# Can't push stool out - HELP!



## ruby333

Whenever there is any stool in my rectum, my bowels spasm violently and I feel the urge to go but I cannot push the stool out. I admit that because of this I've been manually removing stool from my rectum for years, which makes the spasms worse, but the stool doesn't seem to come out any other way. Even when I'm not constipated and my rectum is full of mushy or hard stool, it won't come out and sometimes I have to continually remove it throughout the day and by the end of it just lots of mucous comes out and I end up taking Immodium to try to get some relief. Does anyone have any suggestions for strengthening the muscles or being able to push stool out? I think my body is used to having me remove the feces and won't do it on its own now and I don't want to use enemas because I don't want to make the spasms worse and the Immodium just leaves me constipated for days. I'm worried that I'm weakening my muscles and I'll end up incontinent or something, but my rectal muscles, ironically, seem like they're too tight to allow anything to get out. I just had a colonoscopy and GI tests a few weeks ago and their only suggestion was eat more fibre. Well, I haven't really been eating anything for 2 months and have lost a ton of weight, so I'm trying to retrain my body to accept food and to remove it properly. Any suggestions?


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## Stedwell

No answers for you Ruby but I have the same problems. Any ideas anyone?


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## em.london

I am having the same probs at the moment. I am talking Milk of Magnesium to try and soften adn help with it as it is a mild laxative.Hope it eases for youEmx


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## Gret

Ruby,Why do you take Immodium? Wouldn't that clog you up further? This is a tough one, but it sounds like you need to get your diet balanced and get some fiber involved. You sound miserable, like all of us here have been at some point! Good luck!


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## eric

Has a doctor ever said anything about:"Outlet obstruction type constipation (pelvic floor dyssynergia)The external anal sphincter, which is part of the pelvic floor normally stays tightly closed to prevent leakage. When you try to have a bowel movement, however, this sphincter has to open to allow the fecal material to come out. Some people have trouble relaxing the sphincter muscle when they are straining to have a bowel movement, or they may actually squeeze the sphincter more tightly shut when straining. This produces symptoms of constipation.

https://www.iffgd.org/lower-gi-disorders/dyssynergic-defecation.html


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## eric

PSI know this is a commercial site, but this lady talked at one of our local IBS support groups and although not totally IBS infomration, it is worth reading for the info. http://www.fruit-eze.com/education/colon/retraining.html


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## sillyface

ok, i don't know if this is right or not, it's just a suggestion. In nursing school we learned certain steps to bowel care. manual extraction is what you do when nothing else works. So if you used a laxative, you would be going a steo down from manual extraction. When someone is contipated the first step is to increase fiber and give stool softeners, then if they still can't go (usually after about 3days), give them a glycerine suppository. You could also you a dulcolax suppository, it draws more water into the area, but is also more irritating. then we graduate up to a fleet, which just adds a lot of bulk to the area which hopefully will bring stoll out with it. if that doesn't work, there are two steps. If the person is impacted, as in there is a blockage of stoll, either there are only smal amounts of stoll getting around it, or no stool at all is coming out, then manual extraction is used. if there is no blockage, then we would use an oral fleet. now i wouldn't recommend the oral fleet really. it irritates the bowel a lot, so it can make you feel a lot worse. the point of all this info is to let you know that if you decided to use a regualr fleet for a while, and then backed down to a glycerine suppository, maybe your rectum would get used to pushing stuff out on it's own again. it's just a thought. and fleets are just saline, and glycerine suppositories are just lubrication, so it's not really like using a laxative.it's just a thought. i hope things get better for youkaren


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## missC

what is a fleet? i never heard of it till i found this site.


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## IBS Cat

Hi, I feel for you. I have the same problem.

For me, the only thing that seems to help a little bit is putting my chin close to my knees, and breath out through the mouth while I am pushing. It is like what nurses would tell the moms to do when pushing the baby out. Well, it is not an easy exercise to do if you are not a yoga fan. It doesn't solve all my problems: cramping, bloating, many bowel movements in a day, straining a lot, can't push the stool out. It only helps the bowel to move a little bit more. I still have to remove feces digitally most of the time.

Another thing that can help is having diarrhea. LOL. Some food and some drug can trigger diarrhea, such as Doculax and dragon fruit. I don't like that either. It can mean a lot more cramping and constant discomfort.


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## annie7

hi IBS Cat

like Eric mentioned earlier in this post, if you are having trouble with incomplete bowel movements and have to manually evacuate yourself, you could have pelvic floor dysfunction. have you been tested for that? with pfd, the pelvic floor muscles do not coordinate and/or relax properly to allow easy passage of stool. ineffective pelvic floor muscle coordination results in inadequate relaxation of the pelvic floor while attempting to have a BM. the puborectalis muscle tightens and contracts when it is supposed to relax to allow passage of stool. so you can't get it all out (incomplete) and keep having that "have to go " feeling all day.

a defecatory proctogram test will show if you have pfd as well as reveal if you have any other outlet problems like a rectocele, vaginal prolapse, rectal prolapse, etc. an anal manometry also helps diagnose pelvic floor problems.

biofeedback and physical therapy can be effective in correcting pfd.

so you might want to ask your doc about getting tested for pfd. here is a good link that explains it and also the testing:

https://my.cleveland...oor-dysfunction

also ---elevating your feet on something like a footstool, shoe box, overturned waste bin or squatty potty etc while sitting on a toilet can help. this straightens out the anorectal angle and allow for a more complete evacuation. you might have to experiment a bit to find the right height. i first started with a shoe box, then a foot stool and then finally bought a squatty potty.

here is a good u tube video on how to have a bowel movement without straining. the techniques described by the physical therapist in the video are the same as what my biofeedback PT told me. it's especially important to do what she says and "make your waist wide" and push from there--not from the rectum. and yes, as you mentioned, breathing is important, too--and this is also covered in this video.






good luck with everything.


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## Musgos

best advice for extreme constipation is to do anal / rectal douching try it with warm water, test it first, if it doesnt burn your the skin of your arm wont burn you it wont burn in your large intestine

you can find them in gay shops and hook it up to your shower head, the high pressure and the warm water also estimulates the the muscles which will make them work better in the long run.

when you do this do probiotics with billion bacteria count to replenish, i made a mistake of not replenishing and i ended up having problems.


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