Self-diagnosis of constipation and abuse of laxatives, enemas, and
suppositories to ensure a daily bowel movement
• Expectation of passage of stools at the same time each day
• Overuse of laxatives, enemas, and/or suppositories
• Cultural health beliefs
• Faulty appraisal
• Family health beliefs
• Impaired thought processes
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
The patient will
• Decrease use of laxatives, enemas, or suppositories.
• State understanding of normal bowel function.
• Discuss feelings about elimination pattern.
• Have a return-to-normal elimination pattern.
• Experience bowel movement every _____ day(s) without laxatives,
enemas, or suppositories.
• State understanding of factors causing constipation.
• Get regular exercise.
• Describe changes in personal habits to maintain normal
• State intent to use appropriate resources to help resolve emotional
or psychological problems.
SUGGESTED NOC OUTCOMES
Adherence Behavior; Bowel Elimination; Health Beliefs; Health
Beliefs: Perceived Threat; Knowledge: Health Behavior
INTERVENTIONS AND RATIONALES
Determine: Assess patient’s dietary habits and encourage modiﬁcation
to include adequate ﬂuids, fresh fruits and vegetables, and whole grain
cereals and breads, which supply necessary bulk for normal elimination.
Perform: If not contraindicated, increase patient’s ﬂuid intake to about
3 qt (3 L) daily to increase functional capacity of bowel elimination.
Establish and implement an individualized bowel elimination regi-
men based on the patient’s needs. Knowledge of normal body func-
tions will improve patient’s understanding of problem.
Inform: Explain normal bowel elimination habits so patient can bet-
ter understand normal and abnormal body functions.
Instruct patient to avoid straining during elimination to avoid tis-
sue damage, bleeding, and pain.
Instruct patient that abdominal massage may help relieve discom-
fort and promote defecation because it triggers bowel’s spastic
Inform patient not to expect a bowel movement every day or even
every other day to avoid the use of poor health practices to stimu-
Attend: Encourage patient to engage in daily exercise, such as brisk
walking, to strengthen muscle tone and stimulate circulation.
Encourage patient to evacuate at regular times to aid adaptation
and routine physiological function.
Urge patient to avoid taking laxatives, if possible, or to gradually
decrease their use to avoid further trauma to intestinal mucosa.
Reassure patient that normal bowel function is possible without lax-
atives, enemas, or suppositories to give patient the necessary conﬁ-
dence for compliance.
Manage: Give information about self-help groups, as appropriate, to
provide additional resources for patient and family.
SUGGESTED NIC INTERVENTIONS
Anxiety Reduction; Bowel Management; Counseling; Health Educa-
tion; Nutrition Management; Teaching: Individual
Hernando-Harder, A. C., et al. (2007, March). Intestinal gas retention in
patients with idiopathic slow-transit constipation. Digestive Diseases and
Sciences. [Epub ahead of print.]