You’re walking down the hall and hear Mr. Henderson’s stomach rumbling loud enough to turn heads. That sound is actually peristalsis in action, and while the noises might be embarrassing for him, they are a vital sign that his digestive system is doing its job. Understanding this movement helps you keep your residents comfortable and safe from serious complications.
What is Peristalsis?
Peristalsis (per-ih-STALL-sis) is the wave-like muscle contractions that move food through the digestive tract. Imagine squeezing a tube of toothpaste from the bottom up to get the paste out; your intestines use the same squeezing motion to push contents from the stomach to the rectum. It is an involuntary bodily function that we cannot control consciously, but it is essential for digestion and elimination.
Why Peristalsis Matters in Your Daily Care
Efficient peristalsis ensures your residents can eat without discomfort, absorb nutrients, and have regular bowel movements. If this movement slows down or stops (often called a “paralytic ileus” or post-op ileus), residents can experience nausea, vomiting, bloating, and severe pain. As a CNA, you are the first line of defense in noticing these changes. Reporting a slowdown in bowel function immediately can prevent painful constipation or dangerous bowel obstructions.
What You’ll See During Your Shift
You will observe the results of peristalsis primarily during toileting rounds and meal times. You might hear stomach gurgling (borborygmi) or note that a resident is passing gas, which is a good sign the system is moving. Conversely, if a resident complains of feeling “full” after only a few bites, hasn’t had a bowel movement in three days, or has a hard, distended abdomen, peristalsis may be sluggish.
“Hey Sarah, I assisted Mrs. Rodriguez with lunch and she couldn’t eat more than a few bites because she said she felt stuffed. She also hasn’t had a bowel movement since I came on shift Friday. Her abdomen feels a bit firm and distended to me. I think her bowels are slowing down.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Assuming that a resident isn’t having bowel movements just because they “don’t eat much.” While food intake affects stool output, the lack of movement can also indicate an impaction or medication side effect, not just a lack of fuel.
Pro Tip: Ambulation is nature’s laxative. If you notice a resident hasn’t had a bowel movement, encourage them to walk the hallway with you (if able) or move their arms and legs vigorously in bed. Movement stimulates the abdominal muscles and kickstarts peristalsis.
Memory Aid for Peristalsis
Think of the phrase “The Toothpaste Tube.”
When you squeeze the bottom, the paste has nowhere to go but out. If you stop squeezing, the paste gets stuck. Just like you need to squeeze the tube to get toothpaste, the body needs muscle contractions to move waste.
State Test Connection
While you won’t be asked to define the physiology deeply, expect questions about elimination on the exam. This often involves recognizing signs of constipation or impaction, which are directly related to the lack of peristalsis.
Related Care Concepts
Monitoring peristalsis is directly linked to tracking bowel patterns and input and output (I&O). It connects to abdominal assessment (noticing distention) and hydration (dehydrated residents have slower gut movement). You also need to be aware of medication side effects, specifically opioids, which are well-known for slowing down or stopping peristalsis entirely.
Quick Reference
✓ Key signs: Stomach growling, passing gas, regular bowel movements ✓ When to report: No bowel movement for 3+ days, complaints of nausea/fullness, hard/distended abdomen ✓ Care reminders: • Encourage fluids to keep stool soft and easy to move • Promote walking and mobility to stimulate contractions • Check medication records for constipating side effects like pain meds • Palpate the abdomen gently to check for firmness during care
Bottom line: When you listen to your residents’ stomachs and track their bathroom habits, you are monitoring the engine that keeps their entire body running smoothly.