# Incomplete Evacuation



## jea7065 (May 18, 2015)

Hello. New to the board and glad to have found it. Been suffering with this on and off for about 5 months now. Have the urge to go and can go but still feel something left behind. Stool is not hard but pretty soft so my theory is that it is just breaking up and some is getting left behind. My normal routine for the past 20+ years was to have two BMs in the AM. I would never feel done after the first one but would feel pretty much done after the second BM. Have always been conscious of eating enough fiber and then later on drinking plenty of water. I admit I don't exercise and don't get my fiber from fruits and vegetables; mainly oatmeal and fiber bars. Been taking Metamucil for years.

So far, I have taken these steps:

1) increased the Metamucil dosage to two tablespoons a day
2) had a colonoscopy which was normal
3) took Align for a month per my GI doctor, which did nothing
4) then he ordered an anal monometry test, which was normal.
5) I had a defocogram this past Monday which didn't really show any issues. The doctor for that test was not very helpful and only had me sit on the pot for about two minutes. Soon after the test I was able to expel the barium in the restroom.
6) Also tried the foot stool thing which help the first couple of times but then didn't seem to help anymore

I have been told to just increase my fiber by my GP, the colorectal surgeon and now the GI doc. At this point I am going to go with it being a dietary issue and do research on how I can eat better to perhaps have a more well formed stool. Perhaps more natural soluble fiber? The GI doc was out of ideas so I am taking this issue to the masses in hopes to find a remedy by crowdsource.

Thanks for reading and any suggestions are much appreciated.


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## jaumeb (Sep 1, 2014)

Yeah, you probably will get some ideas reading this forum. I am currently trying boulardii.


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## jea7065 (May 18, 2015)

Thanks for the comment. Do you have issue or another variation?


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## flossy (Dec 8, 2012)

I have the same problem - incomplete evacuations.

I would decrease the amount of fiber you take and see if that helps at all. Believe it or not, about 70% of us on this board seem to think more fiber makes IBS-C and all the side effects way worse, including me.


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## jea7065 (May 18, 2015)

Thanks Flossy. What have your tried for this problem? Do you get relief sometimes after just passing gas? Not even sure it is IBS-C at this point as I don't have any abdominal issues. No cramping or pain thankfully. I have been reading so much about more fiber causing C. I may have tried that already but it was before I started logging what I was doing. I have been researching the difference between soluble vs insoluble fiber to see which can contribute to a more well formed stool.

Never thought about what type of fiber before. Just "eat more fiber", ever since I solved a similar issue like this 25+ years ago. Not totally convinced it's not a physical thing either, regardless of the results of the manometry and defocogram tests. if my recent changes of flaxseed, Pure probiotic, chia seeds, natural calm and fruit does nothing or makes things worse, I'll back off on the fiber. just not sure what type of fiber to take then


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## flossy (Dec 8, 2012)

Yes, sometimes I get relief just passing gas (lol, kinda funny).

I've been taking this the last couple of months (see link below):

http://www.ibsgroup.org/forums/topic/239065-finally-a-product-i-can-recommend/

There is a new thread on probiotics making things worse (more constipation) also. It's right here:

http://www.ibsgroup.org/forums/topic/238953-ibs-c-and-probiotics/


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## jea7065 (May 18, 2015)

Flossy, thanks for the response and advice on reducing the fiber. After many months I finally reduced it and it's been the only real positive change I have seen in close to a year. I read your thread on your recent operation. Glad to hear your better but it's a bummer your still suffering from the incompleteness feeling. I've had a ton of tests done since my original post and after 3 months of pelvic floor therapy and a shot of botox in the internal sphincter, I still get the feeling of incomplete evacuation. The reduction of fiber has helped but many many times my feeling of incompleteness is actually gas. Once passed, I feel fine but it takes hours some days. Just wondering if you have the same experience? At this point, I am going to go down the route of trying to produce less gas in the first place.

I know this board has forums on gas and diet so it's time to head there.

Thanks again and I hope you are doing well.


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## flossy (Dec 8, 2012)

jea7065 said:


> Flossy, thanks for the response and advice on reducing the fiber. After many months I finally reduced it and it's been the only real positive change I have seen in close to a year. I read your thread on your recent operation. Glad to hear your better but it's a bummer your still suffering from the incompleteness feeling. I've had a ton of tests done since my original post and after 3 months of pelvic floor therapy and a shot of botox in the internal sphincter, I still get the feeling of incomplete evacuation. The reduction of fiber has helped but many many times my feeling of incompleteness is actually gas. Once passed, I feel fine but it takes hours some days. Just wondering if you have the same experience? At this point, I am going to go down the route of trying to produce less gas in the first place.
> 
> I know this board has forums on gas and diet so it's time to head there.
> 
> Thanks again and I hope you are doing well.


I don't think this is the same thing, but sometimes when I think I need to have another BM it is just gas instead, but that's about it.


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## tummyrumbles (Aug 14, 2005)

I'm still struggling with this. I think incomplete evacuation is at the heart of IBS for just about everyone here. There's a lot of complex reasons for indigestion and the more you look into it the more complicated it is. I've started the specific carbohydrate diet and made the mistake of eating too much protein to fill up on. Protein needs carbs and fats in order to digest properly. I was reading a very interesting article this morning on "rabbit starvation" which is basically a form of starvation from eating too much lean protein. People can develop diarrhea from this condition, then die - so it's quite serious. I keep to well tolerated veges from the specific carbohydrate diet and low FODMAP diet: broccoli, carrot, beans, peas, pumpkin. No potato or corn. I try to eat these with some fatty meat like steak or pork chop or chicken with the skin on. It's not only what you eat but how you eat: overeating, eating late at night, gulping your food down, drinking water with your meals, eating when you're tense - all these things can affect digestion, and malabsorbed food (not just carbs) = gas. Gas = incomplete evacuation although no-one really seems to know how this works. I'm trying to keep my diet as simple as possible at the moment as I just want to experience a full, solid BM without the usual explosiveness etc. Breakfast is the hardest because I can't stomach the idea of veges for breakfast, so I'm sticking with porridge but will try it with lots of water and no milk. Dinner should be no later than 6.30 pm so your dinner has plenty of time to digest before you lie down.

I think the general consensus is we need a healing diet to eradicate the bacteria first. You'll never get anywhere while you still have a bacterial overgrowth, and bacteria feed on starches and sugar so you need to limit these. Other aspects are things like food opioids that are constipating - casomorphins in dairy, for instance. That's why I think heal your gut first, then try yoghurts, and FODMAPs like cabbage juice etc once it's healed. It's doing things in the right order that's important.


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## jaumeb (Sep 1, 2014)

A few of the veggies you mention are not low fodmaps: broccoli, peas, beans. Green beans are low fodmaps but other kinds of beans are not.

I gave up on the scd and I am currently eating starches in rice and potatoes. I think that scd is great for correcting a bacterial overgrowth, but in my case the problem is a fungal overgrowth. That's why 6 1/2 years on the scd didn't help me. I wish I had known this before.

And good that you mention rabbit starvation. I think I was rabbit-starving myself at some point. Scary.


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## tummyrumbles (Aug 14, 2005)

Do you mean Candida? I looked up the cure for fungal overgrowth and the diet is similar to SPC / low FODMAP with an emphasis on no sugar.

I found a really good discussion on mistakes people make when trying to cure Candida or SIBO and the biggest danger is ketosis.

http://chriskresser.com/top-4-mistakes-people-make-when-treating-candida-overgrowth/

This is what I think I was going through as I felt worse on the SCD diet even though my BMs were more solid. The main points in this discussion is not to go too low in carbs or you get into a ketogenic state, which actually helps to feed Candida. Chris Kresser says he recommends low FODMAP, not SCD, for people with fungal infection or SIBO because it's not as restrictive and allows some carbs. I started on the low FODMAP diet so will have to review my notes to see where I went wrong. Too much protein is definitely something to avoid if you have digestive problems.

Digestion is getting so confusing and complex. I've been aiming for a solid BM but really, I just want complete evacuation - nothing else really matters.


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## jaumeb (Sep 1, 2014)

Tummy, I read that interview at the end of 2014. Then, in Sept 2015 I read some stories indicating that ketosis is bad for patients with fungal overgrowth. Now I eat starch in white rice, potato and dioscoracea.


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## jea7065 (May 18, 2015)

flossy said:


> I don't think this is the same thing, but sometimes when I think I need to have another BM it is just gas instead, but that's about it.


Yep, that is where I am at as well. I've tried doing some yoga positions in order to try work it out quicker.


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## jea7065 (May 18, 2015)

tummyrumbles said:


> Digestion is getting so confusing and complex. I've been aiming for a solid BM but really, I just want complete evacuation - nothing else really matters.


Great post. And this last line rings out so true.


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## Patrick ibs c (Mar 5, 2016)

jea7065 said:


> Thanks for the comment. Do you have issue or another variation?


ive had the same problem too jea


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