# Mini-poll on incomplete evacuation



## SpAsMaN* (May 11, 2002)

To clarify the popular term incomplete evacuation here the poll.You can give some details to explain how you feel it.DO YOU HAVE INCOMPLETE EVACUATION IN THE RECTUM OR IN THE LOWER PUBIC AREA?*Spasman-->I get pubic incomplete evacuation causing pelvic irritation on the pubic bone area which also irritate my whole urologic system.*The problem is even if i get complete evacuation the irritation remain.It makes me wonder about low-grade infflammation in the colon sigmoid of IBSers.


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## I'll B Snookered (Apr 9, 2004)

Incomplete evacuation in my rectum/near my pelvic floor that irritates my entire digestive system.However, truly squatting on the toilet has really helped me. 2 other things seem to really have helped. I started taking 2 fish oil tablets (omega 3 EPA and DHA oils) + 1 black currant (omega 6 GLA oil), and I started taking a small amount of a calcium citrate/magnesium/vitD supplement.In short, this combination of oils acts as anti-inflammatory, and the calcium supplement helps with muscle contractions and relaxation.I do think there is something to the inflammation theory. If you want to know more about the interaction between those oils and why I chose them versus flax:


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## annie7 (Aug 16, 2002)

Spasman--I have that feeling of incomplete evacuation a lot. sometimes it feels like there still is poop stuck in my rectum (like a baseball bat up my butt) and then I take a glycerin suppository (just glycerin, no added stimulants) and usually but not always that will help get the stubborn, up-in-the-rectum poop out. a small enema can help with that too--I use an empty fleets bottle, filled with warm water.but frequently it feels like the poo is stuck up higher than the rectum--like in my left-side sigmoid colon. suppositories don't help then. sometimes I'll try an small enema or a couple of the fleets bottles of water for relief and sometimes that helps and sometimes it doesn't...absolutely hate that feeling though, whether it's in the rectum or higher up. it's very very uncomfortable and i feel miserable being stuck like that all dayI don't get that feeling in my pubic bone area though like you do. that sounds miserable too.


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## SpAsMaN* (May 11, 2002)

Hmmm not many poster on pubic discomfort.It makes me wonder why there is so much different pattern of constipation.Regarding the pubic pain,there is a possibility that it is refered pain from a surronding area.Not necessarly the area where i get extrem discomfort.BUT i'm sceptical about the theory of refered pain even if,2 specialist told me about that i could be that.OFTEN WHEN I PUSH LOWER IN THE PUBIC AREA I CAN RELEASE THE TRAPPED GAS.SO IT MUST BE THE SIGMOID COLON.HOWEVER THE SIGMOID COLON ISN'T SUPPOSE TO PASS ON MY PUBIC BONE.IN OTHER HAND IF I TAKE LAXATIVE LIKE BISOCADYL,I GET CRAMPS NEAR THE PUBIC BONE JUST BEFORE I EVACUATE SO IT MUST BE THE SIGMOID MESSING MY PELVIC AREA BY "REFERED PAIN".But most of the time i feel like my sigmoid has fall down on my pubic bone just under the skin.It's not suppose to makes sense because i assume that is the small bowel being the area where inguinal hernia form.I have been examined 3 times by 3 differents specialist and it is NOT an inguinal hernia(protusion of the small bowel through the abdominal wall).


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## SpAsMaN* (May 11, 2002)

I wonder if a MRI would show abnormality or sigmoid "prolapse".


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## SpAsMaN* (May 11, 2002)

Or another explanation would be that we as individual have different level of sensitivity.For me as an exemple,i always have been sensitive "down there" even before IBS.So what another feel little pain,i feel it to a greater level.


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## SpAsMaN* (May 11, 2002)

...BUT the thing is i don't necessarly buy the sensitivity factor in IBSer.I've had a balloon distention in my rectum and my rectum is NOT more sensitive than another.I don't buy it as a CAUSE of IBS but maybe as a CONSEQUENCE of another problem eg;associated with trapped gas or mucosa alteration.I mean;Why would i get sensitivity if nothing is going wrong in my digestive tract???


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## SpAsMaN* (May 11, 2002)

When i push near my pubic bone on the irritation,i can sometime evacuate.It feel like it's highest part of the rectum but i always thougth it was the sigmoid colon.


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## eric (Jul 8, 1999)

FYIhttp://gut.bmj.com/cgi/content/abstract/43/3/388


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## Mary2001 (Aug 25, 2006)

> quote:Originally posted by annie7:Spasman--I have that feeling of incomplete evacuation a lot. sometimes it feels like there still is poop stuck in my rectum (like a baseball bat up my butt) and then I take a glycerin suppository (just glycerin, no added stimulants) and usually but not always that will help get the stubborn, up-in-the-rectum poop out. a small enema can help with that too--I use an empty fleets bottle, filled with warm water.but frequently it feels like the poo is stuck up higher than the rectum--like in my left-side sigmoid colon. suppositories don't help then. sometimes I'll try an small enema or a couple of the fleets bottles of water for relief and sometimes that helps and sometimes it doesn't...absolutely hate that feeling though, whether it's in the rectum or higher up. it's very very uncomfortable and i feel miserable being stuck like that all dayI don't get that feeling in my pubic bone area though like you do. that sounds miserable too. T


 Thank you Annie for posting.That happens to me all the time and I thought maybe it might be due to some type of prolapse or pelvic floor dsyfunction that was wrong with me, when I feel like I can only do so much and have to keep going and going and never feeling that I'm totally empty. Maybe when we all have that symptom it is the way ibs works and the mind might be perceiving the wrong message, as I don't remember being like that before ibs started, and Spasman I sometimes feel a discomfort in the pubic bone but I cannot pinpoint where its coming from as it does not feel sore to touch, so I cannot figure out either where that pain or discomfort comes from, and it is very hard to describe the sensation of it. Sometimes its there when I keep trying to evacuate and feels like a button stuck, so I do not have any answers to get rid of it, and it goes away at a later date, so I am sort of hanging on to that set of thinking that if today is a bad day, perhaps it might be better day tomorrow. I hope there is some good treatment for this condition very soon. Thanks for posting.


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## eric (Jul 8, 1999)

There is some more info on this threadhttp://ibsgroup.org/groupee/forums/a/tpc/f...261/m/963108682


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## SpAsMaN* (May 11, 2002)

Thanks Eric but i don't feel stool in my rectum.I have pubic bone disconfort and trapped gas.I blame the sigmoid.


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## eric (Jul 8, 1999)

That's not incomplete evacuation then.


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## SpAsMaN* (May 11, 2002)

Hmm good point.Never thougth about it.However,when i use suppository,i poo a lil' bit and get lil' relief from the pubic area.


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## eric (Jul 8, 1999)

That's more of a pressure issue.The incomplete evacuation is more a sensation issue do to the nerves and the way the nerves are in IBS.""What Is The Defecation Reflex?Just prior to elimination, muscular activity in the colon pushes feces down into the flexible rectal sack which expands to accommodate the stools. Nerve endings, stimulated by the expansion, activate the defecation reflex indicating to the body that it is time to move the bowel. This is the urge to â€œgoâ€.You can still get the "urge to go" even when there is no material there.


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## eric (Jul 8, 1999)

Did you see this from the above thread"BackgroundPatients who complain of constipation can be divided into those who have lost the natural call to stool, but develop abdominal discomfort after several days without a bowel movement (no urge); and those who experience a constant sensation of incomplete evacuation (urge). You might be the no urge.


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## 16636 (Sep 29, 2006)

I have both IE and lost the call the stool, so to speak. These are the main symptoms, in fact. To me there seem to be very few hard and fast rules about what it means to be constipated on a daily basis -- things vary depending on a number of factors. Also, I keep hearing how IE is supposed to be a sensation or a nerve issue but I don't have IE AT ALL when I'm pushing out enough stool. It's not a small little amount of stool either, it's enough so that anyone would feel it. And I don't have it when I have diarrhea. I have it constantly when my daily regime isn't working well enough.Dana


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## eric (Jul 8, 1999)

Dana, have you ever had a sitz marker test done?Or a test for Pelvic Floor Dysfunction (Dyssynergia)?Have you seen this site?"FUNCTIONAL CONSTIPATION The Rome Foundation defines functional constipation as persistent symptoms of difficult, infrequent, or seemingly incomplete defecation. Doctors diagnose functional constipation by identifying certain accompanying symptoms and ruling out organic disease, especially colon (large intestine) obstruction. The Rome diagnostic criteria are a useful guide for diagnosing functional constipation.Functional constipation is the presence of two or more of the following: 1. Straining during at least 25% of bowel movements, 2. Lumpy or hard stools in at least 25% of bowel movements, 3. Sensation of incomplete evacuation for at least 25% of bowel movements, 4. Sensation of anorectal obstruction or blockage for 25% of bowel movements, 5. Manual maneuvers to facilitate at least 25% of bowel movements and/or, 6. Infrequent (fewer than 3) bowel movements per week. While the Rome definition attempts to quantitate these symptoms, doctors must ask questions about frequency and severity, in order to determine how important they are.Loose stools are normally not present in chronic constipation unless laxatives are used. Constipation is common in irritable bowel syndrome (IBS) but in that condition there is abdominal pain and the bowel habit is changeable with normal and diarrheal defecations occurring from time to time. It is important to exclude other medical disorders. http://www.aboutconstipation.org/index.html


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## 16636 (Sep 29, 2006)

Sure, I was diagnosed with Rome criteria for IBS-C but never had the sitz marker test done, or the one for pelvic floor dysfunction. I bet I do have some pelvic floor dysfunction because I also have bladder issues. And it seems likely that I would have lots of the markers left in my system after a week, considering I don't have a bm for 5 days or more without outside assistance. So I guess any gastro would assume that I have slow motility, right? At what point would a marker test need to be done -- when drugs don't work?It looks like I could have functional constipation too except for that there's no mention of soreness or pain, which I also have.Dana


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## eric (Jul 8, 1999)

"sitz marker test done, or the one for pelvic floor dysfunction. I bet I do have some pelvic floor dysfunction because I also have bladder issues."I would ask about those tests personally. However pain is a must for an IBS C diagnoses. Bladder issues and IBS are pretty common and there is a connection to IBS the bladder and mast cells embedded in the gut wall. Of course a person can have comorbid problems like bladder conditions or Pelvic Floor Dysfunction as well.Functional C is without pain.Have they ever put you on zelnorm?


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## eric (Jul 8, 1999)

This is a pdf file but you might also want to read this as well. Dr Whitehead is an expert on constiaption.http://www.med.unc.edu/medicine/fgidc/comp...onstipation.pdfandhttp://www.giresearch.org/Whitehead.html


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## 16636 (Sep 29, 2006)

Hi Eric -- yes I've been on Zelnorm since Sept 2006 and it only worked well if I took it with Activia. Then that slowed down so the gastro added Amitiza. It's like getting a colon cleanse 2x a day. Without the Zelnorm, the Amitiza doesn't really do much. It seems like the Zelnorm gives me the all important "urge" which I treasure.The Activia is important for me too because it controls nausea and improves transit time. I feel so much better with that particular probiotic in my system. It's more than just having a bm, it's an overall sense of balance or something. I want to talk to my gastro about the bladder stuff and the pelvic floor test -- my urologist knew about my constipation and told me I needed to do biofeedback for my pelvic floor. If that's all there is to solve the bladder issue I can't afford it right now as it's not covered by my insurance. Maybe someday there will be medication that can really treat these things.Dana


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## 20110 (Mar 31, 2007)

I dont't know specifically what kind of incomplete evacuations I have, I just know I HAVE them! Also, I can feel blockages and sometimes have small bms around the blockages.


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## 20568 (Jan 24, 2007)

Hi all,This is an interesting question. I have a call to stool quite frequently, but just as frequently, when I answer the call, nothing comes out but a lot of gas. This is very frustrating. I also have considerable abdominal distention most of the time, whether I've eaten recently or not, and a concurrent feeling of internal pressure, (sometimes I feel like a balloon that's been overblown and that I'm going to explode if I move or bend over). I often wonder if this is caused by trapped gas, although I'm not sure, as I don't seem to belch much or pass wind, (not from consciously holding back, it just doesn't seem to happen all that often).Is there anythng else that can cause measureable abdominal distention besides trapped gas? Maybe just a lot of backed up stool? I do notice that when I can evacuate it often feels incomplete, (sticky stuff gets stuck in the rectum area), but it does ease the distention and pressure a bit. I take Miralax and MOM daily in order to have regular daily movements, the movements are often very watery, but I'd rather pass a lot of watery d than small hard infrequent painful stools, (which is what was happening prior to taking Miralax and MOM daily).I have been learning a lot from reading on these forums. Thank you to everyone for sharing your experiences and words of wisdom.Best wishes from bookyone


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## overitnow (Nov 25, 2001)

Curiously, I was only D; but during several months of recovery, while the liquid stopped, the stools, while still quite soft, would often break off into IE, with the second half awaiting another "call." I never thought of it as C, rather just a lack of push from the muscles.If I go off of the supplement, IE returns within the first week with D 2-3 weeks behind.Mark


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## 16430 (Oct 30, 2006)

I have 2 kinds of IE...a) in the rectum area which is reduced by taking a sitz bath. This relaxes the anal muscles and allows the stool to come out easilty (this is because I have paradoxical contraction of puborectalis muscle)







near the stomach region. I have been told that it is not the stomach but in the part of the colon just below the stomach. This is very troublesome for me. The way I have tried to reduce this is by sitting with the right leg folded on the floor and left leg raised(have to draw a figure to explain I guess). What this seems to do is squeeze the area near the stomach a bit and then the stool can travel down. I sit in that posture every morning browsing ibsgroup.org (what else?) for half an hour and that clears the bowel.(of course I take zelnorm a day before)


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## SpAsMaN* (May 11, 2002)

Bookyone said:


> quotesometimes I feel like a balloon that's been overblown and that I'm going to explode if I move or bend over).


If you can't use your rectum expulsing muscle,it's in your sigmoid.


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## annie7 (Aug 16, 2002)

thanks for the tip, Ramana. do you have your left leg raised so that it's straight and propped up with your foot resting on a table? like that? or not as high as that? sounds like something worth trying. thanks!


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## 20568 (Jan 24, 2007)

Hi SpasMan,Thanks for the info.. Can anything be done for this?Best wishes from bookyone


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## SpAsMaN* (May 11, 2002)

My only solution for now is the heat.At home i use a hot water bottle and away from home i will use www.thermacare.comOf course eliminate gas would help too.I hope this help.


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## hasenfuss (Dec 28, 2006)

Spasman, I also get that discomfort in my left lower side ( My doctor said it's the sigmoid colon). Often a bm will set of the discomfort. Yesterday I didn't have a bm (happends maybe 1-2 times a months) and than I usually feel almost no discomfort. Today I went twice already and of course the discomfort is back. I also feel often that there is still stool in my rectum and it takes a long time to get it out. Sometimes I have to give up sitting so long on the toilett and I have to walk around with that stuck feeling in my rectum + the left sided discomfort. I don't have Constipation and I go usually anywhere between 1-6 times to the bathroom per day. The heating pad is also the only thing which helps. I guess we are very similar.


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## SpAsMaN* (May 11, 2002)

I'm not truly constipated either.I just can't move gas which is a form of constipation.Some call it IBS-A for alternator.


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## 20568 (Jan 24, 2007)

Hi SpasMan,Thanks for the tip, I'll try it. I find a heating pad helps at times, so heat is definitely a good thing.Best wishes from bookyone


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