hello

suebird3 · Apr 6, 2006

welcome to allnurses.com! i moved your post to a forum that might better suit your needs,

good luck in school!

suebird

jillyk*rn · Apr 6, 2006

Daytonite, BSN, RN · Apr 6, 2006

Hi, Nurse Grace!

I haven't used a rectal tube on a patient in a long time. But, then, I haven't been working in an acute hospital for a few years either. Just a quick search on the Internet got me nothing. I can tell you what it is though. They are used primarily to help remove gas from the lower bowel.

In my years of nursing I have seen two versions of their use. One was to just use a large tube that looked very similar to a foley catheter. The tube was lubricated and inserted into the rectum. Sometimes a bulb was inflated to keep it in place; sometimes it was not. The idea was to leave the tube in long enough while the patient was lying on their left side to allow gas to escape from the lower bowel and relieve an abdomen distended by gas. An obvious problem with this could be the unintended expulsion of feces, so we protected the bed, especially where the end of the tube was with chux.

The second way I've seen gas removed from the colon was to do a modified type of tap water enema where the patient was set up for an enema. Only 200cc of water was allowed to flow into the patient's bowel. The entire enema bag and tubing was then lowered below the level of the bed so the 200cc of water and gas would flow back into the enema bag. You could tell if the gas was coming out because there would be all kind of bubbles in the liquid returns of the fluids coming back into the enema bag. You did this "flush" a number of times until the bubbles stopped coming out and the patient stated relief. The only other treatment I can think that is similar to this is the closed enema system that is used by the techs in radiology for barium enemas, except that the purpose for them is to get a barium solution introduced into the colon. However, they do attempt to remove as much of that barium solution by lowering the enema bag below the x-ray table before removing the rectal tube from the patient.

The only time I saw these treatments ordered was in postop patients who had been NPO and had a lot of gas buildup in their intestines. It is especially painful when they have been NPO for a number of days and are started back on solid food. Those flush enema were ordered a lot for the post-op C-section patients years ago. So, you might want to take a trip to the library and look for older nursing books of surgical or OB care for this kind of treatment if you are not finding it in current textbooks.

I don't know exactly what your oral report needs to focus on as I would think that enema tubing would definitely qualify as a rectal tube. We also introduced indwelling medications into the rectum via rectal tubes or large foley catheters. It was because we could inflate the bulb to hold the catheter in place as well as either clamp off the open end of the catheter or plug it with a catheter plub. One example I can think of is Kayexalate which had to remain in the colon for a bit of time as it's purpose was to remove excess potassium. I have seen GI tubes made of a number of different materials over the years. The yellow synthetic that foleys are made of is still very popular. There are also clear plastic vinyl and Red Robinson catheters as well. You can do a search of medical supply sites for rectal tubes and enema tubes. You might be able to go to the manufacturer's sites and get pictures of the many different products on the market.