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Agents Commonly Used to Promote Bowel Elimination Video

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  • 0:00 Bowel Movement
  • 0:45 Laxatives
  • 2:20 Stool Softeners &…
  • 4:05 Enemas
  • 4:54 Patient Education
  • 6:14 Lesson Summary
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Instructor: Adrianne Baron

Adrianne has taught high school and college biology and has a master's degree in cancer biology.

We are going to discuss the agents that can be used to promote bowel elimination in patients suffering from constipation. We will also cover the patient education points that need to be discussed with administration of the agents.

Bowel Movement

Before entering the nursing field, you probably didn't spend much time thinking or caring about the frequency and consistency of another person's bowel movements. Well, this is now one of your concerns. As a nurse, one of your responsibilities is to make sure that your patients have normal bowel movements each day. If a patient doesn't have normal bowel movements, it is also your responsibility to administer agents to help make the bowel movements regular again.

In this lesson, you'll learn how to promote bowel elimination, also known as defecation, or the discharge of waste from the rectum, to help a patient that is suffering from constipation, or not having or having difficult bowel movements.

Laxatives

There are different types of bowel elimination agents. The first type is one you yourself may have used at some point in time. Oral laxatives are oral agents that help the bowels to move and excrete feces. We'll look at these from the gentlest to the harshest.

Oral bulk formers are laxatives that absorb water into the bowel to form soft and bulky stools. These are available over-the-counter, and are administered in the hospital setting as well. Examples of oral bulk formers are high fiber supplements that get dissolved in water, like Metamucil and Benefiber.

Oral osmotics are agents that use osmosis to move water from the tissues to inside the bowel to form soft stools. Some common oral osmotics include magnesium citrate, Miralax and Milk of Magnesia. The latter of these are used frequently in a hospital and long-term facility settings, and available for purchase over-the-counter.

The last of the laxatives are the oral stimulants. These are agents that increase peristalsis or contractions of the intestinal muscles to move feces out of the bowel. Oral stimulants are pretty harsh on the body and should only be used if other agents haven't helped to relieve constipation in the patient. Examples of oral stimulants include biscodyl, which is sold under the names Dulcolax and Correctol.

Stool Softeners & Suppositories

Another possibility for helping your patients have a bowel movement is to give them stool softeners. The name tells you exactly what these agents are and what they do. They are agents that soften stools. Softening the stool helps to allow them to be passed through, and out of the bowel. The most commonly used stool softener is docusate. This is available by prescription, and sold under the names Colace and Surfak.

Rectal suppositories are yet another option to help relieve constipation in patients. These are solid or oily agents that are inserted into the rectum that cause the release of feces. Some suppositories are biscodyl, docusate, and osmotics like we just discussed. They work in the same manner as they do when ingested, the only difference is simply which end it goes into.

Other suppositories, such as potassium bitartrate - sodium bicarbonate are carbon dioxide releasing agents that cause the buildup of carbon dioxide gas. The gas builds up behind a feces and forces the feces out of the bowel as the gas makes it way out of the bowel. There are many brand names under which these rectal suppositories are sold.

Mineral oil, an agent that acts as a water sealant, can also be inserted into the rectum to relieve constipation. The oil makes the walls of the bowel waterproof so the water will remain in the bowel, allowing the feces to stay loose. The oil also provides a slick surface for the feces to slide out. This particular agent is generic and available over-the-counter under numerous brand names.

Enemas

One of the last agents that you may have to use as a nurse in order to help relieve constipation in your patient is an enema. This is a liquid agent inserted into the rectum to force the release of feces. Enemas may be used to relieve constipation, but they are more frequently used to clear out the bowel before a surgical or medical procedure. Enemas may contain different substances in order to help release feces from the bowel.

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