# Incomplete Evacuation -- almost daily



## 23158 (May 11, 2006)

Hi all -- Any thoughts/suggestions on this would be very helpful! For about 2-3 years, I've had an issue where when I go to the bathroom, about 95% comes out. It's fairly solid, though perhaps a bit softer than I would like, but it's definitely not diarrhea. However, it doesn't all seem to come out. I can feel the "end" so to speak, but it simply won't come out, maybe because it's too soft/sticky. If I strain really hard, I can get little tiny bits, but that's it. Then what happens is I walk around, it really starts to HURT down there, even if I hadn't been straining (which I usually don't because I don't want to cause further problems). The ONLY way I can get the pain to stop is by using a showerhead with the setting on "jet stream" and giving myself what I call a "mini-enema." Basically I point it at my bottom, and it gets enough water in there that I feel like I need to expel it, so I go the toilet and expel it and the water as well as remaining bowel movement comes out. Then I feel fine, no pain, and I can go on with my day. I don't have any pain before the bowel movement, just after. This doesn't happen every time, but I would say it happens 80-90% of the time and is EXTREMELY disruptive. The idea of going running when it hurts, for example, makes me cringe. There's not any blood though, so I don't think it's a hemmorhoid. Here are a few of the things I've tried/investigated to no avail--Probiotics (took Culturelle and I-Flora separately for a month.)--Fiber (tried Benefiber, which only made me go to the bathroom more often, and actually sometimes made it feel like I was having "slow motion diarrhea" where my stomach would hurt a lot and I couldn't go to the bathroom...I'd just sit there for 30 minutes. I definitely feel like I am better off without it).--Colonoscopy -- nothing unusual--Lactose intolerance test -- nothingAny other ideas? This is brutal...I feel like if I could get my stools to be "harder" like rock hard, then this wouldn't happen. Sometimes if I hold my bowels in long enough, it comes out "harder" than usual and I don't have this problem. Unfortunately, I can't hold my bowels in all day long, and after I finally go, it hurts...not the way I wish to live my life. BTW -- I'm male, 29, 5'10 150lbs and in otherwise fine health (if perhaps a tad skinny). I can eat whatever I want and never put on weight...kinda odd...always been that wayThanks for any thoughts!!!


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## smitty2636 (Jun 3, 2007)

Hi there,You are not alone, since I have been having problems, which started about 4 weeks ago I have had similar issues and like you I don't know what to do. I end up just going back to the couch and sitting around till the pain and the cramping in my stomach gets so bad I can go back to the toilet and finish the business. I wish there was some answers out there, my Dr's are making me angry because they havn't officially diagnosed me with IBS yet or with anything else for that matter. Its all really frustrating. I feel your pain!Smitty2636


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## 23158 (May 11, 2006)

It is EXTREMELY annoying. It's happening to me as I type this right now, in fact.Here's my question: is it something wrong with me anal area (i.e., the muscles unable to get the rest out) or is it more something wrong with my digestive system that is creating sticky bowel movements that don't come all the way out? I'm inclined to say the latter, but I just don't know what to do about it. Has anyone ever had sticky bowel movements, and if so, what did you do about them??


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## overitnow (Nov 25, 2001)

I had D for 10 years before finding a supplemental treatment that works for me. For some period it "improved" to what you are experiencing. Eventually, with more supplementing and the addition of a fiber mix that contains both soluble and insoluble fibers, it packed up enough so that that no longer was a problem. (Without the fiber, which I seldom take any more, it is often soft and stickier than I would like; but it does all come out.) Have you thought of trying a little magnesium supplementation? It will draw water into the bowel which may help to expel it. Having never been to the C-side, this is just a guess on my part.Mark


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## 23158 (May 11, 2006)

So, what do you suggest I try? How do I get a fiber mix like the one you're suggesting? As for magnesium, do you mean just a pill that they sell at a local pharmacy? Any particular dosage?Thanks!


overitnow said:


> I had D for 10 years before finding a supplemental treatment that works for me. For some period it "improved" to what you are experiencing. Eventually, with more supplementing and the addition of a fiber mix that contains both soluble and insoluble fibers, it packed up enough so that that no longer was a problem. (Without the fiber, which I seldom take any more, it is often soft and stickier than I would like; but it does all come out.) Have you thought of trying a little magnesium supplementation? It will draw water into the bowel which may help to expel it. Having never been to the C-side, this is just a guess on my part.Mark


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## overitnow (Nov 25, 2001)

Incomplete evacuation gets mentioned frequently, here; but I can't put my finger on any particular approach that has been reported as working for most. I do know that, in the past, if I stopped the flavonoids, I reverted to IE on my way back to D so that clearly plays the major role for me. The fiber seemed to just pack it in, better, so that surface features began to appear.I belong to the your body is your test tube school of thought. The simplist way to add magnesium is probably with Milk of Magnesia. Since it is a liquid, you could start with a minimum dose and move up until something changes. (The stools come out better, they get stickier, they get loose...) That would, at least, cover off if it is a liquidity problem. If it gets worse with more liquid, it might improve with less. I suspect that is why the fiber worked for me. If you can't find a brand that blends both kinds--and if you are in Chicago I would imagine a few phone calls to healthfood/vitamin stores ought to turn up something--I can have a tin of what I use ordered for you. If it is a case of too much liquid, Linda's Caltrate might also work. If none of that helps, we could then try a bottle of the flavonoids and see if they have the same effect on you as they have on me. It's a bit of messing around; but it ought to help you define where the problem lies and maybe find a solution to it. Mark


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## 23158 (May 11, 2006)

Hi -- Thanks so much for your thoughts and insight. My questions/thoughts:1) I'll try Milk of Magnesia first. I have to say, I suspect this will not solve my issue, and may instead just cause D. But I am willing to give it a whirl. I've tried fiber before and it just gave me gas and D. 2) Do you have any suggested brand names for fiber that blends both? What did you use? 3) Is Linda's Caltrate different that normal Calcium w/vitamin D? 4) What are these flavonoids you are referring to? thanks again!


overitnow said:


> Incomplete evacuation gets mentioned frequently, here; but I can't put my finger on any particular approach that has been reported as working for most. I do know that, in the past, if I stopped the flavonoids, I reverted to IE on my way back to D so that clearly plays the major role for me. The fiber seemed to just pack it in, better, so that surface features began to appear.I belong to the your body is your test tube school of thought. The simplist way to add magnesium is probably with Milk of Magnesia. Since it is a liquid, you could start with a minimum dose and move up until something changes. (The stools come out better, they get stickier, they get loose...) That would, at least, cover off if it is a liquidity problem. If it gets worse with more liquid, it might improve with less. I suspect that is why the fiber worked for me. If you can't find a brand that blends both kinds--and if you are in Chicago I would imagine a few phone calls to healthfood/vitamin stores ought to turn up something--I can have a tin of what I use ordered for you. If it is a case of too much liquid, Linda's Caltrate might also work. If none of that helps, we could then try a bottle of the flavonoids and see if they have the same effect on you as they have on me. It's a bit of messing around; but it ought to help you define where the problem lies and maybe find a solution to it. Mark


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## Iwillcuremyibs (May 17, 2007)

To help empty my bowels I drink Starbucks house blends black coffee. The coffee has to be grounded fresh and percolated.Also strong coffee helps calm my spastic colon. Therefore, I keep it handy.


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## 22395 (Apr 16, 2007)

I have horrible incomplete evacuation problems, and am absolutely miserable because of it.I had a defectogram, and the results were fairly normal. With a 'slight' rectocele, that my gynecologist says is not bad.But, otherwise, I can not empty completely.I take my stool softeners, fiber, etc.The stool is fairly softy and formed, but will not empty completely.I use manual evacuation with a glove, and still can not get it all out.And, doing an enema every day is simply not possible.This is ruining my social life, makes it difficult with my boyfriend, and on and on.I'm scheculed to have a manogram and possibly some biofeedback, but am afraid that the muscles are too far beyond that to respond to treatment.Does anyone else use manual evacuation WITHOUT complete results??Like I said, I feel miserable.Evelyn


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## Arnie W (Oct 22, 2003)

You are correct, Mark, in that this topic is raised quite regularly, but I think that you are the first to actually recommend supplements that might be considered. Congrats and thanks for that!Evelyn, I have the same problem. My first 2 or 3 bms come out easily but are not completely evacuated - the later ones in the day become hard and pebbly and what you would call constipated. I do a manual for them, but, again, I cannot get it all out. Often it's just out of reach for easy removal, if you know what I mean. Too much information. I'd better shut up.


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## 22395 (Apr 16, 2007)

Sharing information and trying to figure it all out is what we're here for.I have a problem that I try to eat right, take my fiber, etc.And, end up with a constipated soft paste that will not come out without manual evacuation.I do get some diarrhea that passes around it, but the rest will not come out.I am scheduled to have a manogram and hopefully be a conadidate for biofeedback to help make things 'work.'Question to folks:Other than just going around with a constant liquid/diarrhea stool, is there any 'type' of stool to aim for? Should I be doing something else to have a stool that is not 'paste' like? Something that is more 'formed'?Sorry for the graphic details, but I am desparate.Evelyn


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## Slimmm (Jun 4, 2007)

I can relate to the incomplete evac problems. Besides being frustrating (like wouldn't it be nice to have a real life instead of obsessing over all this IBS stuff?), the incomplete evac takes up a ton of time (really bad if you're in a hurry or have someone waiting for you). It also takes a ton of toilet paper and irritates the skin!


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## eric (Jul 8, 1999)

This can happen to both d and c IBSers.But"Sometimes people experience a sensation of incomplete evacuation, even when the rectum is empty."IN D IBS you may have d and urgency at first followed by the sensation of incomplete evacuation.In IBS the rectum can send abnormal signals to the brain. The nerves in the rectum can be hypersensitive so an extremely small amount of pressure can send a signal to the brain of the "Sensation of incomplete evacuation."Gut directed hypnotherapy might help this along with global symptoms by modifing the signals being sent to the brain and back.with consitpation the pelvic muscles may need to be checked out as well for pelvic floor disorders, that may lead to the feeling of incomplete evacuation."What is pelvic floor dyssynergia?Pelvic floor dyssynergia is the underlying etiology for 25% of cases of primary constipation. Although it is considered a disorder of the rectum and anus, these patients also have abnormal contractions throughout the colon. Dinning and colleagues recently showed that patients with pelvic floor dyssynergia had abnormal colonic pressure waves prior to defecation. Patients with pelvic floor dyssynergia present with symptoms that may include a sensation of incomplete evacuation, excessive straining, a need for digital disimpaction, perianal heaviness, and tenesmus. Soft stools and even enema fluid may be difficult to pass."http://www.emedmag.com/html/pre/gic/consults/041505.asp


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## 16430 (Oct 30, 2006)

If you have pelvic floor issue, try biofeedback AND physical therapy. Very few physical therapists specialize in pelvic floor treatment. For me biofeedback did not work. My problems have worsened now and am now constrained to seek physical therapy. It seems that had I done it earlier, I wouldn't be in this situation. However, I didn't know about it and biofeedback is all that I was told.The key is to learn to relax the pelvic floor muscles. That is also a mind body issue apart from the mechanical muscular thing.


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## olive oil (Aug 15, 2007)

Oh my gosh! I have all of your symptoms, except I dont have pain. I am a female in my mid 30's and have had this problem for 4-5 yeas. My first question is, Do you drink Coke? Or do you drink Tea with artificial sweeteners? I have tried several things and just went to the 3rd GI doctor this past Friday. Please respond and let me know your drinking and food habits. Maybe we can figure this out. Thank you!


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## olive oil (Aug 15, 2007)

chitownguitar123,I wanted to write and see how you are doing. I was wondering if you tried the Fibercon. I have been using it (8capsules/day) and have improved significantly. I don't want to jinx myself, but I am feeling so much better and cannot believe it. I have also realized that greasy foods are something to stay away from. I eat pretty healthy anyway, but realize that even the french fries or baked chicken might not be a good idea. I really hope you are doing better. Please let me know.Take Care.Olive oil


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## Brian0003 (Nov 5, 2006)

I have something very similar, althought 95% of the my stools are "hard-pebble like ones."It's rather unfortunate its that way, because no matter what I eat, its still comes up as the hard pebbles. Don't know exactly why. I have also started drinking a lot more water, and now I pee for like 2 minutes straight.Well anyway, I had an anal manomectomy done and I completely bombed it. The test was mosting done by the doctor sticking something up your butt (Whether it be there finger, a sensor, or a balloon). He gave me 2-3 minutes to try to push the balloon out and once he stuck it in, nothing really happened. So my doctor said I have this Pelvic Floor Dysfunction.I've tried everything perscription medicine out on the market(Well at least everything my doctor has ever prescribed, including steroids) and they haven't done anyway. Fiber doesn't do anything(In fact, it makes it worse), and probiotics don't do anything.Hard core things Like MilkofMagnesia/Enemas/Duclolyax Tablets/Supplements can get the job done. But they aren't natural, though that hasn't ever really bothered me.Maybe you guys/girls will have better luck. How much are you able to push out, like 90%? That really isn't too bad. I would say its more like 10% for me. When I go I scream(Yes, Iliterally SCREAM) and try to get more out but sadly it only sometimes works.


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