In order to add or delete option to any parameter with the Dropdown, Picker List or Group type, go to the account's settings from the Web (you can have a look at THIS article for more details). Search for the parameter you wish to edit (for example, defecation). Click the check mark next to the name of the parameter and then Edit selected (or simply Double click on the name of an item):

You can now edit the selected parameter to customize it. In this example, we will add None as an option in the drop-down list for Defecation:


For this, in the Options field - 'type new option name' , press ENTER (or click Add button), and then click UPDATE: 


NOTE: If you do not press ENTER and simply click UPDATE the changes will not be saved. 


You may add multiple new options if you wish, or press the red X next to existing options to delete them:


When applying changes to the parameter on Settings / Parameters it will ALWAYS be applied both to the existing and new patients. From this point, the new option will appear on the flowsheet: