“MEMBERIKAN LATIHAN DEFEKASI

(BOWEL TRAINING)
 NAMA ANGGOTA
1 Aurora Amanda
2 Yasmine Nurul Azmi
3 Maziyatul Islamiyah
4 Riamah

5 Gozali Sukma
6 Nurul Aulia Aprianti
7 Fitria Handayani
8 Nurul Nadirah
9 Humaira Rahman

10 Musabbihatil Amni

Welcome!
 PETA KONSEP
1.Pengertian Memberikan Latihan
Defekasi ( Bowel Training)
2. Faktor-Faktor yang
Mempengaruhi Defekasi .
3. Gangguan Eliminasi Fekal
4. Tujuan Memberikan Latihan
Defekasi ( Bowel Training)
5. Prinsip Memberikan
Latihan Defekasi (Bowel
Training)
6. Indikasi dan
Kontraindikasi Memberikan
Latihan Defekasi ( Bowel
Training)
7.Prosedur dan Ceklist
Memberikan Latihan
Defekasi ( Bowel Training)
A.PENGERTIAN
Memberikan Latihan Defeksasi ( Bowel Training)

Defekasi adalah proses pengosongan usus yang

sering disebut dengan buang air besar. Tedapat
dua pusat yang menguasai refleks untuk defekasi,
yaitu terletak di medula dan sumsum tulang
belakang. Apabila terjadi rangsangan
parasimpatis, spingter anus bagian dalam akan
mengendur dan usus besar menguncup. Refleks
defekasi dirangsang untuk buang air besar
kemudian spingter anus bagian luar diawasi oleh
sistem saraf parasimpatis, setiap waktu
menguncup atau mengendur. Selama defekasi,
berbagai otot lain membantu proses tersebut,
sperti otot-otot dinding perut, diafragma, dan
otot-otot dasar pelvis.
Dalam proses defekasi terjadi dua
macam refleks yaitu :
1. Refleks defekasi intrinsic.
2. Refleks Defekasi Parasimpatis

B. Faktor-Faktor yang Mempengaruhi Defekasi :

1. Usia dan perkembangan

2. Diet
3. Intake Cairan
4. Aktivitas
5. Psiokologis
6. Pengobatan
7. Gaya Hidup
8. Prosedur Diagnostik
9. Penyakit
10. Anestesi dan Pembedahan
11. Nyeri
12. Kerusakan Sensorik dan Motorik
13. Posisi selama defekasi
C. Gangguan Eliminasi Fekal

1. Konstipasi Konstipasi merupakan gejala, bukan penyakit, yaitu

menurunnya frekuensi BAB disertai dengan pengeluaran faeces
yang sulit’ keras dan mengedan. BAB keras dapat menyebabkan
nyeri rectum. Kondisi ini terjadi karena faces berada di intestinal lebih
lama, sehingga banyak air diserap. Frekuensi BAB masing-masing
orang berbeda. Jika kurang dari 2 kali BAB setiap minggu, maka
perlu pengkajian.

Penyebab:

• Kebiasaan BAB tidak teratur

• Diet tidak sempurna / adekuat
• Meningkatnya stress psikologik
• Kurang olah raga
• Obat-obatan: kodein, morphin, anti kolinergik, zat besi.
• Usia
• Penyakit-penyaki
Kondisi yang tidak diperbolehkan konstipasi :

• Post op abdomen, rectal

• Gangguan kardiovaskuler
• Peningkatan tekanan intra okuler (glaucoma)
• Peningkatan tekanan intra cranial
2. Fekal Impaction

Impaksi Fekal (Fekal Impaction) merupakan masa feses yang kerasdi lipatan
rektum yang diakibatkan oleh retensi dan akumulasi materialfeses yang
berkepanjangan. Biasanya disebabkan oleh konstipasi, intakecairan yang
kurang, kurang aktivitas, diet rendah serat, dan kelemahan tonus
otot(Hidayat, 2008)

Penyebab :

Pasien dalam keadaan lemah, bingung, tidak sadar, konstipasi berulang, pemeriksaan
yang dapat menimbulkan konstipasi.

Tanda :

Tidak BAB, anoreksia, kembung/kram, nyeri rectum. Pengkajian dengan

meraba rectum dengan hati-hati, dan harus dengan “standing order” dari
dokter, karena dapat menimbulkan reflek vital (menurunkan denyut nadi)
dan perform (terutama pada orang tua dengan tumor di kolom).
3.Diare

Menurut WHO Pengertian diare adalah buang air besar dengan

konsistensi cair (mencret) sebanyak 3 kali atau lebih dalam satu hari (24
jam). Ingat, dua kriteria penting harus ada yaitu BAB cair dan sering, jadi
misalnya buang air besar sehari tiga kali tapi tidak cair, maka tidak bisa
disebut daire. Begitu juga apabila buang air besar dengan tinja cair tapi
tidak sampai tiga kali dalam sehari, maka itu bukan diare. Diare
didefinisikan sebagai inflamasi pada membran mukosa lambung dan usus
halus yang ditandai dengan diare, muntah-muntah yang berakibat
kehilangan cairan dan elektrolit yang menimbulkan dehidrasi dan
gangguan keseimbangan elektrolit (Wati, 2016).
Tanda Klinis Diare :

a) Adanya pengeluaran feses cair.

b) Frekuensi lebih dari 3 kali sehari.
c) Nyeri/kram abdomen.
d) Bising usus meningkat.
e) Stress psikologis.
4. Inkontinensia Fekal

Inkontinensia fekal merupakan keadaan individu yang mengalami perubahan

kebiasaan defekasi normal dengan pengeluaran feses tanpa disadari, atau juga
dapat dikenal dengan inkontinensia fekal yang merupakan hilangnya
kemampuan otot untuk mengontrol pengeluaran feses dan gas melalui sfingter
akibat kerusakan sfingter (Hidayat, 2008).

Tanda Klinis :

a) Pengeluaran feses yang tidak dikehendaki.

Kemungkinan Penyebab :
- Gangguan sfingter rektal akibat cedera anus, pembedahan,dan lain-lain.
- Distensi rektum berlebih.
- Kurangnya kontrol sfingter akibat cedera medulla spinalis,CVA, dan lain-
lain.
- Kerusakan kognitif
D.Tujuan memberikan latihan defekasi ( bowel training)
Ada beberapa tujuan dilakukannya bowel training pada klien yang memiliki
masalah eliminasi feses yang tidak teratur, antara lain sebagai berikut:

1. Program bowel taraining dapat membantu klien

mendapatkan defekasi yang normal. Terutama klien yang
masih memiliki control newromuskular (Doughty, 1992).
2. Melatih defekasi secara rutin pada klien yang
mengalami gangguan pola eliminasi feses atau defekasi.
 E. Prinsip memberikan
latihan defekasi (bowel
training)
1. Asupan cairan sekitar 2500-3000 cc/hari.
2. Peningkatan diet tinggi serat.
3. Asupan air hangat, khusunya sebelum waktu defekasi.
4. Peningkatan aktivitas/ Latihan.
5. Pertahankan hal di atas secara rutin harian selama 2-3
minggu
F. Indikasi dan Kontraindikasi memberikan latihan
defekasi (bowel training)

a. Indikasi Bowel training dilakukan pada klien dengan:

1. Konstipasi (susah BAB), dengan memberikan asupan makanan
berserat, cairan hangat, dan jus buah.
2. Inkontinensia usus (tidak bisa mengontrol pengeluran feses secara
normal), membantu klien mendapatkan defekasi normal.

b. Kontra indikasi memberikan latihan defekasi (bowel training)

1. Klien dengan diare
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defekasi (bowel training)
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2500-3000 cc/hari
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