bowel bypass syndrome


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bowel

 [bow´el]
bowel bypass syndrome a syndrome that may occur one to six years after jejunoileal bypass, characterized by rash, malaise, myalgia, polyarthralgia, sterile skin pustules, and a flulike illness; it is probably caused by circulating immune complexes that include bacterial antigens resulting from bacterial overgrowth in the bypassed bowel.
bowel sounds relatively high-pitched abdominal sounds caused by the propulsion of the intestinal contents through the lower alimentary tract. Auscultation of bowel sounds is best accomplished by using a diaphragm-type stethoscope rather than a bell-shaped one. Normal bowel sounds are characterized by bubbling and gurgling noises that vary in frequency, intensity, and pitch. In the presence of distention from flatus, the sounds are hyperresonant and can be heard over the entire abdomen.

The absence of bowel sounds is symptomatic of greatly decreased or totally absent peristaltic movement. This can occur in such conditions as paralytic ileus, advanced intestinal obstruction, gangrene of the bowel, enterocolic ulceration, myxedema, and spinal cord injury. In the early stages of bowel obstruction, high-pitched splashing sounds are heard in the intestine proximal to the obstruction. As the obstruction continues to constrict the lumen of the bowel, the sounds are of shorter duration and eventually cease altogether as the obstruction to the lumen of the bowel becomes complete.

Increased motility of the bowel usually results from some sort of irritating stimulus, such as gastroenteritis with diarrhea, bleeding in the intestine, and emotional disorders. Hyperactivity of the bowel produces a rush of sounds, with waves of loud, gurgling, and tinkling sounds called borborygmi.
bowel training
1. a nursing intervention classification defined as assisting the patient to learn to evacuate the bowel at specific intervals.
2. a program designed to help the patient having difficulty with the regulation and control of defecation. A program of this type may be indicated in cases ranging from chronic constipation to paralysis, as in paraplegia and hemiplegia. Patients who suffer from lesions or congenital anomalies of the intestinal tract also may benefit from such a program.

Before planning a program of bowel control it is necessary to determine the cause of the difficulty, the patient's former bowel habits, and specific symptoms. The plan devised will depend on the patient's needs and physical, mental, and emotional capacities for cooperation in the planning and implementation of the program. It is necessary to know whether the person can realistically be expected to achieve complete control, or if neural damage or anatomical and structural changes in the intestine prevent reaching this goal. For example, a colostomy patient cannot achieve complete control over bowel movements, but regulation of diet and fluid intake can affect the number and consistency of the stools, giving some sense of security. Diet also is important in all other types of bowel training in which the goal is regularity of defecation and stools of normal consistency.

It is important that patients participate as much as possible in planning the program. They will need to give an accurate history of bowel habits, former use of laxatives and enemas, usual time of day for bowel movements, and the frequency, and whether or not they are aware of the urge to defecate. As the program is carried out, revisions may be necessary as the patient learns which techniques are most helpful.

The major components of a bowel training program are choosing the location to ensure some degree of privacy, getting the patient into a sitting position, having him attempt defecation at a specific time that is most natural for him, regulating the food and fluid intake, and establishing some plan of regular exercise and physical activity.

In some cases of paralysis it may be necessary to stimulate bowel function through the use of suppositories and digital stimulation. Enemas, laxatives, and bulk-forming medications are used only if necessary, not on a regular basis if at all possible. These measures may be necessary, however, at the beginning of a bowel training program to remove constipated stool and fecal impaction.

bow·el by·pass syn·drome

recurrent fever, chills, malaise, and inflammatory cutaneous papules and pustules on the extremities and upper trunk with diffuse neutrophil infiltration, sometimes with polyarthralgia or polyarthritis following bowel bypass surgery.

bowel bypass syndrome

a series of adverse effects that may follow bowel bypass surgery, which include chills, fever, joint pain, and skin inflammation on the arms, legs, and thorax.

bow·el by·pass syn·drome

(bowĕl bīpas sindrōm)
Recurrent fever, chills, malaise, and inflammatory cutaneous papules and pustules on the extremities and upper trunk with diffuse neutrophil infiltration, sometimes with polyarthralgia or polyarthritis following bowel bypass surgery.