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‘Why is bowel care given such a low priority?’

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Reading the Francis report I was struck by the number of references to poor bowel and bladder care. Yet continence care has always been an essential part of nurses’ work.

I was reminded me of a personal reflection that we published a few years ago which highlighted the long term problems associated with living with bowel dysfunction and its effect on relationships, work and self-esteem.

The author describes her experience of living with faecal incontinence, “I discussed how the worst experience for me was the loss of the physical side of our marriage. I learnt that many of the women were experiencing the same feelings or, even worse, it had resulted in divorce”.

This is a stark reminder of why careful and sensitive bowel assessment is an essential part of patient care.

Nurses have an important role in identifying and assessing abnormal bowel function, exploring its impact on daily life as well as educating patients about managing their symptoms.

But why is bowel care given such a low priority?

One of the most common gastro intestinal disorders encountered in clinical practice is constipation.

It affects around 20% of people living in the community yet many people live with it for years before asking for help.

When patients get the courage to tell you about the problem, is you knowledge up to date?

  • How would you assess a patient with constipation?
  • What laxative regime should be prescribed?
  • What advise should you give patients about fibre?
  • When should you use suppositories or enemas?
  • What training is required to do a digital rectal examination?
  • How should you treat constipation in people with spinal injuries?

If you sometimes feel uncertain when faced with a patient with constipation and have a question, join our constipation clinical chat on 25th April at 1pm.

You can email questions to or tweet@eileenshepherd

You can learn more about constipation by taking part in our online learning unit: Advances in treatment of constipation.


Participating in NT Clinical Chats can contribute to you CPD. How to get the most out of Clinical Chats:

  • Look at the topic in advance of the chat and plan questions you would like to ask
  • Participate in the chat by posting questions or comments
  • Download the transcript after the chat as evidence of your participation. This will be available here after the webchat
  • Write a reflection on what you have learned and how you could use this information in clinical practice, to store in your portfolio.
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