hyperactive bowel sounds and abdominal pain

Discourage use of bedpans and urinal bottles unless it is unsafe, or impractical to get the patient out of bed to the toilet.

Ensure immobile patients are moved and/or transferred out of bed frequently. Continue to encourage patients to get out of bed and walk around. Physiotherapy can be utilised to assist patients to mobilise. See Appendix 2 for daily recommended oral fluid intake by age. Consider fluid alternatives such as milk, soup and fresh fruit if the patient does not want to drink water. Water is the best choice for patients over 12 months of age.

Should medical team be concerned about abdominal distension they may order an Abdominal x-ray.

Palpation of the abdomen, to detect faecal masses in line of the colon.

Consider using a tape measure to compare abdominal girths over time.

Observe if the child’s abdomen is bloated or distended.

Discuss the child’s oral intake at home, including their usual diet and eating patterns before surgery.Considerations include oral intake, hydration status, vomiting, urine output and colour. Assess their oral intake by monitoring their fluid balance on the fluid balance flow sheet to identify the patient’s input and output.Decreased or absent bowel sounds may also indicate Patients must not commence oral fluids if bowel sounds are not present as this finding may indicate an ileus. Auscultate the abdomen for bowel sounds, if bowel sounds are present, or the patient reports they are passing flatus, clear fluids can commence, and aperients can be administered.What is their mobility like? Is their mobility decreased? Are they likely to be resting in bed for a long period of time?.Are they allowed to eat and drink, or take oral/enteral medications?.Does the patient have a history of constipation? Are they on regular aperients at home?.What is causing the child to be unwell? What is their reason for admission?.When was the last time they opened their bowels? Were they already constipated before surgery?.

If the patient reports difficulty passing stools, has not had a bowel action since surgery, or is currently taking opioids, then the following should be considered: This leads to a reduction in gastrointestinal propulsion and an increase in fluid absorption. Constipation is a common adverse effect from opioid medication use due to the action upon opioid receptors in the gastrointestinal It is often accompanied by abdominal cramps, increasing abdominal distension, constipation or vomiting, electrolyte disturbances andĪll post-operative patients are at risk of developing constipation due to a variety of factors, such as changes in mobility status, reduced oral intake and as a side effect of medications.

Ileus - A post-operative complication that is characterized by the loss of forward flow of intestinal contents.These can be given both orally or intravenously. Opioids - Analgesics that are useful agents for managing acute or chronic pain.Fibre - Indigestible parts of plant foods (such as wholegrain cereals, fruits and vegetables) that helps to soften and add bulk to faeces making it easier to pass through the digestive tract.A common side effect of aperient and antibiotic use. Diarrhoea - Passing loose, watery or more frequent stools.Constipation - An alteration in the consistency or ease of passing stool or the failure of the bowels to open for 3 consecutive days.Aperients - Oral or rectal medications which can be given to stimulate or facilitate the evacuation of the bowels.The aim of this guideline is to assist nurses who work within the paediatric field around the prevention and management of constipation in the post-operative patient.

Conversely, the patient’s medical condition and medications such as antibiotics can also lead to diarrhoea. Faecal impaction may occur causing pain and discomfort for patients as well as Constipation is one of the most frequent, adverse reactions that can occur post-operatively secondary to a reduction in fluid intake, immobility and medications such as opioids.

Hyperactive bowel sounds and abdominal pain