient must not eat or drink anything except sips of water for at least 12 hours before a hydrogen breath test.

A positive hydrogen breath test indicates too much hydrogen in the blood, likely due to bacterial overgrowth in the gut or malabsorption.

IBS is diagnosed primarily based on symptoms, not lab tests. Tests like the hydrogen breath test are used to rule out other conditions but not confirm IBS.

Diarrhea-predominant Irritable Bowel Syndrome, characterized by frequent, watery stools.

A medication that slows down bowel movements by decreasing peristalsis and increasing stool bulk, helping manage diarrhea.

A bulk-forming laxative that adds fiber to stools, aiding in regularity and managing diarrhea.

A medication specifically for IBS-D that blocks serotonin receptors in the gut, reducing urges and making stools firmer.

A medication specifically for IBS-D that blocks serotonin receptors in the gut, reducing urges and making stools firmer.

Alosetron is contraindicated for clients who have a history of bowel obstruction, Crohn’s disease, ulcerative colitis, impaired intestinal circulation, or thrombophlebitis.

An IBS-specific medication that increases fluid secretion in the intestine to promote intestinal motility, indicated for IBS-C.

Linaclotide is a medication used to treat irritable bowel syndrome with constipation (IBS-C). It works by increasing fluid and motility in the intestines, which can help relieve pain, cramping, and constipation.

A mechanical bowel obstruction occurs when something physically blocks the intestines, preventing food and waste from moving through. This can be caused by things like adhesions, tumors, or a hernia.

A nonmechanical bowel obstruction happens when the intestines are paralyzed, meaning there's no muscle movement to help things move through. This can be caused by things like surgery or certain medications.

Depending on the type, treatment for a bowel obstruction can include fluid and electrolyte replacement, decompression of the bowel (removing the blockage), and surgical intervention if needed.

Conditions that increase your risk of developing a mechanical bowel obstruction include adhesions, tumors, endometriosis, Crohn's disease, radiation therapy, and hernias. Older adults are more susceptible due to conditions like diverticulitis, fecal impaction, and cancer.

A bowel obstruction caused by a lack of muscle movement (paralysis) in the intestines, preventing food and waste from moving through.

Paralytic ileus, a type of nonmechanical obstruction, can be caused by factors affecting the intestines' ability to contract, such as neurogenic disorders, vascular disorders, electrolyte imbalances, and inflammatory responses.

Neurogenic causes of paralytic ileus include conditions that affect the nerves controlling intestinal movement, such as manipulation of the bowel during surgery or spinal fractures.

Vascular causes of paralytic ileus include problems with blood flow to the intestines, such as vascular insufficiency or mesenteric emboli.

Electrolyte imbalances, particularly low potassium (hypokalemia), can contribute to paralytic ileus by disrupting the proper functioning of intestinal muscle cells.

Inability to pass stool or gas for more than 8 hours despite feeling the urge to defecate.

Severe fluid and electrolyte imbalance, metabolic alkalosis, visible peristaltic waves (possible), epigastric or upper abdominal distention, abdominal pain, projectile vomiting with fecal odor.

High-pitched bowel sounds above obstruction, hypoactive or absent bowel sounds below.

Abdominal distention, visible peristaltic waves (possible).

Obstipation: inability to pass stool or gas for more than 8 hours despite feeling the urge to defecate.

Increased hemoglobin, BUN, creatinine, and hematocrit levels in blood tests can indicate dehydration.

Elevated blood amylase and WBC count may suggest strangulating obstructions, indicating compromised tissue.

Arterial blood gases (ABGs) reveal metabolic imbalance, depending on the type of obstruction.

CT scan precisely identifies the cause and location of the bowel obstruction.

Flat plate and upright abdominal x-rays assess the presence of air and gas patterns to evaluate bowel obstruction.

A medical instruction to avoid eating or drinking anything, allowing the digestive system to rest and heal.

A position where the patient's head and upper body are raised to 30-45 degrees, promoting comfort and breathing.

A condition where the intestines are paralyzed, preventing food and waste from moving through, often caused by surgery or medication.

Medical instructions to withhold food and fluids by mouth.

Once the cause of the obstruction is identified, focus on managing pain effectively to improve patient comfort and recovery.

A medication used for short-term treatment to reverse the effects of opioids on bowel motility after surgery, helping to restore normal bowel function.

A condition where the intestines are paralyzed after surgery, preventing normal movement of food and waste.

A tube inserted through the nose into the stomach to decompress the bowel and remove excess fluid/gas. The vent prevents damage to the stomach lining during continuous suction.

Regularly removing fluid/gas from the stomach through the NG tube, as prescribed by the doctor.

A surgical procedure where the abdomen is opened to investigate and correct the cause of a bowel obstruction, if possible.

A surgical procedure that creates an opening in the colon, allowing stool to be diverted through a stoma on the abdomen, often used for bowel obstruction relief.

A condition where the body's circulatory system is compromised, leading to fluctuations in blood pressure, heart rate, and other vital signs.

Ensuring that the nasogastric tube is open and functioning correctly to drain fluids and gas from the stomach.

Temporarily stopping the flow of drainage through the nasogastric tube to allow the patient to tolerate food and drink before removal.

Dehydration occurs due to persistent vomiting caused by a small bowel obstruction, leading to fluid and electrolyte imbalances.

Electrolyte imbalances, particularly low potassium levels, arise from persistent vomiting associated with small bowel obstruction.

Assess for signs of dehydration, such as changes in hematocrit, BUN, vital signs, skin turgor, and urine output. Notify the provider and administer IV fluids as ordered.

Monitor electrolyte levels, especially potassium. Notify the provider of any imbalances and administer IV fluids as ordered to replenish electrolytes.

An electrolyte imbalance occurs when the levels of essential minerals in your body's fluids, like sodium, potassium, and calcium, become too high or too low.

A condition caused by persistent vomiting in a small bowel obstruction, resulting in loss of minerals like potassium.

An imbalance where the body becomes too alkaline due to loss of gastric acid from persistent vomiting.

An imbalance where the body becomes too acidic due to obstruction preventing waste removal.

A compensatory action by the lungs to correct metabolic alkalosis by reducing breathing rate and increasing CO2 levels.

A compensatory action by the lungs to try and correct metabolic acidosis by breathing faster and deeper, attempting to expel excess CO2 and bring the body's pH back to normal.

Monitor for deep, rapid respirations, confusion, hypotension, and flushed skin. Obtain arterial blood gas and notify the provider of any unexpected laboratory findings.