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Disturbance IN Absorption AND Elimination

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yaz ferrer
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26 views

Disturbance IN Absorption AND Elimination

Uploaded by

yaz ferrer
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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DISTURBANCE

IN
ABSORPTION
AND
1. DISORDER OF INTESTINAL MOTILITY
a. Fecal Incontinence
b. Irritable bowel syndrome
2. MALABSORPTION SYNDROME
3. STRUCTURAL AND OBSTRUCTIVE
BOWEL DISORDERS
A. INTESTINAL
B. OBSTRUCTION
C. DIVERTICULAR DISORDERS
DISORDER OF FECAL INCONTINENCE
> Involuntary passage of stool form the rectum
> Influencing factors:
a. Ability of the rectum to sense and
accommodate stool.
b. The amount and consistency of stool
c. Integrity of the anal sphincters and
musclulature
d. Rectal motility
> Embarassing and socially incapacitating
Pathophysiology
➢ In general, it reaches from the conditions that interrupt or
disrupt the structure or function of the anorectal unit
CAUSES:
1. Trauma (e.g. after surgical procedures-rectum)
2. Neurologic Disoroders (e.g. Stroke, multiple sclerosis,
diabetic nuropathy, dementia.
3. Inflammation
4. Infection
5. Chemotherapy
6. Radiation treatment
7. Fecal Impaction
8. Pelvic floor relaxation
9. Laxative abuse
10. Medications and Advance aging
CLINICAL MANIFESTATION
➢ Minor soiling, occasional urgency and loss of control, or complete
incontinence
➢ Poor control of flatus, diarrhea or constipation.

ASSESSMENT AND DIAGNOTIC FINDINGS


➢ Flexible sigmoidoscopy – rule out tumors, inflammation or fissures
➢ X-ray studies: barium enema, CT anorectal manometry and transit
studies – identify alterations in intestinal mucosa and muscle tone
or detect structural or functional problems.
➢ Anorectal manometry (ie. presssure studies sucha s balloon
expulsion test) – maybe performed to assess malfunction of the
sphincter.
➢ Defecography and Colonic transit studies – assessment of active
anorectal function
➢ Pelvic floor magnetic resonance imaging (MRI) – identify occult
pelvic floor defects.
MEDICAL MANAGEMENT
➢ No known cure, specific management – quality of life
➢ Related to diarrhea – disappear when diarrhea is successfully
treated
➢ Frequent symptoms of fecal impaction – after removal of
impaction and the rectum is cleansed, normal functioning of
the anorectal area can resume
➢ Biofeedback therapy with pelvic floor muscle training – if the
problem is decreased sensoru awareness or sphincter control
➢ Surgical procedures – surgical reconstruction, artificial
sphincter, implantation, sphincter repair or fecal diversion.
NURSING MANAGEMENT
➢ GOAL: help patient achieve fecal incontinence; manage problems so
patient can have predictable, planned elimination
➢ Suppositories (sometimes) – stimulate the anal reflex; Discontinue if
regular schedule achieved.
➢ Bowel regulation: initiate bowel-training program that involves
setting a schedule; therapeutic use of diet and fiber.
> Foods that thicken stool (e.g. applesauce) and
> Fiber products (e.g. Psyllium) help improves incontinence
> Maintain skin integrity, especially in the debilitated or elderly patient:
incontinence briefs/diapers(brief period); meticulous skin hygiene; use
of perineal skin cleansers/ protection products.
➢ If continence not achieved – assist patient and family to accept and
cope with chronic situation.
NURSING MANAGEMENT
➢ Fecal incontinence devices (Flexi Seal Fecal
Management System)
> External devices – special rectal pouches, called
fecal incontinence collectors (drainable)
> Internal drainage systems – eliminate fecal skin
contact; especially useful when there is extensive
excoriation or skin breakdown.
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