OT 504 Week 8 LG1 – GI/GU Health Flashcards

What are the main functions of the gastrointestinal (GI) system?

Digests food, absorbs nutrients and water, eliminates waste.

What GI changes occur with aging?

Reduced motility, decreased stomach acid, reduced absorption, decreased liver function, weakened sphincter muscles, higher risk of gallstones, changes in bowel habits, increased GI cancer risk, reduced sense of thirst, medication side effects.

What are the main functions of the genitourinary (GU) system?

Produces urine, stores urine, eliminates waste, regulates fluid/electrolytes.

What GU changes occur with aging?

Decreased bladder capacity, reduced bladder control, weakened pelvic floor muscles, increased risk of UTIs, prostate changes, medication side effects, difficulty emptying bladder, weakened kidney function.

What are proper toileting habits?

Avoid straining. Urination → relax pelvic floor. Defecation → relax pelvic floor while gently contracting abdominals. Exhale instead of holding your breath. Go when you first feel the urge.

How long should someone sit on the toilet?

No more than 5–10 minutes.

Why use a Squatty Potty or stool?

Improves anorectal angle, relaxes puborectalis muscle, makes stool easier to pass. Contraindication: Hip precautions.

What additional strategies improve bowel movements?

'Poop walk', I-Love-You abdominal massage.

How common is constipation?

15% of adults in Western countries and 33% of adults >60 years; often underreported.

What are the causes of constipation?

Pharmacological, cancer, metabolic, hormonal, neurological, psychological, social.

What are the symptoms of constipation?

Reduced bowel frequency, hard, dry stool, difficulty defecating.

How is constipation diagnosed (Rome IV criteria)?

Symptoms for ≥3 months during previous 6 months, plus 2 or more: Straining ≥25% of bowel movements, hard/lumpy stools ≥25%, incomplete evacuation ≥25%, feeling of blockage ≥25%, manual maneuvers (digital evacuation/pelvic floor support) ≥25%, fewer than 3 bowel movements/week. PLUS: Loose stools rarely occur without laxatives. Does not meet IBS criteria.

What complications can constipation cause?

Physical symptoms, reduced quality of life, difference between physician and patient definitions.

What are the research themes regarding constipation?

'Bodily symptoms, impact on social participation, striving for bowel balance, difficulty finding solutions, "wait and see", considered a private problem.'

What are the first-line constipation interventions?

Increase fiber, increase fluids, exercise, improve sleep, reduce stress, bowel retraining program.

What are the two types of fiber?

Soluble and insoluble.

What are the characteristics of soluble fiber?

Dissolves in water, forms gel, adds stool bulk, may lower LDL cholesterol, may lower blood glucose.

What foods are high in soluble fiber?

Bananas, beans, white rice, white bread, pasta, oats, melon, carrots. Best for: Diarrhea.

What are the characteristics of insoluble fiber?

Doesn't dissolve, speeds digestion, draws water into stool, prevents constipation, supports insulin sensitivity.

What foods are high in insoluble fiber?

Whole grain bread, brown rice, nuts, green beans, berries, spinach. Best for: Constipation.

What is the prevalence of urinary incontinence?

46% of women >80, 34% of men >80; 2/3 report decreased quality of life; more common with chronic disease.

What are the six types of urinary incontinence?

Stress, urge, mixed, overflow, functional, transient.

What is stress incontinence?

Leakage caused by increased intra-abdominal pressure. Causes: weak pelvic floor, pelvic surgery, obesity, chronic cough.

What is urge incontinence?

Sudden urge followed by leakage. Causes: overactive bladder, MS, Parkinson disease, UTI, bladder stones, bladder-irritating medications.

What is mixed incontinence?

Combination of stress and urge.

What is overflow incontinence?

Continuous dribbling due to incomplete bladder emptying. Causes: enlarged prostate, diabetes, SCI, bladder/urethral blockage.

What is functional incontinence?

Unable to reach toilet because of: arthritis, paralysis, dementia, medication effects.

What is transient incontinence?

Temporary incontinence. Causes: diuretics, UTIs, constipation, limited mobility.

What is nocturia?

Waking 2 or more times/night to urinate.

What are the causes of nocturia?

Drinking before bed, small bladder capacity, diuretics, OAB, UTI, diabetes, heart disease, neurologic disease, prostate problems.

What are the top evidence-based interventions for urinary incontinence?

Group exercise, behavioral therapy, bladder training, pelvic floor muscle training (PFMT).

What is the bladder training protocol?

Void every hour initially, increase interval by 30 minutes each week. Goal: 2.5–3 hours between voids.

What is the pelvic floor muscle training (PFMT) protocol?

15 contractions, hold each for 10 seconds, 3 times/day.

What is biofeedback?

Equipment provides visual/auditory feedback about pelvic floor contraction and relaxation.

What is a strategy for managing stress incontinence?

Contract pelvic floor before and during coughing, sneezing, or lifting.

What is a strategy for managing urge incontinence?

Don't rush; sit down and relax. Perform 3-4 quick pelvic floor contractions and walk to the toilet after urge decreases.

What are the risk factors for fecal incontinence?

Age >65, physical inactivity, chronic disease, gallbladder removal, smoking.

What causes fecal incontinence?

Diarrhea, constipation, muscle weakness/injury, nerve damage, neurologic disease, physical inactivity.

What are the five types of fecal incontinence?

Passive, urge, overflow, passive with awareness, total.

What is passive fecal incontinence?

Leakage without awareness.

What is urge fecal incontinence?

Sudden overwhelming urge difficult to control.

What is overflow fecal incontinence?

Chronic constipation causes rectal overfilling, leading to stool leaking around impaction.

What is passive fecal incontinence with awareness?

Person knows they need to go but cannot control timing.

What is total fecal incontinence?

Complete loss of bowel control with continuous/unpredictable leakage.

What are the problems associated with fecal incontinence?

Skin irritation, emotional distress, social isolation, reduced quality of life.

What are the main interventions for managing fecal incontinence?

Absorbent pads, diet modification, medication, bowel training, pelvic floor exercises.

What are community strategies for managing fecal incontinence?

Toilet before leaving home, carry cleanup supplies/change of clothes, locate public bathrooms, wear absorbent or disposable underwear, use fecal deodorants, take antidiarrheal medication before eating out (if prescribed).

How can one prevent anal skin irritation?

Wash after BM, change underwear promptly, keep skin dry, use moisture barrier cream, non-medicated powders, wicking pads, breathable clothing.

When should OT consider referral?

Refer to pelvic health OT/PT with advanced pelvic health and biofeedback training.

What is common adaptive equipment for toileting?

3-in-1 commode, toilet seat riser, toilet safety rails, bidet, self-wipe aid.

What OT interventions may be used for bowel/bladder dysfunction?

Daily routine management, disease self-management, caregiver training, relaxation training, stress management, cognitive retraining, neuromuscular reeducation, edema management, ADL retraining, IADL retraining, transfer/functional mobility training, adaptive equipment training, energy conservation, fatigue management, visual retraining, sensory retraining, pain management, education (sleep hygiene, body mechanics, joint protection, ergonomics, body systems, home modifications, community resources, urge control), therapeutic activities (endurance, strength, balance), therapeutic exercise, pelvic floor muscle retraining, manual therapy.