Increased, decreased, ineffective, or lack of peristaltic activity within the gastrointestinal system

• Altered water source
• Anxiety
• Eating pattern change
• Excessive stress
• Exposure to contaminated materials
• Impaired physical mobility
• Malnutrition
• Sedentary behaviors
• Unsanitary food preparation

• Decreased gastrointestinal circulation
• Diabetes mellitus
• Enteral nutrition
• Food intolerance
• Gastroesophageal reflux
• Infections
• Pharmaceutical preparations
• Treatment regimen

• Health status, educational level, cultural status, requests for information; demonstrated understanding of material
• Diet
• Recent travel
• Recent surgical procedures
• Fluid and electrolyte status, including blood urea nitrogen level, creatinine level, intake and output, mucous membranes, serum electrolyte levels, and skin turgor
• Nutritional status, including dietary patterns, laboratory tests, and serum protein level
• Neurologic status, including level of consciousness, mental status, motor function, and sensory pattern
• Gastrointestinal (GI) status, including nausea and vomiting, bowel habits, stool characteristics, history of GI problems, disease, or surgery; bowel sounds

• Abdominal cramping
• Abdominal pain
• Absence of flatulence
• Acceleration of gastric emptying
• Altered bowel sounds
• Bile-colored gastric residual
• Diarrhea
• Difficulty with defecation
• Distended abdomen
• Hard, formed feces
• Increased gastric residual
• Nausea
• Regurgitation
• Vomiting

• Patient will not experience gastrointestinal cramping/pain.
• Patient will not have gastrointestinal distention.
• Patient will have bowel movements every 1 to 3 days.
• Patient will have normoactive bowel sounds.
• Patient will verbalize strategies to promote healthy bowel function.
• Patient will acknowledge the importance of seeking medical help for persistent alteration in GI motility.
• Patient will not experience any fluid and electrolyte imbalance as a result of altered motility.
• Patient will understand the need for early ambulation following abdominal surgery.

Suggested NOC Outcomes

• Assess abdomen including auscultation in all four quadrants noting character and frequency to determine increased or decreased motility.
• Assess current manifestations of altered GI motility to help identify cause of alteration and guide development of nursing interventions.
• Monitor intake and output to identify need for restoration of fluid balance.
• Assess for nausea, vomiting, bloating, and pain as these are signs of decreased gastric motility.
• Collect and evaluate laboratory electrolyte specimens. Some altered motility states may require electrolyte replacement therapy.
• Insert nasogastric tube as prescribed for patients with absent bowel sounds to relieve the pressures caused by accumulation of air and fluid.
• Educate patient regarding importance of maintaining diet high in natural fiber and adequate fluid intake. Fiber increases stool bulk and softens the stool. Fluid will promote normal bowel elimination pattern.
• Encourage activities such as walking as tolerated for patients with decreased GI motility. Increased activity will stimulate peristalsis and facilitate elimination.
• Collaborate with dietitian and other health care professionals as needed to meet the unique needs of each individual patient.

Suggested NIC Interventions

• Patient does not experience bowel/abdominal cramping.
• Patient does not exhibit signs of abdominal distention.
• Patient has a bowel movement every 1 to 3 days.
• Patient verbalizes strategies to promote healthy bowel function.
• Patient states plan to seek medical assistance for GI problems.
• Patient maintains normal electrolyte balance.
• Patient ambulates according to schedule.

• Patient's laboratory results and bowel characteristics
• Observations of physiologic and behavioral manifestations of decreased GI motility
• Interventions performed for management of nasogastric tube
• Teaching provided and patient's response
• Patient's response to interventions
• Evaluations for expected outcomes

• Eastwick, E., Leise, J., Sabo, J., Clute, L., & Stoj, P. (2017). Effect of gum chewing on bowel motility following elective colon resection. MEDSURG Nursing, 26(3), 185-189.
• Frazer, C., Hussey, L., & Bemker, M. (2018). Gastrointestinal motility problems in critically ill patients. Critical Care Nursing Clinics of North America, 30(1), 109-121.
• Kashima, H., Sugimura, K., Taniyawa, K., Kondo, R., Endo, M. Y., Tanimoto, S., … Fukuba, Y. (2018). Timing of post-resistance exercise nutrient ingestion: Effects on gastric emptying and glucose and amino acid responses in humans. British Journal of Nutrition, 120(9), 995-1005.
• Madsen, J. L., Damgaard, M., Fuglsang, S., Dirksen, C., Holst, J. J., & Graff, J. (2019). Gastrointestinal motility, gut hormone secretion, and energy intake after oral loads of free fatty acid or triglyceride in older and middle-aged men. Appetite, 132, 18-24.