Bowel Incontinence

ADS

Change in normal bowel habits characterized by involuntary passage of stool.

Defining Characteristics:
  • Constant dribbling of soft stool, fecal odor; 
  • inability to delay defecation; 
  • rectal urgency; 
  • self-report of inability to feel rectal fullness or presence of stool in bowel; 
  • fecal staining of underclothing; 
  • recognizes rectal fullness but reports inability to expel formed stool; 
  • inattention to urge to defecate; 
  • inability to recognize urge to defecate, red perianal skin

Related Factors:
  • Change in stool consistency (diarrhea, constipation, fecal impaction); 
  • abnormal motility (metabolic disorders, inflammatory bowel disease, infectious disease, drug induced motility disorders, food intolerance); 
  • defects in rectal vault function (low rectal compliance from ischemia, fibrosis, radiation, infectious proctitis, Hirschprung's disease, local or infiltrating neoplasm, severe rectocele); 
  • sphincter dysfunction (obstetric or traumatic induced incompetence, fistula or abscess, prolapse, third degree hemorrhoids, pseudodyssynergia of the pelvic muscles); 
  • neurological disorders impacting gastrointestinal motility, 
  • rectal vault function and sphincter function (cerebrovascular accident, spinal injury, traumatic brain injury, central nervous system tumor, advanced stage dementia, encephalopathy, profound mental retardation, multiple sclerosis, myelodysplasia and related neural tube defects, gastroparesis of diabetes mellitus, heavy metal poisoning, chronic alcoholism, infectious or autoimmune neurological disorders, myasthenia gravis)

NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels
  • Bowel Continence
  • Bowel Elimination
Client Outcomes
  • Regular, complete evacuation of fecal contents from the rectal vault (pattern may vary from every day to every 3 to 5 days) (Roig et al, 1993)
  • Defecates soft-formed stool
  • Decreased or absence of bowel incontinence incidences
  • Intact skin in the perianal/perineal area
  • Demonstrates the ability to isolate, contract, and relax pelvic muscles (when incontinence related to sphincter incompetence, pseudodyssynergia) Increases pelvic muscle strength (when incontinence related to sphincter incompetence)

NIC Interventions (Nursing Interventions Classification)

Suggested NIC Labels
  • Bowel Incontinence Care
  • Bowel Training
  • Bowel Incontinence Care: Encopresis

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