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Bowel training programs

LTC Nursing Assistant Trainer, February 17, 2005

Constipation is the primary elimination problem among nursing home residents. Depending on the cause of the problem, constipation can be treated with surgery to remove bowel obstructions, medication, or bowel training programs, several of which we'll explore today.

Bowel training programs are useful for people who have continual difficulty with constipation. They usually include the following measures:

• Adequate intake of fluid. When waste takes longer than normal to pass through the intestines where liquid is absorbed from the material, it can become dry and hard. Intake of enough fluids to keep the stool soft is an essential part of a bowel training program.

• Providing fibrous foods. This increases the bulk and size of stool, which assists in the movement of waste through the intestines. An increase in fluids is especially important when residents eat fiber-rich foods because fiber absorbs water. A full, well formed stool encourages peristalsis-the rhythmic muscular contractions that push food through the digestive tract.

• Exercise and physical activity. Promoting movement of the abdominal muscles stimulates peristalsis.

• Providing regular, private time for defecation. This helps residents develop a regular evacuation pattern. If we familiarize ourselves with our residents' normal defecation patterns, we can better assist them in promptly responding to their toileting schedules.

• Suppositories may be used to stimulate defecation. Laxatives and enemas, however, should not be used on a regular basis.

Unless there is a specific cause, such as disease or injury, relieving constipation is largely a matter of following good eating, fluid intake, exercise, and elimination habits. Encouraging residents to develop and maintain good bowel habits will help them avoid the general discomfort, straining, lack of appetite, and headaches that often accompany constipation.

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