Fecal elimination

Introduction:

Elimination of the waste products of digestion ‫التخلص من فض(ت الهضم‬

from the body is essential to health. ‫من الجسم أمر ضروري‬
‫للصحة‬

Physiology of defecation:
‫اخراج البراز من فتحه‬
Defecation: Is the expulsion of feces from the anus and the ‫الشرج‬
rectum, it is also called a bowel movement .
The excreted waste product are referred to feces or stool.
‫تسمى فض(ت البراز‬
Feces: The semi solid mass of waste products in the colon that
are expelled through the anus.

Stool: Excreted feces.

-Large intestine is a muscular tube, line with mucous membrane

The main function of colon are: ‫ساسيه للقولون‬J‫الوظيفه ا‬

-Absorption of waters and
nutrient. ‫اء‬N‫امتصاص ا‬-
-Mucoid protection of the mucoid‫معاء بواسطه ال‬J‫حمية ا‬-
intestinal wall. (‫تخلص من الفض(ت )البراز‬-
-Fecal eliminations.

- The waste product leaving the stomach through the

small intestine and then passes to the ileocecal valve ,
It regulate flow to large intestine and prevent back
flow to small intestine.

-Colon secrete mucus which stimulated by excitation

of parasympathetic nerves.

-The mucus protect the wall of large intestine and it serve

as adherent for holding the fecal material together.
!"

-The colon transport along its lumen the products

( flatus and feces) of digestion and eliminated through
anal canal.

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 Large intestine have three types of movement:

Haustral churning: Move Peristalsis: Is wave like Mass peristalsis: Is the Feces : Normal feces are made
movement, produced by third movement of colon of about 75% water and 25%
the Chyme back and forth
solid materials .
to mixing the content and muscle wall of intestine, the is awave of muscular :‫ﻣﺤﺘﻮﯾﺎت اﻟﺒﺮاز‬
move it forward. Chyme move along the contraction, move the ‫ﻣﺎء‬٪٧٥
large intestine. feces into the sigmoid ‫ﻣﻮاد ﺻﻠﺒﮫ‬٪٢٥
‫حركة ل(مام والخلف لخلط‬ colon and rectum.
Feces normally brown, due to
.‫حتويات و تحريكها ل(مام‬N‫ا‬ ‫ينتجه عضله جدار‬..‫وجه‬N‫حركة مثل ا‬ ‫ﻣﻮﺟﮫ ﻣﻦ اﻻﻧﻘﺒﺎض‬ the presence of urobilin which
‫يتحرك البراز عن طريق‬،‫معاء‬J‫ا‬ ‫ﯾﺤﻤﻞ اﻟﺒﺮاز اﻟﻰ اﻟﺴﻘﻨﻮﯾﺪ‬..‫اﻟﻌﻀﻠﻲ‬ derived from bilirubin.
‫معاء الغليظة‬J‫ا‬ .‫اﻟﻘﻮﻟﻮن واﻟﻤﺴﺘﻘﯿﻢ‬ ‫ان اﻟﺒﺮاز ﺑﻨﻲ ﺑﺴﺒﺐ ﻣﺎده‬
urobilin
The sensory nerve in the
rectum are stimulated and Another factor that affect fecal
individual becomes need color is the action of bacteria
to defecate. which are normally present in
the large intestine.
-‫ﻋﻨﺪﻣﺎ ﺗﺤﻔﺰ اﻟﻌﺼﺐ ﻓﻲ اﻟﻤﺴﺘﻘﯿﻢ‬ ‫وﻓﻲ ﻋﻮاﻣﻞ اﺧﺮ ﺗﺎﺛﺮ ﻓﻲ ﻟﻮن اﻟﺒﺮاز ھﻮ‬
‫ﺗﺒﺮز‬ ‫ﻋﻤﻞ اﻟﺒﻜﺘﯿﺮﯾﺎ اﻟﻤﻮﺟﻮده ﻓﻲ اﻻﻣﻌﺎء‬
.‫اﻟﻐﻠﯿﻈﮫ‬
Internal sphincter relax
then, feces move into the
anal canal. ‫ﯾﺮﺗﺨﻲ اﻟﺼﻤﺎم‬
‫اﻟﺪاﺧﻠﻲ ﻓﯿﺪﺧﻞ اﻟﺒﺮاز ﻋﺒﺮ ﻓﺘﺤﮫ‬
.‫اﻟﺸﺮﺟﯿﮫ‬

After individual sit on the

toilet, external sphincter
relax voluntary and feces
expelled. ‫ﻋﻨﺪﻣﺎ ﯾﺠﻠﺲ اﻻﻧﺴﺎن ﻓﻲ‬
‫ﺗﺒﺮز‬-‫اﻟﺤﻤﺎم ﯾﺮﺗﺨﻲ اﻟﺼﻤﺎم اﻟﺨﺎرﺟﻲ‬

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 Factors that affect defecation

- Personal habit.‫العادة‬
‫الشخصية‬ - Anxiety.‫قلق‬ - Pregnancy ‫الحمل‬
- Nutrition and fluid - Depression. ‫اكتئاب‬ - Motor or sensory
intake. disturbance. ‫الخلل في‬
- ‫التغذية والسوئل‬ ‫ ا>حساس‬،‫الحركة‬
- Physical activity.‫النشاط‬ - Medication. ‫ادوية‬
- Surgery and anesthesia.
‫جراحه تخدير‬

Fecal elimination problems

Constipation: Fecal impaction : Is Flatuence: The presence of Fecal incontinence: Is loss of

Is difficult evacuation collection of hardened excessive flatus in the intestine voluntary ability to control fecal
of stool‫ﺻﻌﻮﺑﺔ اﻻﺧﺮاج‬ feces in the folds of and lead to stretching and and gaseous discharge through
rectum. inflation of the intestine. the anal sphincter.
Causes: ‫ﯾﺘﺠﻤﻊ اﻟﺒﺮاز ﺻﻠﺐ ﻓﻲ اﻟﻤﺴﺘﻘﯿﻢ‬
- Insufficient fiber and ‫معاء وتؤدي‬N‫وجود غازات مفرطة في ا‬ ‫ﻓﻘﺪ اﻟﻘﺪرة اﻻرادﯾﺔ ﻟﺘﺤﻜﻢ ﻓﻲ اﻟﺒﺮاز واﻟﺮﯾﺢ‬
fluid intake.‫أﻟﯿﺎف ﻏﯿﺮ‬ Causes: Causes:
‫معاء‬N‫إلى شد وتضخم ا‬.
‫ﻛﺎﻓﯿﮫ‬ -Impaired functioning of anal
-Poor defecation habits canal and nerve supply
-Insufficient activity Causes: ‫ﻣﺸﻜﻠﺔ ﻓﻲ ﻗﻨﺎة اﻟﺸﺮج او اﻻﻋﺼﺎب‬
‫ﺣﺮﻛﺔ ﻏﯿﺮ ﻛﺎﻓﯿﮫ‬ -Unrelieved constipation. - Food
-Irregular habit. - Abdominal surgery. -Neuromuscular disease.
‫ﻋﺎدة ﻏﯿﺮ ﻣﻨﺘﻈﻢ‬ Diarrhea: Is an increase - Narcotics.
frequency of liquid feces. - Decreased peristalsis -Tumor.
‫زﯾﺎده ﺗﺮدد اﻟﺒﺮاز اﻟﺴﺎﺋﻞ‬ - Decreased activity -Spinal trauma.

Causes:

-Stress.
-Disease in colon.
-Medication .
-Intolerance of food and
fluid.

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 Interventions to Promote Elimination:
‫خراج‬%‫ت لتعزيز ا‬,‫تدخ‬

-Privacy.‫ﺧﺼﻮﺻﯿﮫ‬
-Timing‫اﻟﺘﻮﻗﯿﺖ‬
-Nutrition and Fluid.‫اﻟﺘﻐﺬﯾﺔ واﻟﺴﻮاﺋﻞ‬
-Positioning.‫اﻟﻮﺻﻔﯿﺔ‬
-Exercise.‫اﻟﺘﻤﺎرﯾﻦ‬
-Laxatives ‫اﻟﻤﺴﮭﻼت‬
-Enemas‫ادﺧﺎل ﻣﻮاد ﻣﻦ اﻻﺳﻔﻞ‬
-Suppositories‫اﻟﺘﺤﻤﯿﻠﺔ‬

Bowel diversion ostomies‫ﺗﺤﻮﯾﻞ ﻣﺎر اﻻﻣﻌﺎء‬

Altered means of elimination:

An ostomy: Is the surgical creation of an artificial opening .

The opening is called a stoma.
‫ﺧﻠﻖ ﻓﺘﺤﮫ اﺻﻄﻨﺎﻋﯿﺔ‬

Colostomy : Is the surgical creation of an artificial opening

between the colon and the abdominal wall.
‫ﻓﺘﺤﮫ اﺻﻄﻨﺎﻋﯿﮫ ﺑﯿﻦ اﻟﻘﻮﻟﻮن وﺟﺪار اﻟﺒﻄﻦ‬

Ileostomy: Is a surgically created opening between

the small intestine and the abdominal wall.
‫ﺧﻠﻖ ﻓﺘﺤﮫ اﺻﻄﻨﺎﻋﯿﮫ ﺑﯿﻦ اﻻﻣﻌﺎء اﻟﺪﻗﯿﻘﮫ وﺟﺪار اﻟﺒﻄﻦ‬

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