Gelatinous BM?

  1. A patient on our unit had 2100 cc's of gelatinous, nonfoul-smelling, clear colored substance from her rectum. She continues to pass this material rectally. C. Diff was negative. Any ideas what this may be? Thanks!
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    About Zee_RN

    Joined: Oct '00; Posts: 1,664; Likes: 177
    RN, Inpatient Hospice; from US
    Specialty: 17 year(s) of experience in Hospice, Critical Care


  3. by   sunnygirl272
    Hmmm...sounds familiar..heehee...check this thread out for theories...
  4. by   cactus wren
    Just a thought ( I do have them at times ), has this patient had bowel surgery, and has been on antibiotics for a long time? Could be she has a sterile bowel, with all the good bugsies killed off.....?
  5. by   nursenoelle
    Md explained to us that it was irritation of the mucosa- in this particular case it was caused by laxative admin w/ enema following, ewwww.... basically EVERTHING the good bad and ugly was being expelled . LOL Gotta love our work!
  6. by   rncountry
    The only patient I have had that exhibited same symptoms, after much clashing with physician got an ABD. xray. Showed toxic mega colon and it was determined he would need surgical intervention ASAP. Problem was family had been fighting over who would get guardenship, patient with no wife or children, and while they dithered with the courts despite being told repeatedly the patient needed immediate surgery, the patient died. This poor man's abd. swelled to proportions I didn't think were possible in the meantime, and was as taut as a drum. Though he never complained of pain and always answered no when asked if he was in pain.
    Has any abd. diagnosics been done?
  7. by   Zee_RN
    Wow, sunnygirl, I checked out that thread. Sounds like the same thing!

    As to infection, I really don't know. It wasn't my patient and I don't have all the details. She was in the Unit for poor 02 sats. She's a bad COPD'er on 100% AFM and with sats in the 80s. No ABD surgery.

    I'll bring this screen up when I go back to work on Tuesday. Thanks for your suggestions.

    It is an amazing job we have!
  8. by   adrienurse
    Just a thought. Is patient on Metamucil? Passing mucous?
  9. by   fab4fan
    Possible obstruction/impaction?
  10. by   911fltrn
    Pt had severe diverticulitis when i saw something similiar!
  11. by   Peeps Mcarthur
    Perhapse an enzyme defiiciency.

    COPD on 100%! and 80 sats.

    You'd better take a good look,definitely CTD baby.
  12. by   CaliNurse
    I can't think of anything except Gastric Bypass that I have seen this with. But what does concern me is why is she on 100% oxygen mist if she is a COPD'R. She is only sat'ing in the 80%'s. That is alarming to me.

    Since this isn't correlated to a previous gastric procedure I would start by looking up each one of her meds. I would pay special attention to of course side affects but also how these drugs are expected to interact with each other.

    Very puzzling ...... keep us informed please. We will all learn from this.

  13. by   Peeps Mcarthur
    There can't be much ventillation going on there. COPD pts don't have a normal 02 drive. That sat is right on the edge of the curve before it falls into oblivion if it is acurate. What you have is a pt that runs on an 02 drive being given 100%,sat in the 80's.................If they stop using accessory to breath,I would use an ABG to titrate. In the meantime I wouldn't rely on pulse ox,especially from a clubbed finger,since their etiology is poor perfusion in the first place.

    Mother of God.................I hope the RT has an art-line

    Been 10 years since I stepped foot in an ICU,but your always playing with fire by using 02,poor sites for P.O.,and a hesitation to hypoventilate indirectly with pain meds with an end stage COPD.
    I don't know if it's good news,but it can't get worse from there!

    Meanwhile I'm stuck in a LTC giving LOL's bedbaths,and will have to use fat-burners for my adrenalin rush for now :stone

    BTW,I wrote the above for the benefit of lurkers that might be too shy to ask. There's nobody better than an ICU nurse. For all I know,you might be reading dynamic sats from an indwelling catheter by now.

    Just gets me excited.

    Please.......please...........pretty please, with a bathroom break on top,tell us some more!!
  14. by   misti_z
    I have seen gelatinous BM in toxic megacolon as rncountry said, although it had a green tint.