Promoting a Healthy Bowel Delivered by: The Continence Advisory Service Ashfield Community Hospital Portland Street Kirkby-in-Ashfield Notts NG17 7AE

Aims & Objectives The aims of this module to enable learners to identify: Anatomy of the Bowel What is Normal? Promoting a Healthy Bowel Function Signs of Constipation Causes of Constipation

Anatomy of the Gastrointestinal Tract

What is Normal? Frequency of bowel actions: 3 times a day to 3 times a week is normal. The stool should be firm, but soft and easily passed. The colour of the stool should be brown in colour. It is normal for the stool to have an odour.

Bristol Stool Scale

Changes in routine can affect the bowels Travel Exercise Work Fluid intake Diet Drugs Environment

Promoting a healthy bowel habit What time does the individual usually open their bowels Prompt individuals who may not be aware of their needs, 20 to 30 minutes after eating Try not to delay responding to the need to pass faeces.

Privacy Patient involvement & consent Maintain privacy & dignity Remember they may be aware of making noise or smell Ensure toilet paper is available Hand washing facilities available Give assistance as required with clothing & hygiene

Diet Regular meals Fibre content, 5 portions fruit & vegetables a day Types of food Remember dentures or the condition of teeth is important to aid chewing and digestion

Fluid Intake 1 to 2 litres of fluid a day Ensure drinks are at right temperature Individual choice, favourite drinks, time to have them Drinking vessel, mugs cups and beakers

Correct position on the toilet

Correct position on the toilet

Signs of Constipation

Causes of Constipation Drugs Poor Diet Poor Fluid intake Immobility Ignoring the need to empty your bowels Underlying disorders

Treating Constipation Promote a healthy bowel habit to avoid it occurring in the first place Good record keeping and documentation Doctor may prescribe a laxative Encourage activity Increase fluid and dietary fibre intake

Faecal Incontinence High incidence in older people in long term care One of the most common causes is constipation Often more embarrassing and distressing Increases risks of skin breakdown.

Faecal incontinence Keep the skin clean & dry to reduce risk of skin breakdown & urinary tract infections Containment products if worn need checking regularly as formed faeces won’t change the wetness indicator Apply barrier creams sparingly if containment products used

Summary Promote a healthy bowel habit Encourage a well balanced diet & plenty of fluids Encourage activity Good record keeping to ensure constipation is reported