What factors influence bowel elimination?
Intake of food, transit of GI contents, proper motility, digestion, and absorption.
What is peristalsis?
The movement of GI contents from the esophagus to the anus.
What stimulates peristalsis?
Distension in response to food entry.
Is peristalsis a reflex?
Yes, it is an enteric nervous system reflex.
What regulates peristalsis?
The ANS, hormones, and local mediators such as serotonin.
What is gastric emptying?
Peristaltic contractions that slowly empty the stomach following a meal.
What is the normal rate of gastric emptying?
90% of a meal should be emptied by four hours.
What is the migrating motor complex?
A process that occurs between meals to move contents from the stomach to the colon.
How often does the migrating motor complex occur?
Every 90 minutes.
What triggers the cessation of the migrating motor complex?
Eating the next meal.
What are mass movements?
3-4 times per day, they move contents from the colon towards the rectum.
What is the gastrocolic reflex?
A reflex that occurs when food enters the stomach, stimulating mass movements in the colon.
What should be recommended for patients with constipation based on the gastrocolic reflex?
Try to use the toilet 30-60 minutes after meals.
Which factors normally improve the movement of contents through the GI tract?
- PNS activation
- Mild to moderate physical activity
- Eating foods high in insoluble fibre
What is the role of dietary fibre?
Attracts water, forms a thick gel, adds bulk, and softens stool.
What are examples of soluble fibre?
- Oats
- Nuts
- Seeds
- Beans
- Apples
- Berries
What is the difference between soluble and insoluble fibre?
Soluble fibre attracts water and softens stool, while insoluble fibre creates bulk and speeds up movement in the colon.
What is considered normal bowel function?
3x/day to 3x/week, soft brown formed stool, with straining in less than 25% of bowel movements.
What defines constipation?
Infrequent bowel movements (<3/week) or hardening of stool making passage difficult.
What symptoms might a patient with constipation report?
- Excess straining
- Hard, small or lumpy stools
- Bloating
- Cramping
- Painful BM
- Feeling of obstruction
Is it constipation if a patient has gas but no BM in 3 days?
Yes, increased gas can be a symptom of constipation.
What mechanisms can cause constipation?
- Stool hardening
- Slow GI motility
- Obstruction of stool passage
- Impaired defecation
What is fecal impaction?
Inability to pass a hard collection of stool.
What are risk factors for constipation in women?
- Effects of hormones (progesterone)
- Pregnancy
- Iron supplements
- IBS
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Module 3 Post-Op Pain29
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Module 1 Perioperative Environment20
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Module 1 PSR26
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Module 2 Inflammation and Arthritis30
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Module 2 Osteoarthritis18
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Module 4 Tissue Integrity11
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Module 4 Post-Op Infection19
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Module 5 Elimination38
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Module 5 Elimination Part 217
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Module 6 Antibiotics12
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Module 7 Thermoregulation25
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Module 8 Venous Thrombosis34
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Module 9 Sodium33
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Module 9 Potassium18
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Module 10 CAD/Angina/MI52
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Module 11 Cancer Part 145
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Module 11 Cancer Part 229
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extra questions for final19
