Physical Activity in constipation management
Working in a medical adult day program, I frequently hear about the discomfort that constipation causes. McKay, Fravel and Schoenfelder (2012) describe constipation as a “reduction in the frequency of stool or difficulty in formation or passage of stool.” Clients complain of a stomachache, discomfort and become more irritable. They are often prescribed stool softeners and laxatives, but with the prevalence of polypharmacy, could their constipation be managed by nursing interventions and without additional medications?
According to Kyle (2011), assessing for constipation can be challenging for nurses, as “communication barriers associated with bowel habits and the embarrassment associated with an intimate rectal examination need to be overcome.” The ideal outcome in treating constipation is to establish a bowel regimen which provides relief but also prevents future occurrences of constipation (Kyle, 2011). Lifestyle changes, including exercise, increased fluid intake and increased fiber intake, are recommended as the first interventions for the treatment of constipation Kyle, 2011). Yet, Kyle states, “evidence fails to demonstrate convincingly that these measure reduce the impact of constipation” (2011). However, Kyle does reference a study where patients diagnosed with constipation did regular physical exercise over 12 weeks which resulted in relief of constipation by decreasing bowel transit time (2011). Kyle suggests nursing interventions, such as encouraging mobility and proper toileting positioning to increase bowel motility (2011).
McKay et al. (2012) suggests identifying risk factors such as “age older than 65, limited physical mobility, inadequate diet, history of constipation, particular drugs and co-morbidities known to associated with am increased risk of constipation” when completing a comprehensive nursing assessment (2012). Nursing assessment should also include review of a bowel movement diary, listing...