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Abdominal Assessment for the Correctional Nurse: Constipation and Diarrhea

Constipation and diarrhea are common complaints in the correctional environment.  In this class, the basic abdominal assessment skills will be reviewed.  Constipation and diarrhea will be explained, and potential reasons for each will be discussed.  Common nursing interventions for the patient with constipation and diarrhea will also be discussed.

Constipation is defined as a condition where an individual has fewer than three bowel movements a week; or has stools that are hard, dry or lumpy; or has stools that are difficult and/or painful to pass; or the feeling after a bowel movement that there is still stool to pass (tenesmus). It is important to note, however, that each person has his/her own “normal” bowel pattern. Constipation is not a disease, but it may be a symptom of one. Complications of constipation include hemorrhoids, anal fissures, rectal prolapse, and fecal impaction.

Diarrhea is defined as a condition where an individual has loose, watery stools three or more times a day. Diarrhea may be acute, persistent, or chronic.  Acute diarrhea is a common problem that typically lasts 1 or 2 days and goes away on its own.  Persistent diarrhea lasts longer than 2 weeks but less than 4 weeks.  Chronic diarrhea lasts at least 4 weeks. Chronic diarrhea symptoms may be continual or intermittent.  Complications of diarrhea include dehydration and electrolyte imbalance, and malabsorption.

As with the assessment of all patient complaints, the evaluation of constipation and diarrhea should begin with a thorough history.