Gut Feelings: Navigating Lower GI Disorders w/ Care & Compassion

Ashley Tyler

Welcome to Poetic Nursing: The Nurse’s HEART, a space where nursing meets inspiration, science meets compassion, and your calling as a caregiver is both celebrated and enriched. I’m Ashley Tyler, and I’m so glad you’re here today as we explore a topic that’s, well, both complex and deeply impactful—noninflammatory bowel disorders, or NIBDs.

Ashley Tyler

Now, I want you to picture this for a moment. You’re on a busy medical-surgical floor, shuffling between patient rooms, when you hear that familiar ding from a call light. You step in to check, and there she is—a patient, hands pressed against her abdomen, her face tight with discomfort. She looks at you and says, "I haven’t had a bowel movement in days. And, when I do, it’s either rock-hard or completely watery." It’s clear she’s suffering, isn’t it?

Ashley Tyler

Then, just across the unit, you check in on an elderly gentleman. He struggles to sit up, wincing with sharp pain in his lower abdomen. As you assess him, you discover something—there’s a lump near his groin, protruding and tender—and it wasn’t in his chart before. These are the realities nurses face every single day, the visible and, sometimes, invisible weight carried by our patients.

Ashley Tyler

Noninflammatory bowel disorders are conditions that disrupt daily life, causing pain, distress, and often a sense of helplessness in those who suffer from them. Despite this, they can go unnoticed or misdiagnosed, sometimes for weeks, months, even years, until they require urgent intervention.

Ashley Tyler

In this episode, we’ll be pulling back the curtain on these disorders—ones like irritable bowel syndrome, hernias, hemorrhoids, bowel obstructions, and even colorectal cancer. And as we do, I’ll guide you through their effects, the power of nursing in managing them, and why patient advocacy isn’t just important—it’s transformative.

Ashley Tyler

So, let’s start with something that might seem small at first—a slight bulge or a twinge of discomfort, dismissed as nothing more than a strain or overexertion. But, as time goes on, that bulge grows, and it begins to interfere with everyday life—tugging, aching, sometimes even burning, especially when lifting or coughing. This is often how it begins—an unnoticed bulge that turns out to be something much more significant: a hernia.

Ashley Tyler

Now, what exactly is a hernia? Put simply, it’s when an organ or a piece of tissue pushes through a weakened spot in the muscles or connective tissue that normally contain it. It’s like, imagine if you had a tent with a small tear in the fabric and, little by little, something inside starts to press through. Over time, that small tear can grow if left unaddressed, leading to potential complications. And this is exactly what happens in the body.

Ashley Tyler

There are different types of hernias we see in clinical practice. One of the most common is the inguinal hernia, where part of the intestine slips through a weak area in the lower abdominal wall, often into the groin. Then, there’s the femoral hernia, which is more common in women, and occurs a bit lower, near the thigh. Umbilical hernias happen around the belly button, and incisional hernias occur at the site of a previous surgical incision. Each type comes with its own set of challenges and risks, but all require careful attention because they don’t just go away on their own.

Ashley Tyler

As nurses, understanding the key signs of a hernia can truly make a difference. A visible lump or bulge that can sometimes be pushed back in, pain during activities like coughing or bending, and even symptoms of bowel blockage in severe cases—all of these are red flags. And here's the thing—patients often wait until the discomfort becomes unbearable to seek help, because they mistook early signs as “normal” or thought it would resolve on its own. But early detection? It’s everything.

Ashley Tyler

In terms of interventions and treatments, it starts with assessment—getting to know the patient’s history, examining the nature of their symptoms, and educating them about the seriousness of a hernia. While some minor cases might be managed with support belts or lifestyle adjustments, many hernias will eventually require surgical repair. And of course, post-operative care is critical for preventing recurrence—things like teaching patients the importance of avoiding heavy lifting, maintaining a healthy weight, and strengthening core muscles over time. You see, our role as nurses extends far beyond bedside care; it’s about equipping patients with the knowledge they need to heal and thrive.

Ashley Tyler

Stay tuned in, let's find out what happens when the gut and brain don't get along!

Ashley Tyler

Imagine this—you’re at a restaurant, about to enjoy a meal with friends. The kind of gathering that’s supposed to be relaxing, a moment to celebrate and connect. But, for you, there’s this gnawing worry in the back of your mind. What if, right in the middle of dinner, your stomach rebels? What if you can’t find the bathroom in time? For someone living with irritable bowel syndrome, or IBS, that fear isn’t hypothetical—it’s their constant reality.

Ashley Tyler

IBS is, essentially, this complicated tango between the gut and the brain. Instead of working together in harmony, like they normally should, they’re miscommunicating, sending mixed signals that throw digestion completely off-track. Imagine a GPS giving you wrong directions over and over—you’d feel frustrated, maybe even lost. That’s what’s happening internally for people with IBS, leading to symptoms like cramping, bloating, diarrhea, or constipation—or sometimes both. There are various types of IBS such as with Frequent loose stools, urgency after meals, with Hard, infrequent stools, bloating, and with Alternating diarrhea and constipation.

Ashley Tyler

What makes IBS particularly challenging is its unpredictability. One day, a person might feel fine, enjoying their favorite foods, and the next day, even sipping water can seem risky. Many patients experience what I refer to as “bathroom proximity anxiety.” They absolutely will not leave home without knowing exactly where all the bathrooms are along the way. This fear of accidents and embarrassment begins to shrink their world, you see? Social events, long commutes, or even just grabbing coffee with a friend become, well, a calculated gamble. As nurses, we can educate our patients about dietary and lifestyle modifications, such as the Low FODMAP Diet, which involves avoiding foods that trigger bloating like onions, garlic, wheat, dairy, and beans. We can also encourage them to increase their fiber intake gradually, drink 2-3 liters of water daily, and steer clear of artificial sweeteners and high-gas foods like certain processed items, some dairy products, broccoli, and cabbage. Medications that are often prescribed include Loperamide or Imodium for IBS-D to control diarrhea and Linaclotide or Linzess for IBS-C to enhance motility during constipation. Since stress can trigger IBS, teaching our patients positive methods for managing stress—such as Cognitive Behavioral Therapy (CBT), mindfulness, yoga, and probiotics for gut health—are just a few holistic strategies that promote quality care.

Ashley Tyler

And here’s the kicker—IBS isn’t life-threatening, but it is life-altering. It’s a disorder that doesn’t show up on standard tests, so many patients are dismissed, told it’s just stress or, worse, that it’s all in their head. Can you imagine that frustration? For nurses, that makes our role even more crucial—not just to provide compassionate care but to advocate for these patients when others might dismiss their struggles.

Ashley Tyler

Alright, let’s talk about something that many patients... well, they’d rather not talk about—hemorrhoids. It’s one of those conditions that people often suffer from in silence, you know, hidden under layers of embarrassment or pain that they don’t even wanna bring up to their provider. But, honestly, it’s more common than we think and deserves a bit more kindness and understanding.

Ashley Tyler

Hemorrhoids, simply put, are swollen veins in the lower rectum or around the anus, and they come in two main types—internal and external. Internal hemorrhoids are tucked away inside the rectum, and while they might not always be painful at first, they can bleed. Patients may report noticing bright, red blood on their toilet paper after wiping. External hemorrhoids, on the other hand, are what most people imagine when they hear the word—those visible, often painfully tender lumps near the anus which may be very itchy, painful, and may develop thrombosis or clotting.

Ashley Tyler

Now, what leads to this? It’s kind of a mix, really. Things like straining during bowel movements, prolonged sitting on the toilet, chronic constipation, and even pregnancy. All these factors create extra pressure in the rectal area, and over time, they’ve worn down those veins. When you think about it, it’s like inflating a balloon over and over—it eventually stretches and weakens. The same idea applies here.

Ashley Tyler

And here’s a critical point—beyond the pain and discomfort, hemorrhoids can deeply affect patients emotionally. I mean, this is an issue that's intrinsically tied to one of our most basic, personal functions. So when there’s bleeding, swelling, or even so much as a whisper of pain “down there,” people feel scared. They feel ashamed and isolated. For some, it’s bad enough that they avoid medical care altogether.

Ashley Tyler

As nurses, we play a pivotal role here. It starts with creating a safe, judgment-free space for patients to share what they’re going through. I’ve often found that asking the right question gently, openly can make a world of difference. Something like, “Have you noticed any discomfort or changes when going to the bathroom?” It’s simple, but it opens a door that might otherwise stay, well, firmly closed.

Ashley Tyler

In terms of management, our goal is twofold—relieving symptoms and preventing recurrence. For mild cases, this might mean advising patients to up their fiber intake, hydrate more, use warm sitz baths, and avoid straining or prolonged sitting and encourage movement. In other instances, they might need over-the-counter creams or medications such as Witch Hazel wipes, hydrocortisone creams, a common cream is Preparation H, or even the use of stool softeners like docusate sodium to prevent straining. Of course, for more severe cases—like thrombosed external hemorrhoids or chronic bleeding—surgical intervention like rubber band ligation or hemorrhoidectomy might be necessary. And post-treatment, it’s all about educating patients... empowering them, really, to take proactive steps to prevent flare-ups.

Ashley Tyler

What I always want to emphasize, though, is that we don’t just treat the symptoms—we treat the person. Teaching someone to see these changes as manageable, not shameful, can be incredibly transformative.

Ashley Tyler

Now, let’s take a moment to imagine something. Picture a highway during rush hour—cars gridlocked, honking, all trying to get somewhere but stuck in a massive jam. Frustrating, right? Now, I want you to think of that same kind of traffic jam happening inside the body. This time, it’s not cars—it’s your intestines, and the stakes are a lot higher. This is the essence of a bowel obstruction, a condition that transforms a basic bodily function into a medical emergency.

Ashley Tyler

A bowel obstruction occurs when something blocks the flow of digestive contents through the intestines—whether it’s food, gas, or fluid. And honestly, the causes vary widely. It could be something mechanical, like scar tissue from a previous surgery, a hernia, or even a tumor. Or, in some cases, the problem’s functional—when the muscles in the intestines stop working properly at times after surgery, leading to what we call a paralytic ileus. Either way, the result is the same—the road is blocked, and things start backing up.

Ashley Tyler

The symptoms of a bowel obstruction? Oh, they’re hard to ignore. Sudden severe abdominal pain that comes and goes, bloating, nausea, projectile vomiting—ribbon-like stools or obstipation, even the absence of bowel movements or gas can be a telltale sign. And here’s the thing—it’s not just about discomfort. Left untreated, a complete obstruction can lead to serious complications, including infection, perforation, and even death. This is one condition where timing isn’t just important—it’s everything.

Ashley Tyler

Now, let’s talk about what we, as nurses, can do when we encounter these situations. First and foremost, assessment is key. You’re looking at vital signs, observing for signs of dehydration from all that vomiting and fluid loss, and monitoring for that classic distended abdomen. And of course, auscultating bowel sounds—that’s a big one. Are they hypoactive? Or maybe they’ve, well, gone entirely silent?

Ashley Tyler

And then, there’s the nursing interventions, which span both immediate care and long-term management. For starters, patients are often NPO, meaning nothing by mouth, to rest the bowel and prevent further complications. You'll encourage the patient to ambulate to restart peristalsis. And work closely with providers to manage IV fluids and electrolyte imbalances, ensuring the patient stays hydrated and stable. An NG tube is sometimes inserted to decompress the stomach and relieve symptoms like bloating and nausea. Sure, it’s not the most comfortable intervention, but for patients, it can be such a relief—like letting the pressure off a boiling kettle.

Ashley Tyler

But our role doesn’t stop at the physical care, does it? For patients, especially ones facing surgery, the experience of a bowel obstruction can be deeply unsettling—scary, even. This is where we step in, offering not just medical expertise but reassurance. Whether it’s explaining what to expect, easing their fears of the unknown, or just being there to listen—these moments of connection have a ripple effect.

Ashley Tyler

What’s more, prevention is just as vital as treatment. Educating patients about how to avoid future obstructions can make all the difference. Adopting a high-fiber diet, staying hydrated, and managing underlying conditions contribute to long-term gut health. Every bit of guidance we provide empowers them to take control of their health journey.

Ashley Tyler

And that’s what nursing is really about, isn’t it? Turning what might feel like an overwhelming crisis into something manageable, step by step. When the road is blocked, we step in as the guiding light to help clear the path forward.

Ashley Tyler

Let's take a moment to take it all in; reviewing the Lower Gastrointestinal Disorders may seem overwhelming, but take it step by step. You’re doing great!

Ashley Tyler

Let's start with a story—because I’ll tell you, sometimes the most powerful lessons come from the lives we touch. A few years back, I cared for a patient—I’ll call her Mary. She was in her early 50s, active, vibrant, and, honestly, the last person you'd expect to find sitting in a hospital gown waiting for a colonoscopy. But Mary had this persistent feeling, a little voice inside saying something wasn’t quite right. And that’s what led her there that day.

Ashley Tyler

The results? A shock. Early-stage colorectal cancer—something detected early enough to be treated with an excellent prognosis. And Mary? She told me that screening didn’t just save her life; it gave her the chance to watch her first grandchild take her first steps. Moments like these remind us just how much is at stake.

Ashley Tyler

Colorectal cancer is one of those conditions that kind of sneaks up on people. It grows quietly, almost invisibly, often giving little warning until it becomes advanced. And the statistics? Startling. It’s currently the second leading cause of cancer-related deaths in the U.S., affecting both men and women. But here’s the thing—screenings and early detection can significantly reduce that risk. It’s one of the few cancers we can truly get ahead of with the right tools and timing. Some risk factors for Colorectal cancer are age over 50 or earlier with a family history, low-fiber, high-fat diets, sedentary lifestyle or obesity, smoking and excessive alcohol use, or a history of polyps or Inflammatory Bowel Disease also known as IBD.

Ashley Tyler

Now, you might wonder—what are the signs? What should we, as nurses, be looking for? It’s often subtle: changes in bowel habits like persistent diarrhea, constipation, or narrow stools, unexplained weight loss, and bright red or dark and tarry blood in the stool that could easily be overlooked, abdominal discomfort, weakness, and fatigue. And for some patients, there’s no sign at all. That’s why routine screenings, like colonoscopies to detect precancerous polyps, are so critical.

Ashley Tyler

Our role as nurses is just as vital here. We’re not only educators but also advocates—encouraging patients to take that important step to schedule annual fecal occult blood tests, promoting lifestyle modifications like a high-fiber diet, regular exercise, smoking cessation, and screenings every 10 years starting at age 50 or earlier if they are at high risk, even when they’re hesitant or afraid. And trust me, those conversations aren’t always easy. Some patients worry about the procedure itself—will it hurt? Will it be embarrassing? Others might ask, “I feel fine, why would I need this?” But through patience, empathy, and education, we can guide them to see the value in prevention. It’s about helping them understand that a few moments of discomfort can lead to years—or even decades—of a healthy, thriving life.

Ashley Tyler

And as healthcare professionals, our awareness matters, too. Understanding disparities in colorectal cancer outcomes—how factors like race, socioeconomic status, and access to care influence survival rates—is key to addressing inequities and empowering all patients to take charge of their gut health.

Ashley Tyler

Ultimately, it’s not just about catching cancer early; it’s about creating a culture of trust and action. And each time we advocate for screenings, each time we guide a patient through their fears, we’re not just practicing nursing—we’re changing lives.

Ashley Tyler

And that brings us to the end of today’s journey, where we’ve explored the world of noninflammatory GI disorders, from hernias to IBS, hemorrhoids, bowel obstructions, and even the sobering reality of colorectal cancer. Each condition, as we’ve seen, presents unique challenges—not just for the patients we care for but for us, as nurses and caregivers, navigating the complex interplay between science and humanity.

Ashley Tyler

I want to leave you with this thought. As nurses, we often dwell in the in-between spaces—between illness and healing, fear and hope. Our ability to educate, to advocate, and to intervene early doesn’t just impact lives; it transforms them. Every moment we show up with compassion, every question we ask, and every piece of advice we offer has the potential to ripple far beyond that single interaction. Isn’t that something powerful to reflect on?

Ashley Tyler

Now, before we part ways, I want to remind you—what we’ve discussed today isn’t medical advice. If you or someone you care about has questions or concerns, always, always reach out to a trusted healthcare provider. Your health is invaluable, and seeking support is a strength, not a weakness.

Ashley Tyler

If today’s discussion resonated with you, if it sparked a new perspective or reignited your sense of purpose as a caregiver, I encourage you to share it. Whether it’s with a colleague, a nursing student, or a friend—it’s through these small acts of connection that we build a stronger, more empowered community. And don’t forget to subscribe to *Poetic Nursing: The Nurse’s HEART* if you haven’t already. There’s so much more to explore, and I’d love for you to be part of the journey.

Ashley Tyler

So, until next time, my friends—keep showing up with compassion, keep learning with curiosity, and above all, keep nurturing the heart of nursing. Remember, the work we do matters deeply. You matter deeply. And together, we have the power to bring healing and wholeness to a world that, quite honestly, needs it now more than ever. 💙