Keys to Bowel Success

Weeks, Sandra Kenney; Hubbartt, Elizabeth; Michaels, Teresa King

doi:10.1002/j.2048-7940.2000.tb01866.x

Cited by 11 publications

(3 citation statements)

References 24 publications

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“…Böhmer et al (2001) note that until research provides clear answers as to how to manage constipation in people with intellectual disabilities, the basic principles for treatment are the same for individuals with intellectual disabilities as for the general population. As a basic principle, it has been suggested that bowel management should begin with the "eight keys to bowel success" prior to developing an individualised bowel programme: physical exercise, high fibre intake, high fluid intake, consistent habit time, an upright position on toilet or commode, privacy, medication management, and patient and family education (Weeks, Hubbartt, & Michaels, 2000).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of constipation in people with intellectual disability: A systematic review

Robertson

Baines

Emerson

et al. 2017

Journal of Intellectual & Developmental Disability

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Background. Constipation can lead to serious health issues and death. This systematic review summarises international research pertaining to the prevalence of constipation in people with intellectual disability. Method. Studies published from 1990 to January 2016 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests, and cross-citations. Studies were reviewed narratively. Results. 31 studies were identified. Constipation rates of 50% or more were reported in 14 studies; 21 studies reported rates over 33%. Based on the most representative study, over 25% of people with intellectual disability received a repeat prescription for laxatives in one year, compared to 0.1% of people without intellectual disability. Constipation was more common in those with cerebral palsy and profound intellectual disability, and associated with immobility but not age. Conclusion. Constipation is a significant issue for people with intellectual disability across the life course and should be actively considered as a diagnosis in this population.

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Section: Discussionmentioning

confidence: 99%

Prevalence of constipation in people with intellectual disability: A systematic review

Robertson

Baines

Emerson

et al. 2017

Journal of Intellectual & Developmental Disability

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“…8,15 In rehabilitation centres, nurses care for the bowel management of patients with SCI and initiate a bowel management program. 21 The aim of such programs is to eliminate faecal incontinence or other complications 3,19 and to evacuate stool at a regular, predictable time 14,19 within 60 min. 7 The interventions include the manual removal of stool 11,15,17,19,22 for patients with an areflexic bowel as well as techniques like digital stimulation 11,15,22 and suppositories 11,15,22 for patients with a reflexic bowel to initiate reflex peristalsis, 14 frequency, 14 timing of bowel evacuation, 11,22 and the usage of oral laxatives.…”

Section: Introductionmentioning

confidence: 99%

Bowel management in patients with spinal cord injury – a multicentre study of the German speaking society of paraplegia (DMGP)

et al. 2005

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Study design: A descriptive, cross-sectional, multicentre design was used. Objective: To analyse bowel management in patients with spinal cord injury (SCI) especially the occurrence of unplanned bowel evacuations and duration of planned bowel evacuation. Setting: In total, 29 rehabilitation facilities for SCI patients in Austria, Germany, the Netherlands and Switzerland, with a total of 837 hospitalized SCI patients. Method: Data were collected by nurses within 1 week in November 2001 using a quantitative questionnaire containing 14 questions. For data analysis, a w 2 -test was used for differences in the outcome of bowel evacuation procedures associated with different interventions. Stepwise multiple logistic regression was used to analyse the relationship between the outcome of bowel management and the interventions as well as intervening factors. Results: More unplanned bowel evacuations were associated with usage of oral laxatives (n ¼ 444, Po0.001) as well as bowel evacuation every day (n ¼ 270, Po0.05) or every second day (n ¼ 368, Po0.05). The outcome of less unplanned bowel evacuations was associated with manual removal of stool combined with digital stimulation (n ¼ 35, Po0.05) and spontaneous bowel evacuations (n ¼ 104, Po0.001). Short duration of bowel evacuation (o60 min) was associated with manual removal of stool (n ¼ 64, Po0.05), the sitting position at defecation (n ¼ 494, Po0.001) and low frequency of bowel evacuation (X3 days) (n ¼ 638, Po0.05). Duration 460 min was associated with the use of oral laxatives (n ¼ 444, Po0.001) and complete loss of sensory function (n ¼ 349, Po0.05). Stool of hard consistency was associated with the manual removal of stool (n ¼ 64, Po0.001), the manual removal of stool in combination with digital stimulation (n ¼ 53, Po0.001) and the sitting position at defecation (n ¼ 494, Po0.05). Stool of soft consistency (n ¼ 341) was associated with the complete motor lesion (n ¼ 443, Po0.05). Conclusion: Manual removal of stool was combined with low risk of unplanned bowel evacuations and short duration of evacuation time. These results are useful to improve the outcomes of bowel management in SCI patients.Spinal Cord (2005) 43, 724-730.

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“…() note that until research provides clear answers as to how to manage constipation in people with intellectual disability, the principles for treatment are the same for individuals with intellectual disability as for the general population. As a basic principle, it has been suggested that bowel management should begin with the “eight keys to bowel success” prior to developing an individualized bowel programme: physical exercise, high fibre intake, high fluid intake, consistent habit time, an upright position on toilet or commode, privacy, medication management, and patient and family education (Weeks, Hubbartt, & Michaels, ). Whilst early studies on constipation management for people with intellectual disability focused on specific elements of constipation management (e.g., dietary fibre), a recent study considers the management of constipation using abdominal massage in the context of a total bowel management programme (Connor et al., ).…”

Section: Discussionmentioning

confidence: 99%

Constipation management in people with intellectual disability: A systematic review

Robertson

Baines

Emerson

et al. 2017

Research Intellect Disabil

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Keys to Bowel Success

Cited by 11 publications

References 24 publications

Prevalence of constipation in people with intellectual disability: A systematic review

Prevalence of constipation in people with intellectual disability: A systematic review

Bowel management in patients with spinal cord injury – a multicentre study of the German speaking society of paraplegia (DMGP)

Constipation management in people with intellectual disability: A systematic review

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