We begin with a trip through the bowel (starting as food and ending as stool), followed by a trip through the life of The Bowel – what is most likely to go wrong when? Particular attention is paid to the (most recent) Rome IV guidelines and how they advise a shift in thinking when managing gastrointestinal and colorectal patients.
We shall address the various types of bowel dysfunction including constipation, slow colonic transit, obstructed defaecation, and non-retentive functional faecal incontinence, as well as the various presentations of irritable bowel syndrome. Management post stoma reversal will also be mentioned. No bowel masterclass would be complete without mentioning the microbiome – the intestinal flora, and we conclude asking questions of the impact of gut health on everything from allergies to autism.
• to review anatomy and physiology of the gastrointestinal tract and associated structures including pelvic floor muscles and connective tissue
• become best buddies with your bowel
• to appreciate the cascade of events involved in normal colonic activity
• appreciate the impact of stress and anxiety on bowel function
• to differentiate between symptoms and systems
• to list at least 3 types of evacuation problems
• to list at least 2 other common bowel issues
• to apply simple strategies of advice and education in the management of common bowel problems
Take home messages
1. Make friends with your own bowel and PFMs
2. Be aware of function under normal circumstances and under abnormal circumstances
3. Don’t treat the symptom, manage the system
4. Correct management lies in accurate diagnosis based on comprehensive questioning
5. Change someone’s relationship with the toilet, change their life!
6. Fluid!!!! Fiber!!!! Movement!!!!