# Does anybody else have to do this?



## Industrial

This is kind of embarrassing but I need to ask. Most days for the last long while ive needed to use my finger to assist in evacuating my stools. It just seems like it stops moving on its own sometimes and needs assistance. I'm disgusted at myself and embarrassed but I feel like I have no choice. I'm afraid that if it continues that I won't be able to move my bwels without that kind of assistance. Does anyone else have to do this? Speak up, your advice/support would be much appreciated.


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## em_t

I don't personally but from what I've read online lots of people have to do this. It shows that you have a problem with either your pelvic floor (yes men can have this too) or your anal sphincter - I'd ask your doctor about getting this tested, because there might be exercises or surgery that could help you.


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## Industrial

well how do you test it?


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## em_t

They do it by introducing a catether into your anus with a balloon attached and measure the reaction of your muscles to the different pressures. You can easily find more information about it online.


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## tourist

Yes, I have had to do this often. But there is nothing wrong with my pelvic floor or rectum. It is due to asynchronized and or incomplete peristalsis, which my doctor says is called, atonic colon and it is a common symptom for IBS-C sufferers. And according to several articles I have read, one of the common symptoms of IBS-C is when the patient reports that there is a sensation like a "golfball" left in the rectum after a movement.Apparently for some with IBS-C, myself included, it's not so much about constipation as defined by hard, dry stools, but a feeling of a full bowel that won't move or that empties incompletely even when the stool is normal or even soft.


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## debbie38london

yes i have to empty my bowels by putting tons of toilet tissue up my rectum to empty myself as my bowel stopped working long ago, i also thought it was just me doing this ive never got help before as i was embarrsed, it causes lot of spamses and pain and i never feel empty, i have ibsc, now my doctor has got me down for colorectual surgery on 14th march , pretty scared as dont know what they going do, im glad that im not the only one having to use fingers or tissue for bowel movement, as gp to get you tested


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## Industrial

so the fact that i need a little help from my finger on some bowel movements means I may need surgery? I can still have natural bowel movements but it's usually subsequent ones that require manual assistance.


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## em_t

Not necessarily, you may just need to practice some exercises which help you empty your bowel more efficiently. Also colorectal surgeons do not just specialise in surgery, sometimes they have better access to various resources and diagnostic techniques, which may be why your GP has sent you to a surgeon rather than a physician.


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## Tiss

One of my doctors actually advised me to do this a few years back thinking that it would help the evacuation process and it is not harmful. It didn't help me but apparently this is very common.


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## tourist

Surgery may not be necessary if you can get the bowel to constrict again as it is meant to. It may have become atonic due to laxative dependence or it may be so distended with gas and fluids that it no longer works. The standard advice is that if the bowel doesn't move, you should put more pressure on it, i.e., fill it with fiber which will draw fluid and that will trigger the peristaltic activity. I have found though, that it is not always the case.Once I realized I have fructose malabsorption I have dramatically cut back on fiber simply by avoiding FODMAP foods. This will sound like heresy, but once I gave up my heavy fiber, vegetarian diet and was careful to avoid FODMAPs, my bowel began to come back to life and move almost normally. It's as if it became paralyzed with the gas and fluid buildup. Just so you don't think I typed it wrong; my bowels finally began to move when I cut back on fiber. But I cut back on the kind of fiber that was disagreeing with my system. I also cut out the Miralax since it was only making things worse. It's only been three weeks since I started the FODMAPS elimination but I already feel better than I have in years. It was so bad, and my colon was so dead that I had trouble eliminating the colonoscopy prep fluids. I had nothing but clear fluids and laxatives for two days in preparation for a colonoscopy. That's virtually unheard of.No more gas, no more bloating, no more belly noises, hemorroids act up only once in a while and some days there is no bleeding at all, where it was a daily thing before. As a bonus my muscle cramps and irregualr heartbeat (PVCs) have also disappeared. It appears that the fluid drawn into the gut was causing an electrolyteimbalance. That's my guess anyway. If you haven't looked into the possibility that you have a fructose, lactose or galactose malabsorption, I urge you to do so. I was reasdy to sign up for surgery. This is better.


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## Mary5

How was your malabsorption diagnosed? What tests?


tourist said:


> Surgery may not be necessary if you can get the bowel to constrict again as it is meant to. It may have become atonic due to laxative dependence or it may be so distended with gas and fluids that it no longer works. The standard advice is that if the bowel doesn't move, you should put more pressure on it, i.e., fill it with fiber which will draw fluid and that will trigger the peristaltic activity. I have found though, that it is not always the case.Once I realized I have fructose malabsorption I have dramatically cut back on fiber simply by avoiding FODMAP foods. This will sound like heresy, but once I gave up my heavy fiber, vegetarian diet and was careful to avoid FODMAPs, my bowel began to come back to life and move almost normally. It's as if it became paralyzed with the gas and fluid buildup. Just so you don't think I typed it wrong; my bowels finally began to move when I cut back on fiber. But I cut back on the kind of fiber that was disagreeing with my system. I also cut out the Miralax since it was only making things worse. It's only been three weeks since I started the FODMAPS elimination but I already feel better than I have in years. It was so bad, and my colon was so dead that I had trouble eliminating the colonoscopy prep fluids. I had nothing but clear fluids and laxatives for two days in preparation for a colonoscopy. That's virtually unheard of.No more gas, no more bloating, no more belly noises, hemorroids act up only once in a while and some days there is no bleeding at all, where it was a daily thing before. As a bonus my muscle cramps and irregualr heartbeat (PVCs) have also disappeared. It appears that the fluid drawn into the gut was causing an electrolyteimbalance. That's my guess anyway. If you haven't looked into the possibility that you have a fructose, lactose or galactose malabsorption, I urge you to do so. I was reasdy to sign up for surgery. This is better.


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## tourist

[quote name='Mary5' timestamp='1299895786' post='824436']How was your malabsorption diagnosed? What tests?[/quoteMy doctor and I plan to discuss tests to confirm when I see him next month but both of us are inclined at this point to think that testing is not necessary, given the dramatic change that occured just with the change of diet. This is eight years of progressive incapacitation that turned around in just a couple of weeks.


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## em_t

As far as I know doctors perform hydrogen breath test in order to test for fructose malabsorption, but I do not think there are any other diagnostic tests for other FODMAPs - its usually just based on personal experience. If you feel better following a low FODMAP diet for a month then try introducing small quantities of the "not allowed foods" to test your reaction to them, much in the same way you would do if following any other elimination diet.


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## KBMELB

em_t said:


> As far as I know doctors perform hydrogen breath test in order to test for fructose malabsorption, but I do not think there are any other diagnostic tests for other FODMAPs - its usually just based on personal experience. If you feel better following a low FODMAP diet for a month then try introducing small quantities of the "not allowed foods" to test your reaction to them, much in the same way you would do if following any other elimination diet.


what is galactose malabsorption? I did the FODMAP diet for 2 weeks but not dramatically better and still very constipated. What did you use or are you using for constipation?


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## CinMari

I've never done that but I've definitely had moments where that crossed my mind. It feels like it's literally stuck and nothing you do helps it come out and it's very uncomfortable. I'll sit there for 45 minutes or longer just waiting for it to come out. I'll try sitting differently, lifting my knees up and stuff too. I find doing my best to relax helps because I strain a lot. I feel like that's TMI lol, but I figure it's worth sharing. You're not alone.


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## humiliated

Straining seems to make matters worse for me. I do this little back and tummy exercise while sit there and wait. I sit up very straight like stretch high then slowly round my back. 5 second up and 5 down, breathing deeply through mouth. If nothing else after 5 years of it, my tummy is nice and flat(when I'm not bloated and full of it).A friend of mine had the same issue as you Industrial. She started taking aloe-lax every night at bed time and goes regularly every morning now. its worked for her for quite a few years now. Aloe seems to be the easiest on you as far as laxatives go. I go with all the others though in saying talk to your Dr., malabsorption can be fixed by natural means, if thats all it is you'll kick yourself for not doing it sooner.And I don't know about the rest of you, but I have never seen malabsorption respond to more fiber like the Dr.'s always order. I'm just thinking they don't know what they're talking about on that one. Makes matters worse and they take your money and act like they did something for you.


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## LOOKING4EASE

ive needed to use my finger to assist in evacuating my stools. yep, once I allowed myself to do this it has helped me immensely. I sometimes think that the nerve endings just don't work that well, and I sometimes must not only 'assist' the fecal matter out, but then re-insert my finger and try stretching the tissue in my rectum in different directions to stimulate a further movement. I began to feel better about this when a nurse friend of mine non=challantly that this was called, 'digital assistance'.do it if it works. wash your hands well. I know it sucks, but it can help a lot. Hope this helps you feel better about this.


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## wildflowers2

children's glycerin suppositories. That's what I use and take with me when I travel. Lubes the butt and makes for a smoother BM.Good Luck....


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## CherECoz

I use the glycerin suppositories too. And occasionally whe that won't work I use the Dulcolax suppositori


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## Sohail Durrani

Heya people today i googled my problem and found this topic exactly the same as i have from years with a fe addition i felt so good people shared there evatuation problems 
i m 26 years old and i had the problem of manual evacuation of stools since 2004 till now which has become worse where i visited so many doctors but the last one doctor said its ulcerative colitis n i have to take masacol tabllets (mesalazine) which will help my intestine ulcer to heal up but no benefit in one year so now m nt even taking any medicines he even said use agilax i had it but no effect once in a month or twice i feel im normal but the rest the it the d same as manual evacuation with finger by standing up in the middle pushing my belly feeling pain all the time even wake up with a bloated belly and lower abdomen pain it has become a biggest pain in my life please please please being humans help me to get out of this hell rotien this hell pain i cant focus on anything i daily take 30 to 45 mins by rubbing anus n found it completly closed sumtimes a lil inside my anuse that cant evn pass my finger n stools n gas remains inside i know its so very shameful but what should i do im so so very disturbed becuase i have a life ahead to get married to keep on doing business ................... pleas help me i have tried fiber and everything else but no effect 24/7 pain in lower abdomen bloating and alot alot alot of burning please tel me what should i do i have lost alot of weight im so very week also


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## Double Trouble

I have had to do it but found it easier to use a glycerin suppository to help me to go. I now know if I haven't moved my bowels within 48 hours of the last BM

then using a glycerin suppository makes it easier and less painful to move my bowels.


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## sm00sm00

I have done this too! Sometimes it just gets so irritating when your straining and straining but nothing happens.


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## jakmak52

wildflowers2 said:


> children's glycerin suppositories. That's what I use and take with me when I travel. Lubes the butt and makes for a smoother BM.Good Luck....


Yes, Ducolax suppositories have worked for me.


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## pepperidge

Yes, I've often had to do that to get some decent relief when I'm on one of my constipated cycles. I keep a box of disposable gloves for when I need to do it. It's unhygienic to do it with bare fingers I've read a fair few articles about germs being trapped in the tiny crevices of the skin and especially under the nail.


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## tanya345

sohail, hi ! and hello to everybody else.

ok, so I have been diagnosed with something close to what you've been detected with.

my suggestion so hail, is particular to you would be to set a routine and follow it. I have been prescribed the mesacol (asacol) suppository as opposed to the tablets.

I am sure that you are aware of bringing about some modification in your diet. which means that you must cut down on your intake of processed foods (cheese, flour etc) and meat- red meat in particular. try switching to whole wheat breads etc. do include a LOT of fruits in your diet and drink A LOT of water! cut down on caffeine intake... don't exceed beyond one regular cup of coffee/tea/coke(as it was in my case) etc. in addition have a lot of yoghurt and other probiotic stuff.

going back to the benefit of making a routine and following it will make your body get conditioned to go to the bathroom around a particular time in the day. for me, I wake up and eat my breakfast first thing in the morning along with piping hot water, which gives an automatic signal to my body (now) to go. it took patience and positive thinking to get here!

don't lose hope you guys!!, I'm on my way to getting recovered and this is all because of thinking positively along with bringing about a discipline to my life.

besides this, regular exercise is a must! so hail, try getting your doc to prescribe u the suppository .

be patient and give yourself half an hour a day to spend in the bathroom... don't tell yourself that it's not gonna happen... it will happen, it won't stay in your body forever.. just listen to music or read something pleasant when you're in the loo... you'll be able to push it out automatically..

befriend anyone - who induces positive thinking in you , for me it's my mother! having to tell her about the problem and talking about it to someone who makes you happy and who cares for you will make it happen!

all the best!


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## Flax

Yes, i have to use my finger to assist BM. I don't like it - at all! It makes me want to be close to my own toilet and my nail brush. It not a very hygienic thing to have to do. And not very gentle after the fifth toilet visit the same day.

My doctor stay completely passive to this information. The same to my irregular heartbeat that follows my trouble with being backed up and with my evacuation problems.

How does glycerin suppository works? Side effects? Will it on the long run slow me down even more?


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## tanya345

you need to visit a GI specialist, most doctors will remain passive to this information- I don't know why though! it isn't all that uncommon. But you have to look for somebody who specializes in this field.

In my opinion, don't use anything till you're prescribed to use it. Before visiting a GI specialist I made an attempt to use a glycerine suppository, it didn't work.

A proper, qualified doctor will prescribe you a medicated suppository.


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## jdinvirginia

Hi all,

I have moderate fecal incontinence with severe chronic constipation. Incomplete evacuation has been one of my problems for years, so I am very familiar with latex gloves and digital removal techniques.

One small thing that has helped me a lot is a simple off-the-shelf product called Calmol-4. It is a lubricating rectal suppository with no active ingredients. It contains only cocoa butter and zinc oxide. You can order them online or from your pharmacy. No prescription required.

The suppositories are to be inserted after each bowel movement to melt internally and lubricate the rectum for the next one. I found that it helped markedly with incomplete evacuation - not always but most of the time, and also made cleanup much easier afterward.

One thing - I do wear diapers so it was no big thing for me, but you can leak some, particularly when you pass gas, with some minor staining of your underpants. If you wear diapers, a pad, or a panty liner that would not be a problem.

Best wishes,

--JD


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## Bpd1962

I have not had to do it but its certainly not shameful, and not alone from reading the posts. Fiber and calcium both can turn to concrete in the bowel if your intake of fluids is low. No, just fluids won't work as sodas, teas and coffees ARE diuretic and you won't have the water available in your system to be drawn in by the colon. I literally carry a 32oz bottle of water all day drinking water. I try to drink 2-3 bottles of water every day since I do drink coffee. Have your caffeine but add more water, whether you "like" water or not. I promise you will still like the water better than what you are going through. Fiber is good but has to have fluid to make it travel.


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## Bpd1962

I don't see much mention on this forum about using enemas. I have used the occasionally to make sure I evacuate well. Once I had to do 4 enemas in an hour to clear out. After the first one only produced light brown water I was so disappointed but it was after a full day of laxatives 12 pills total, AND 2 bottles of magnesium citrate, a BOTTLE of Miralax in Gatorade. I had to go to ER where they did X-ray and CT scan. Told me I was full completely and sent home with instructions to take a teaspoon of Miralax a day. HELLO, did you hear all I took already, doc???
So, with my husbands assistance I made up an olive oil and water enema. As I said, first one didn't seem to work. Then DH talked me into trying again in 15 minutes, it was better but not a lot out. So after the 2 more tries I did evacuate very well. The oil helped lubricate and make it much easier. I have tried packages enemas (fleet) but the don't contain lubrication. My olive oil is organic so I felt ok to use it.
When I can occasionally ( only occasionally) do an enema and clear out well, I feel way more comfortable. Regular enema use can make lazy rectal muscles and that is much worse.


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## jdinvirginia

Bpd1962,

You mentioned enemas. I take traditional bag enemas (not Fleets) daily at the direction of my doctors to control my fecal incontinence and severe chronic constipation which causes overflow diarrhea. It has worked extremely well. The enemas are predictable, immediately effective, have no lingering chemical effects and have given my control back over my incontinence. I have written a paper on enemas to control incontinence. I spent a lot of time on research learning how to make them a more comfortable experience because, as I said, I have to take them every day. If anyone is interested, my paper may be found at the link below:

https://www.dropbox.com/s/dnk64tmuryi4ajt/Enemas%20for%20fecal%20incontinence%20-%20MS%20Word.doc

--JD


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## Bpd1962

Thanks for sharing this. I have been fortunate not to suffer fecal incontenenca but have had trouble will incomplete BMs. I feel better having this info though. Thanks for the further info.


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## Gooby

Bpd1962 said:


> I don't see much mention on this forum about using enemas. I have used the occasionally to make sure I evacuate well. Once I had to do 4 enemas in an hour to clear out. After the first one only produced light brown water I was so disappointed but it was after a full day of laxatives 12 pills total, AND 2 bottles of magnesium citrate, a BOTTLE of Miralax in Gatorade. I had to go to ER where they did X-ray and CT scan. Told me I was full completely and sent home with instructions to take a teaspoon of Miralax a day. HELLO, did you hear all I took already, doc???
> So, with my husbands assistance I made up an olive oil and water enema. As I said, first one didn't seem to work. Then DH talked me into trying again in 15 minutes, it was better but not a lot out. So after the 2 more tries I did evacuate very well. The oil helped lubricate and make it much easier. I have tried packages enemas (fleet) but the don't contain lubrication. My olive oil is organic so I felt ok to use it.
> When I can occasionally ( only occasionally) do an enema and clear out well, I feel way more comfortable. Regular enema use can make lazy rectal muscles and that is much worse.


Olive oil can be quite a good natural laxative, too. If taken on an empty stomach. I take 2 to 6 tablespoons of extra virgin olive oil, depending upon how constipated I am, and drink them down like medicine and then chase them down with a small sip of water. If you are not constipated, and just want to use olive oil for "maintenance" then try taking 1 or 2 tablespoons on an empty stomach each day. It really seems to lubricate things down there quite nicely.


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## Dominic22

Yes, I have had to do this. I used to feel ashamed of having to do it as well, but it doesn't bother me anymore. Anything to make it easier to have a bowel movement. I've only had to do this on rare occasions where it was coming out partly but not able to complete.


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## Flax

Don't you get trouble with bleeding, soreness etc when you have to use your finger?

I often have to go to the toilet up to ten times a day to pass all that I am supposed to during one day (sometimes I still have to go to bed feeling the urge). I recently got bleeding after this procedure and now I feel helpless. My body can't handle this? What am I supposed to do then?


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## Dreamcatcher32

Sounds like you've got some pelvic floor issues! Should look into biofeedback. Also digital stimulation is not bad - it can help you. I would do this as much as you feel necessary to get things 'moving.'


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## Flax

Thanks for your advice! Here in Norway there isn't much focus on pelvic floor issues and I have never heard of biofeedback used to help IBS. I have to move to USA







But digital stimulation is maybe something I can do at home? Can you please post a link to explain the equipment I need and the procedure?


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## debolina roy

i am debolina roy.I had ibs c type

i practiced manual evaculstion for 3 years.now it turns to nonspecific colitis.ulcers r clear bt symptoms r still on.is it curable????


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## songbird

Hi Looking: have you thought about using a glove instead of your finger. On the occasions I have had to do this I use nitrile (not latex) glove.


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## Dreamcatcher32

Manually removing stool occurs with pelvic floor dysfunction, meaning your pelvic floor is too tight and not 'relaxing' to let the stool out. It's also diet-related, of course. Make sure you are drinking a large glass of water after every single meal. Cut out the things that give you harder stool.

On days you know the stool will be hard, you can always use suppositories to help the stool out. But you need to make sure you are pushing in the correct way. Make sure you are in a 'squat' position (this is the natural way) when having a BM, also be sure to bloat your tummy muscles OUT only. Do not push them down and inward, only push your belly out. Make sure your rectum is SLACK.

Also try Baclofen (muscle relaxor) suppositories, this might help you. I've also heard of some using a candle (cutting the wick off) and inserting this slowly in while 'clenching' and then 'relaxing' the muscles to a more relaxed state. After that, you try to excrete the candle out gently using the techniques described. I think the squat position is going to be your new best friend, though.


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