/clinical/,/clinical/pted/,/clinical/pted/hffy/,/clinical/pted/hffy/stroke/,

/clinical/pted/hffy/stroke/6551.hffy

201511328

page

100

UWHC,UWMF,

Clinical Hub,Patient Education,Health and Nutrition Facts For You,Stroke

After a Stroke, Managing Your Bowels (6551)

After a Stroke, Managing Your Bowels (6551) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Stroke

6551





After a Stroke
Managing Your Bowels


People who have had a stroke may have problems with their bowels. These problems occur
because the stroke has damaged the part of the brain that controls bowel function. Some patients
have trouble passing stool. Others report bowel movements that were once like clockwork, now
come few and far between. Still others report having lost control over bowel movements. Each
of these problems can cause distress and discomfort.

Constipation
A person is constipated when they have trouble passing their bowel movements or they are not
having bowel movements as often as they need to. Constipation can cause hemorrhoid pain. It
can also lead to hard-packed stool that is so hard to pass a person needs help with getting the
stool out of the rectum. It is worth taking steps to avoid it.

Factors That Lead to Constipation
 Not enough fiber in the diet
 Eating hurried meals and having meals at odd times
 Not drinking enough fluids
 Not enough physical activity
 Pain medicine
 Antacids that contain aluminum and calcium
 Antidepressant medicine
 Depression
 Drinking too much caffeine and alcohol
 Ignoring the urge to have a bowel movement

Treatment of Constipation
 Eat high fiber foods. Fruits, vegetables, whole grain breads, cereals, bran cereals, wheat
germ, beans are some foods that are high in fiber.
 Drink 8 – 10 glasses of fluids every day. Fluids may include water, fruit juice, and
vegetable juice.
 Exercise every day or at least every other day to help get the bowel moving.
 Go to the bathroom if you feel the urge to have a bowel movement. Do not ignore the
urge to have a bowel movement. The best time to have a bowel movement is after a
meal, especially the first meal of the day.
 Sit upright on the commode or toilet if able. Sitting upright makes it easier to have a
bowel movement.
 Review your medicine with the doctor. Some can cause constipation.
 Stool softeners, laxatives, or enemas may be needed. Always talk to your doctor before
using any of these treatments.






Fecal Impaction
This occurs when a large, hard, dry mass of stool stays in the rectum and cannot be passed out of
the body. It is most often caused by chronic constipation. Watery stool may leak out around the
stool mass causing soiling of clothing. A fecal impaction will need medical care. If you have
the symptoms described below, you must call the doctor.


Symptoms of Fecal Impaction
 Watery stool which may occur after not being able to pass a hard stool
 Pain in your gut, or feeling uneasy in your gut
 Bloating or swelling
 Losing interest in food
 Weight loss
 Headache
 An upset stomach, or throwing up
 Constant urge to have a bowel movement


Treatment of Fecal Impaction
 A doctor or nurse may remove the stool from the rectum
 Bowel program ordered by the doctor to prevent further problems.


Loss of Bowel Control (Fecal Incontinence)
Sometimes people who are having soft or normal stools lose the control over bowel movements.
You may feel the urge to have a bowel movement, but you may not be able to hold it until you
get to a toilet or commode. This can cause a person to feel embarrassed, frustrated, and
humiliated.


Factors that Lead to Loss of Bowel Control
 Constipation
 Fecal impaction
 Chronic use of laxatives
 Diarrhea
 You just cannot get to a toilet or commode fast enough when there is the urge to have a
bowel movement
 Loss of strength and tone of the anal sphincter
 Nerve damage to the anal sphincter or the nerves that sense stool in the rectum






Treatment of Loss of Bowel Control
 Tell your doctor if you are having bowel accidents.
 Eat high fiber foods. Fruits, vegetables, whole grain breads, cereals, bran cereals, wheat
germ, beans are some foods that are high in fiber.
 Drink 8 – 10 glasses of fluids every day. Fluids may include water, fruit juice, and
vegetable juice.
 Exercise every day or at least every other day to help bowel action.
 Go to the bathroom if you feel the urge to have a bowel movement. Do not ignore the
urge. If it is hard for you to move around by yourself, perhaps it is worth getting a
commode in your room. The best time to have a bowel movement is after a meal,
especially the first meal of the day.
 Sit upright on the commode or toilet if you are able. Sitting upright is helpful for having
a bowel movement.
 Do pelvic floor exercises to improve the strength of the anal muscle. Contract the rectal
muscles 15 to 20 times, three times each day.
 Review your medicines with the doctor. Some can cause diarrhea or constipation which
can cause loss of bowel control.
 Stool softeners, laxatives, or medicine to prevent diarrhea may be needed to treat the loss
of bowel control. Always talk to your doctor before taking any of these.
 Incontinence pads may be worn to prevent soiling of clothes.























Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright 10/2015. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#6551