Question

Comparison of Bowel Elimination Disorders:

	Diarrhea	Bowel Obstruction	Hemorrhoids
Pathophysiology
Etiology
Clinical Manifestations
Interventions

Answer 1

	Diarrhoea	Bowel obstruction
Pathophysiology	Absorption of water in the intestines is dependent on adequate absorption of solutes. If excessive amounts of solutes are retained in the intestinal lumen, water will not be absorbed and diarrhea will result. Osmotic diarrhea typically results from one of two situations: Ingestion of a poorly absorbed substrate: The offending molecule is usually a carbohydrate or divalent ion. Common examples include mannitol or sorbitol, epson salt (MgSO4) and some antacids (MgOH2). Malabsorption: Inability to absorb certain carbohydrates is the most common deficit in this category of diarrhea, but it can result virtually any type of malabsorption.	The bowel is basically a hollow tube that transports food and digested food waste from the stomach to the back passage (anus). There are two sections of the bowel: the small bowel, also called the small intestine, which is where the nutrients in the food are digested and absorbed; and the colon and rectum form the large bowel, or large intestine, which absorbs water from the digested food, forming it into stools (faeces/poo) that are passed out of the back passage. When an obstruction occurs, undigested food, liquids and digestive secretions accumulate above the blockage, the bowel section involved in the blockage becomes distended and the segment can collapse. The normal functions of the bowel wall are compromised and the distended section gets progressively worse. A completely blocked large bowel is a medical emergency.	Hemorrhoid cushions are a part of normal human anatomy and become a pathological disease only when they experience abnormal changes.There are three main cushions present in the normal anal canal. These are located classically at left lateral, right anterior, and right posterior positions.They are composed of neither arteries nor viens, but blood vessels called sinusoidsand smooth muscles . Sinusoids do not have muscle tiss in their walls, as veins do. This set of blood vessels is known as the hemmorroidal plexus. When a person bears down, the intra-abdominal pressure grows, and hemorrhoid cushions increase in size, helping maintain anal closure. Hemorrhoid symptoms are believed to result when these vascular structures slide downwards or when venous pressure is excessively increased
Etiology	* Viral infection - viruses such as rotavirus, norovirus * Bacterial infection such as E. Coli, campylobacter. *. Intestinal diseases such as irritable bowel syndrome, diverticulitis and Chris disease * Reactions to certain drugs * Intolerance or allergic to some foods. * Radiation treatment * laxatives abuse * abdominal surgery	Impacted stools (poo) from severe constipation Diseases that affect the intestinal wall such as Crohn's disease or diverticular disease Gallstones A swallowed item Intussusception, where part of the intestine folds in on itself Congenital malformation of the bowel Pyloric ileus Abdominal surgery	Pushing during bowel movements Straining when you do something that's physically hard, like lifting something heavy Diarrhea and constipation Pregnancy
Clinical Manifestations	* Increased frequency of bowel movement * watery liquid stool * abdominal cramps * bloating and gas * dehydration * fever	Intermittent pain in the middle abdominal area when there is a blockage in the small bowel - it is more severe the higher the blockage, but paralytic ileus pain may be less or even absent. Lower abdominal cramps with obstruction of the large bowel. Abrupt onset of continuous pain, sometimes with superimposed waves, in volvulus. Vomiting, early on when there is a high-level obstruction - vomiting of faecal matter indicates a lower obstruction. Abdominal distension, or swelling, more apparent the lower the obstruction is. Failure to pass stools, early on in a large bowel blockage and later if the blockage is higher up - there may also be an inability to pass wind. Diarrhoea if there is a partial blockage - passing of a liquid stool provides temporary relief.	About 40%of cases are not showing any symptoms Other symptoms includes bleeding while degradation, pain and constepation
Interventions	* treat dehydration hey fluids replacement   * anti diarrheal medicine such as loperamide * antibiotics for bacterial infection Antiviral medicine * pro biotic for antibiotics associated infection * education about sanitation and hygiene *good personal hygiene Clean drinking water	ssess the nutritional needs of the client. Rationale: By knowing the nutritional needs of the client can be observed the extent of the client's nutritional deficiencies and subsequent action. 2) Observation of signs of nutritional deficiencies. Rationale: To determine the extent to which lack of nutrients due to excessive vomiting. 3) Encourage activity restrictions during the acute phase. Rationale: Reduces the need to prevent a decrease in metabolic calorie and energy savings. 4) Evaluate periodically the condition of intestinal motility.	Management included conservative treatment and surgical procedure. Other interventions include * fibre rich diet to avoid constipation * exercises * hydrating the body * avoid aneamia