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Hertfordshire County Council

Dying for a poo: Constipation and Sepsis

Written by Anne Hunt, Sepsis Lead Nurse, East & North Hertfordshire NHS Trust

Sepsis is a life threatening condition that happens when the body over reacts to an infection, injuring its own tissues and organs.

  • Sepsis is not the same as septicaemia or blood poisoning
  • Sepsis starts with an infection but the infection is not always obvious
  • The infection might be bacterial, viral, fungal or parasitic
  • Sepsis can develop very quickly or over a number of days
  • Sepsis can develop even if you are already receiving treatment for an infection
  • Sepsis can lead to shock, multiple organ failure and death especially if not recognized early and treated promptly
  • Sepsis is difficult to spot in the early stages but is relatively easy to treat.
  • When Sepsis becomes really obvious it is much harder to treat.

The gut (intestine) is home to thousands of bacteria.  They do lots of ‘good’ jobs like producing Vitamin K, helping with digestion and preventing harmful bacteria from multiplying. A healthy bowel will empty regularly, removing & replenishing these bacteria before they reach harmful levels.

When the speed of gut emptying slows, such as when someone becomes constipated, these bacteria can multiply to dangerous levels. When constipation is left unresolved the stools become impacted, that means the poo becomes dry, hard and stuck. The bowel stretches around the impacted faeces (poo) & as more faeces is made, the blockage gets bigger and the bowel stretches more. If you imagine blowing up a balloon – the more it is stretched, the thinner the surface becomes.

The bowel is very well supplied with blood vessels. When the bowel stretches, these blood vessels stretch with it, making the surface of the blood vessels thinner too. Bacteria can pass through the thin walls of the bowel & blood vessels into the blood stream where they cause infection. The presence of bacteria in the blood is known as bacteraemia. It used to be called septicaemia or blood poisoning. When the body over reacts to this infection, the person becomes septic.

Know your normal bowel pattern; prevention is better than cure.

If you, or someone in your care has an infection or becomes impacted and begins to feel much worse:

  • Look for the signs of sepsis
  • Take immediate action

Seek medical help urgently if you, or someone in your care, develop any one of the following:

Slurred Speech or confusion

Extreme shivering or muscle pain

Passing no urine in a day

Severe breathlessness

It feels like you’re going to die

Skin that is mottled or discoloured

Websites

NICE - Constipation management scenario for adults

NHS Choices - Constipation

Global Sepsis Alliance - A great video explaining the global burden of sepsis.

Youtube - Pathophysiology of sepsis

Sepsis Trust

amotherwithoutachild.com

Sepsis Vitality - Rebuild your life after sepsis.

Starfish - A feature length film about sepsis.

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