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Anatomy and physiology of the bowel

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Secretion Mucus secreted by the colon to help lubricate the faeces ... Sphincter 'snaps shut' after completion 'Normal' 3 times / day to 3 times / week ... – PowerPoint PPT presentation

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Title: Anatomy and physiology of the bowel


1
ANATOMY PHYSIOLOGY OF THE BOWEL Gill
Nottidge Continence Nurse Specialist
2
5 Main functions of the bowel
  • Storage unabsorbed food residue
  • Absorption Minerals, water, fats
  • Secretion Mucus secreted by the colon to help
    lubricate the faeces

3
5 Main functions of the bowel
  • Synthesis Synthesises some vitamins
  • Elimination Propulsion of faecal matter and
    absorption of fluid

4
Digestion period
  • Stomach
  • 3hours
  • Small intestine
  • 4 6 hours
  • Large intestine
  • 12 72 hours

5
Small intestine
  • Duodenum
  • 25-30cm
  • Jejunum
  • 2 metres
  • Ileum
  • 3 metres

6
Small intestine
7
Large intestine
  • Caecum with appendix
  • Ascending colon
  • Transverse colon
  • Descending colon
  • Sigmoid colon

8
Structure of intestine
  • Small large intestine has 4 layers
  • Peritoneal
  • Muscular
  • Submucosal
  • Mucosal

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10
Excretion
  • How does it work?
  • Muscles work together to propel waste matter
  • (Peristalsis)
  • During process substances not absorbed by the
    body becomes faeces
  • Faeces arrives in rectum to be expelled

11
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Normal Defaecation
  • Full rectum
  • Adopt correct posture
  • Raise intra-abdominal pressure
  • Internal and external anal sphincters relax
  • Rectum contracts to expel stool
  • Should pass soft formed stool with minimal
    effort
  • Sphincter snaps shut after completion
  • Normal 3 times / day to 3 times / week

15
Normal Defaecation
16
Bristol Stool Chart
17
What affects the bowel?
  • Poor diet
  • Lack of fluid
  • Mobility
  • Medications
  • Surgery

18
  • Continence is Complex
  • Anal sphincters (structural integrity, residual
    function if damaged)
  • Internal anal sphincter - passive stool retention
  • External anal sphincter- control of urge to stool
  • Pelvic floor and mucosal seal
  • Sensory function and co-ordination
  • Stool consistency (e.g. diet)
  • Gut motility
  • Emotional factors
  • Lifestyle and toilet access

19
  • What Goes Wrong?
  • Anal sphincter (childbirth, injury, iatrogenic
    damage, degeneration)
  • Internal - passive soiling External - urge
    incontinence
  • Gut motility (infection, inflammation, radiation,
    hypermotility, emotions)
  • Stool consistency (diet, motility, anxiety

20
What Goes Wrong?
  • Local pathology (prolapse, piles, fistula)
  • Neurological damage (motor or sensory)
  • Lifestyle, toilets, drugs,immobility, frailty
  • Impaction with overflow diarrhoea most
  • common in frail dependent individuals

21
Facts
  • The UK is the most constipated nation in the
    world
  • The UK has the highest incidence of bowel cancer
    in the world with 20,000 new cases per year
  • One in three people consulting GPs have a bowel
    problem
  • Bowel disorders such as irritable bowel syndrome,
    colitis, crohns disease and diverticulitus are
    now widespread

22
Severe Constipation
23
Thank you for your attention. Any
questions? Gill Nottidge Tel 01274
322210 Gillian.nottidge_at_bradford.nhs.uk
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