The Impact of Bedrest on the Abdominal System: How to Prevent Complications

When it comes to extended periods of bedrest, the effects on the abdominal system can be significant. In this article, we will explore the gastrointestinal and renal complications that can arise from immobility and discuss preventive measures to mitigate these risks.

Gastrointestinal Effects: Constipation and Gastric Reflux

One of the damaging consequences of prolonged bedrest is constipation. Research shows that individuals confined to bed have a 16 times higher likelihood of experiencing constipation compared to those who are mobile[^1]. To reduce this risk, patients should be encouraged to drink plenty of water and consume a fiber-rich diet. Normally, peristalsis aids in pushing and breaking down food while also exerting pressure on the anal sphincter when a person is in an upright position. However, in a supine position, peristalsis is compromised, leading to slower food processing and potential gastric reflux[^2].

Gastric reflux can become a problem for patients on bedrest. In a supine position, gastric juices become more acidic as the gastric juices’ bicarbonate levels decrease. This increase in acidity irritates the lower esophageal sphincter, leading to symptoms associated with Gastro-oesophageal reflux disease, such as regurgitation and heartburn[^2]. By nursing the patient at a 30-degree head of bed angle, the effects of gastric reflux can be minimized.

Renal Effects: Reduced Urge to Urinate and Urinary Calculi Formation

In the vertical position, gravity causes urine to collect at the lower portion of the bladder. As the bladder fills, pressure is exerted on the bladder wall, neck, and sphincter, stimulating the urge to urinate[^3]. However, in the supine position, the effects of gravity are reversed, and the urge to urinate significantly decreases. While this is advantageous during sleep, as we spend approximately eight hours in bed, it can lead to complications.

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The shift of abdominal organs towards the thorax due to prolonged bed rest reduces pressure on the bladder. Consequently, the urge to urinate diminishes, even when the bladder is full[^3]. For conscious patients confined to bed, emptying the bladder properly can be challenging, especially when using bedpans or urine bottles while in a seated position. This discomfort and embarrassment increase the chances of urine retention. Moreover, prolonged bed rest elevates the risk of urinary solutes’ precipitation and crystallization, leading to the formation of renal calculi[^3]. Encouraging early mobilization, even transitioning from bed to chair, can help reduce the risk of urinary tract infections[^4].

To avoid complications arising from immobility, it is crucial to prioritize preventive measures. By incorporating mobility into the care plan as soon as feasible, healthcare providers can decrease the overall risks associated with bedrest.

To learn more about the effects of immobility on various bodily systems, continue reading our series:

  • Part 1: Cardiovascular
  • Part 2: Respiratory
  • Part 3: Haematological
  • Part 5: Musculoskeletal

For comprehensive information on diverse topics, visit 5 WS. Empower yourself with knowledge and take charge of your well-being.

References

[^1]: Spellman, NT (2000) Prevention of immobility complications through early rehabilitation. In: Belandres PV,
[^2]: Knight J, Nigam Y, Jones A (2018) Effects of bedrest 3: gastrointestinal, endocrine and nervous systems. Nursing Times [online]; 115: 2, 50-53.
[^3]: Montague SE, Watson R, Herbert R. (2005) Physiology for Nursing Practice. Physiology for Nursing Practice. London: Bailliere Tindall.
[^4]: Rogers, M.A., Fries, B.E., Kaufman, S.R. et al. Mobility and other predictors of hospitalization for urinary tract infection: a retrospective cohort study. BMC Geriatr 8, 31 (2008). https://doi.org/10.1186/1471-2318-8-31

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