Know the risks 
 
Constipation and Bowel Obstruction 
 Constipation occurs when a person has less than three bowel movements per week, although this varies from person to person. Stools are usually hard, dry, small, and difficult to pass. 
 Bowel Obstruction is a partial or complete blockage of the small or large intestine. 
 Perforation occurs when the intestine or bowel gets torn, which allows intestinal contents to enter the abdominal cavity. This condition is very dangerous and can quickly lead to serious infection. 
Common issues that increase the risk of bowel obstruction:  A person whose mobility is impaired and cannot walk around on their own;  A person with muscle weakness or poor body alignment;  A person who has difficulty eating or drinking;  A person who does not eat enough fiber;  A person who does not drink enough liquids;  A person with cerebral palsy or similar diagnosis that can affect the muscles that move waste through the bowel;  A person who has diabetes;  A person with a degenerative condition, such as Parkinson's disease;  A person taking medications that have a side effect of constipation;  A person who does not have adequate time or privacy to use the bathroom. 
 
 Know the signs 
 
These are signs that a person may have a bowel obstruction:  No passing of stool or gas;  Leakage of small amounts of watery stool;  Nausea and/or vomiting  Abdominal cramps, often felt in waves;  Abdominal distension (bloated stomach) or hardened 
abdomen;  Seizures. 
Know what to do 
 
Prevention Strategies: 
 
 Consultation with a physician about a constipation protocol, frequency 
 
of bowel movements for this person, and what treatment is 
 
recommended (such as laxatives or enemas); 
 
 Consultation with a dietitian; 
 
 Carefully follow all diet orders and document what the person eats; 
 
 Ensure that the person consumes adequate fiber and liquids daily; 
 
 Keep accurate bowel tracking and ensure that it is regularly monitored; 
 
 Make sure that any symptoms of constipation are communicated and 
 
documented between shifts; 
 
 Make sure all staff work together to help the person receive the 
 
medications they need, including PRN medications; 
 
 Support the person in staying as active as possible; 
 
 Make sure the person has adequate 
 
IN AN EMERGENCY: 
 
time and privacy for using the toilet. 
 
Call 9-1-1 if a person: 
 vomits stomach contents or digested 
 
food that smells like feces; 
 
 has low blood pressure and/or a very 
 
rapid pulse; 
 
 loses consciousness (becomes 
 
unresponsive). 
 
State of Georgia Department of Behavioral Health and Developmental Disabilities 
 
This Constipation and Bowel Obstruction Fact Sheet is # 2 in a series of Improving Health Outcomes Fact Sheets. It was developed with reference to resources available through the Arizona Division of Developmental Disabilities Quality Assurance Unit and the Illinois Department of Human Services. This Fact Sheet is not a substitute for clinical evaluation or physician's orders.