The Big Picture
Several common problems can affect a person’s normal bowel movements. These include constipation, fecal impaction, loose stools, diarrhea, fecal incontinence, and too much gas.
Some problems mainly change how often stool passes or what the stool looks like. Others can lead to pain, dehydration, skin problems, or difficulty controlling bowel movements.
Support workers help by noticing changes, giving appropriate care, following the care plan and workplace policies, reporting concerns, and keeping accurate bowel-movement records when required.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- constipation means bowel movements happen less often than usual, with hard, dry stool that is difficult to pass.
- fecal impaction is a buildup of feces in the rectum. Signs or symptoms of an impaction must be reported at once.
- diarrhea means frequent liquid stools and can lead to dehydration and skin breakdown.
- fecal incontinence means a person cannot control the passage of feces and gas through the anus.
- flatulence means excessive gas or air forms in the stomach and intestines.
- Support worker care includes prompt toileting help, skin care, privacy, accurate recording, following the care plan, and reporting important changes.
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Course Notes: Key Ideas You Need to Know
Constipation
Constipation is a condition in which bowel movements happen less often than usual. Stool becomes hard, dry, and difficult to pass, and the client may need to strain.
A client with constipation may have:
- abdominal discomfort
- a feeling of fullness
- increased gas
- large stools
- small, marble-sized stools
- pain when a large stool passes through the anus
Constipation happens when feces move slowly through the intestine. This gives the colon more time to absorb water from the feces.
Common Causes of Constipation
Supported causes include:
- a diet low in fibre
- ignoring the urge to have a bowel movement
- decreased fluid intake and dehydration
- inactivity
- medications
- aging
- certain diseases
Constipation can lead to other health problems if it is not relieved.
Preventing and Recognizing Constipation
A client may feel embarrassed about constipation and may not tell the support worker about it.
Report: If you notice that a client is having fewer bowel movements than normal, inform your supervisor.
If a client is prone to constipation, keeping an accurate record of bowel-movement frequency is important.
Common measures used to prevent or relieve constipation include:
- increasing fibre
- increasing fluids
- encouraging physical activity
A designated health care provider may order medications, suppositories, or enemas when constipation continues.
The Support Worker’s Role
Support workers help prevent constipation by supporting:
- adequate activity
- adequate fluids
- privacy
It is essential to accurately record the client’s bowel movements during the shift. This helps team members recognize and treat constipation in a timely way.
Hemorrhoids
Hemorrhoids are swollen veins in the anal canal.
They are often associated with constipation and straining during bowel movements. They can also have other causes, including pregnancy.
Fecal Impaction
Fecal impaction means feces stay and build up in the rectum for a prolonged time.
As more water is absorbed, the feces become harder or more puttylike. The stool may form one large, solid mass or several smaller hard masses.
Fecal impaction can develop when constipation is not relieved. Once feces become impacted, the client cannot easily have a bowel movement without intervention.
Untreated fecal impaction can lead to complete bowel obstruction. Complete bowel obstruction will require surgery.
Signs and Symptoms of Fecal Impaction
A client may repeatedly try to have a bowel movement.
Report at once if a client shows any of these signs or symptoms:
- abdominal discomfort, which may be severe, with or without swelling
- cramping
- fullness or pain in the rectum
- nausea or vomiting
- vomit that smells like stool
- fever
- an increased urge to urinate
- decreased ability to urinate
- liquid feces seeping from the anus
Liquid seepage around an impaction can look like diarrhea. In this situation, liquid feces are moving around the hardened mass.
Checking and Treating Fecal Impaction
A designated health care provider can perform a digital, or finger, examination to check for a hard mass in the rectum.
A designated health care provider may order:
- medications
- a rectal suppository to help lubricate the stool
- enemas to remove the impaction
On some occasions, a designated health care provider or nurse may manually remove the fecal mass with a gloved finger. This is called digital removal of an impaction.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition describes treatments such as suppositories, enemas, and manual removal when fecal impaction needs intervention. In Nova Scotia, a CCA should not treat these examples as permission to perform a rectal intervention independently.
Current Nova Scotia CCA Occupational Standards specifically give suppositories as an example of a client-specific or delegated personal-care task. When a task is delegated, it must be employer-approved and specified in the care plan by a regulated health care professional. The CCA also needs the required training and verified competency, with the required level of supervision . (novascotiacca.ca)
A Nova Scotia CCA must stay within the CCA Occupational Standards and employer policies. When an intervention is beyond the CCA’s training or capabilities, the CCA must contact the relevant health care provider. (novascotiacca.ca)
Why this matters in Nova Scotia: Reading about a suppository or another rectal treatment does not mean a CCA independently decides to perform it. The CCA must follow the current provincial practice requirements, care plan, employer policies, and any required delegation process.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: September 23, 2026
Diarrhea
Diarrhea is the frequent passage of liquid stools.
With diarrhea, feces move quickly through the intestines. This leaves less time for the colon to absorb fluid.
The urge to have a bowel movement may be sudden and urgent. Some clients may not reach the bathroom in time.
Other possible problems include:
- abdominal cramping
- nausea
- vomiting
Why Diarrhea Needs Attention
Excessive loose stools or diarrhea can cause dehydration. Infants, children, and older persons have particular risk.
In severe cases, dehydration can become life-threatening.
Fluid lost through diarrhea must be replaced. When diarrhea is extreme and rapid or large-volume fluid replacement is needed, the client may receive intravenous therapy, usually after hospital admission.
Causes of Diarrhea
Supported causes include:
- infections
- certain medications
- foods that irritate the stomach
- contagious illnesses, such as influenza
- pathogens in food or water
Diet and medications that reduce peristalsis may be used to stop diarrhea.
Infection Precautions and Diarrhea
In many agencies, enteric transmission precautions begin when a client passes three or more loose stools in one day.
Number to remember: Three or more loose stools in a day may trigger these precautions in many agencies.
Safety: Strict hand hygiene must always be followed.
Skin Care and Diarrhea
Liquid stool and frequent wiping can increase the risk of skin breakdown and pressure ulcers.
Barrier creams are often applied to the anal area after each cleaning. Follow the employer’s policies for applying any topical product.
When caring for a client with diarrhea, the support worker should:
- help with elimination needs promptly
- dispose of stools promptly to reduce odours and the spread of microbes
- provide good skin care according to agency or facility policies
Fecal Incontinence
Fecal incontinence, also called anal incontinence, means the person cannot control the passage of feces and gas through the anus.
Supported causes include:
- intestinal diseases
- nervous system diseases
- injuries
- fecal impaction
- diarrhea
- some medications
- delayed requests for help with the bathroom, commode, or bedpan
Fecal Incontinence and Resistance to Care
Some clients living with mental health disorders, dementia, or cognitive disorders may not recognize the urge to have a bowel movement. They may soil themselves or their surroundings.
Some clients may resist washing or changing after an episode of fecal incontinence.
CCA action: Follow the client’s care plan.
Report or ask for help: Talk to your supervisor if you have difficulty providing care to a client who has been incontinent of stool and is resisting care.
Flatus and Flatulence
Flatus is gas or air from the stomach or intestines that passes through the anus.
Gas and air can also leave through the mouth as belching.
Flatulence means an excessive amount of gas or air forms in the stomach and intestines.
Common Causes of Flatulence
Causes include:
- swallowing air while eating or drinking, especially when chewing gum, eating quickly, drinking through a straw, or drinking carbonated beverages. People who feel tense or anxious may also swallow large amounts of air while drinking
- bacterial action in the intestines
- gas-forming foods, including onion, beans, cabbage, cauliflower, radishes, and cucumber
- constipation
- bowel or abdominal surgery
- medications that decrease peristalsis
Gas-forming foods listed include onion, beans, cabbage, cauliflower, radishes, and cucumber.
What Happens When Gas Is Not Expelled
When gas does not leave the intestines, pressure can make the intestines swell or enlarge.
The client may experience:
- abdominal cramping or pain, which can sometimes be severe
- shortness of breath
- a swollen abdomen
- belching or burping
- bloating
Exercise, walking, and lying on the left side often help produce flatus and relieve bloating.
A designated health care provider may order suppositories, enemas, medications, or rectal tubes to relieve flatulence.
Exam Clue Words
- Report at once: Signs or symptoms of fecal impaction require immediate reporting.
- Must: Strict hand hygiene must always be observed when caring for clients with diarrhea.
- Follow the care plan: Use the client’s care plan when fecal incontinence and resistance to care make washing or changing difficult.
- Report: Tell your supervisor when a client has fewer bowel movements than normal.
- Record: Accurately record the client’s bowel movements during the shift so team members can recognize and treat constipation in a timely way.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| Constipation and fecal impaction mean the same thing. | Constipation involves hard, dry, difficult-to-pass stool. Fecal impaction is prolonged buildup of feces in the rectum. |
| Liquid stool always means ordinary diarrhea. | Liquid feces can seep around a hardened fecal impaction and look like diarrhea. |
| Flatus and flatulence mean the same thing. | Flatus is gas passed through the anus. Flatulence is excessive gas formation in the stomach and intestines. |
Fast Review
Keep these points in mind during a quick review:
- Constipation involves bowel movements that are less frequent than usual, with hard, dry stool that is difficult to pass.
- Common constipation causes include low fibre, low fluid intake, inactivity, medications, aging, certain diseases, and ignoring the urge to defecate.
- Fecal impaction is a prolonged buildup of feces in the rectum and can develop when constipation is not relieved.
- Signs or symptoms of fecal impaction must be reported at once.
- Liquid feces leaking around an impaction can look like diarrhea.
- Diarrhea means frequent liquid stools and can cause dehydration and skin problems.
- In many agencies, three or more loose stools in one day lead to enteric transmission precautions. Strict hand hygiene must always be observed.
- Fecal incontinence is the inability to control feces and gas passing through the anus.
- When a client with fecal incontinence resists care, follow the care plan and speak with your supervisor if you have difficulty providing care.
- Flatus is gas passed through the anus. Flatulence means excessive gas forms in the stomach and intestines.
- Support workers help prevent constipation by supporting adequate activity, fluids, and privacy.
- Accurate bowel-movement records help the care team recognize and address constipation in a timely way.
Final Pep Talk
There are several similar bowel-movement terms in this topic, so focus on what makes each one different. Review the definitions, the signs that require reporting, and the support worker actions a few times until those differences feel familiar.