Table of ContentsView AllTable of ContentsWhy It HappensCausesUniversal StrategiesWith ConstipationWith DiarrheaWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Why It Happens
Causes
Universal Strategies
With Constipation
With Diarrhea
When to See a Provider
An incomplete bowel movement—the feeling that you still have to poop, even when you don’t—can be uncomfortable and frustrating.
Verywell / Cindy Chung
What Is Incomplete Evacuation?
Incomplete evacuation is the sensation that a bowel movement has not been completed even if it has. This is not an uncommon symptom affecting people with chronic (frequent or persistent)constipationor chronic diarrhea.
When you’re chronically constipated, the passage of small,hard stoolscan make the rectum, anus, and colon extra sensitive. The same can occur with chronic diarrhea, particularly when you are straining. Uncontrollable clenching sensations may also occur even when no stools are present.
There are two mechanisms that are thought to underpin incomplete evacuation in people with constipation-predominantirritable bowel syndrome(IBS-C) and diarrhea-predominant irritable bowel syndrome (IBS-D):
Straining during bowel movements can also lead tohemorrhoids, which can also cause tenderness and a feeling that “something is up there” in the rectum.
Possible causes of incomplete evacuation include:
How to Empty Your Bowels Completely
When these aren’t enough, additional treatments may be recommended depending on what condition you have.
Incomplete Evacuation With Constipation
If you have constipation, the sensation of incomplete evacuation may be accurate. Due to the difficulty in passing stool, it is likely you have not fully emptied the rectum, leaving you with feelings of dissatisfaction and discomfort.
Prescription Medications
The Food and Drug Administration (FDA) has approved two medications for treating IBS-C:Linzess(linaclotide) and Trulance (plecanatide). Both drugs are classified asguanylate cyclase activators, which target receptors in the intestines. That prompts an increase in the intestinal fluid which:
These drugs are considered safe and well-tolerated, with the most common side effect being mild to moderate diarrhea.
Although they are not approved specifically to treat IBS, tricyclic antidepressants are known to have a therapeutic effect on the gastrointestinal system. For this reason, healthcare providers may prescribe them off-label to treat IBS symptoms such asabdominal pain.
Tricyclic antidepressants help maintain serotonin levels in the gut, which reduces inflammation and promotes gut motility.Motility refers to the movement of food and stool through the intestines.
Commonly prescribed tricyclic medications include:
Self-Care Strategies
You can also try several self-care strategies at home to relieve the feeling of incomplete evacuation when you have IBS-C.
The ACG guidelines specifically state that insoluble fiber, in studies, has not been shown to improve IBS symptoms, while soluble fiber has. Insoluble fiber is found in foods like wheat bran and vegetables.
Adequate fiber intake is defined as 25 grams for adult women and 38 grams for adult men.If you’re having trouble eating enough soluble fiber, consider including afiber supplementto boost your intake.
Gut-Directed Psychotherapy
Dyssynergic defecationis a problem with the function of the nerves and muscles used to pass stool. If you believe you have this problem, you may want to look into biofeedback or physical therapy as a way to ease your symptoms.
The goal of gut-directed psychotherapy is to reduce gastrointestinal symptoms through coping strategies.
In particular, cognitive behavioral therapy (CBT) can teach muscle relaxation and breathing techniques to lower pain sensitivity and encourage the mind to better regulate gut motility.
Incomplete Evacuation With Diarrhea
Fortunately, effective therapies are available to aid with symptoms.
Prescription Medication
Xifaxan stays active in your gastrointestinal tract but is not absorbed—a factor that contributes to its safety profile, as it’s not likely to interact with other medications or become less effective over time. Side effects with rifaximin are mild and uncommon but can include:
If you pass stool that is loose and watery, it’s likely that any firm stool in the colon has already passed. Yet, nerve and muscle dysfunction can make it feel like you still need to empty your bowel.
In order to counteract this sense of urgency, it helps to remind yourself that no further stool really needs to come out.
Keep in mind that there is no such thing as a truly empty bowel, as new stool is constantly being produced. In terms of the fear of future diarrhea episodes, remember that it is easier for the muscles of the anus to contain stool that is firm than watery stool that isn’t ready to pass yet.
If you feel a constant urge to run to the toilet, try to delay yourself. Sit quietly in a spot near the bathroom and see if you can userelaxation exercisesto calm your body until the sense of urgency passes without having to make another trip to the bathroom.
Calming your body will also help to reduce any anxiety that might be causing the nervous system to continue to send out signals for further (unnecessary) emptying.
As with IBS-C, gut-directed psychotherapy such as CBT is recommended as a complementary therapy that improves IBS symptoms and the distress that can accompany them.
When to See a Healthcare Provider
Summary
Incomplete evacuation, the sensation that a bowel movement is not complete, is common in people with chronic constipation and chronic diarrhea, particularly those with irritable bowel syndrome (IBS).
In people with constipation-predominant IBS (IBS-C), treatment options include a high-fiber diet, bowel retraining, gut-directed psychotherapy, and pharmaceutical drugs like Trulance and Linzess.
In people with diarrhea-predominant IBS (IBS-D), options include bowel retraining, gut-directed psychotherapy, and the antibiotic Xifaxan.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Choi YJ, Kim N, Yoon H, et al.Overlap between irritable bowel syndrome and functional dyspepsia including subtype analyses.J Gastroenterol Hepatol. 2017 Feb;32(9):1553-1561. doi:10.1111/jgh.13756Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016 Oct;22(4):558-574. doi:10.5056/jnm16001International Foundation for Gastrointestinal Disorders: AboutConstipation.org.Causes of constipation.International Foundation for Gastrointestinal Disorders.Chronic constipation.Centers for Disease Control and Prevention.Colorectal cancer basics.International Foundation for Gastrointestinal Disorders.Diverticulosis and diverticulitis.International Foundation for Gastrointestinal Disorders.Inflammatory bowel disease.International Foundation for Gastrointestinal Disorders.Motility disorders.International Foundation for Gastrointestinal Disorders.Dyssynergic defecations: About a common cause of constipation.Vahora IS, Tsouklidis N, Kumar R, Soni R, Khan S.How serotonin level fluctuation affects the effectiveness of treatment in irritable bowel syndrome.Cureus. 2020 Sep;12(8):c36. doi:10.7759/cureus.c36Dahl W, Stewart M.Position of the Academy of Nutrition and Dietetics: Health implications of dietary fiber.JAND. 2015 Nov;115(11):1861-1870. doi:10.1016/j.jand.2015.09.003Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul;22(3):423-435. doi:10.5056/jnm16060Riehl M.The emerging role of brain-gut therapies for irritable bowel syndrome.Gastroenterol Hepatol. 2018 Jul;14(7):436-438.Karuppiah S, Pomianowski K.Rifaximin (Xifaxan) for irritable bowel syndrome.Am Fam Physician.2017;95(4):258-259.Kinsinger SW.Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights.Psychol Res Behav Manag. 2017;10(1):231-237. doi:10.2147/PRBM.S120817Additional ReadingShim SE, Jones M, Prott GM, Morris LI, Kellow JE, Malcolm A.Predictors of outcome of anorectal biofeedback therapy in patients with constipation.Alimentary Pharmacology and Therapeutics.2011;33: 1245-1251.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Choi YJ, Kim N, Yoon H, et al.Overlap between irritable bowel syndrome and functional dyspepsia including subtype analyses.J Gastroenterol Hepatol. 2017 Feb;32(9):1553-1561. doi:10.1111/jgh.13756Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016 Oct;22(4):558-574. doi:10.5056/jnm16001International Foundation for Gastrointestinal Disorders: AboutConstipation.org.Causes of constipation.International Foundation for Gastrointestinal Disorders.Chronic constipation.Centers for Disease Control and Prevention.Colorectal cancer basics.International Foundation for Gastrointestinal Disorders.Diverticulosis and diverticulitis.International Foundation for Gastrointestinal Disorders.Inflammatory bowel disease.International Foundation for Gastrointestinal Disorders.Motility disorders.International Foundation for Gastrointestinal Disorders.Dyssynergic defecations: About a common cause of constipation.Vahora IS, Tsouklidis N, Kumar R, Soni R, Khan S.How serotonin level fluctuation affects the effectiveness of treatment in irritable bowel syndrome.Cureus. 2020 Sep;12(8):c36. doi:10.7759/cureus.c36Dahl W, Stewart M.Position of the Academy of Nutrition and Dietetics: Health implications of dietary fiber.JAND. 2015 Nov;115(11):1861-1870. doi:10.1016/j.jand.2015.09.003Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul;22(3):423-435. doi:10.5056/jnm16060Riehl M.The emerging role of brain-gut therapies for irritable bowel syndrome.Gastroenterol Hepatol. 2018 Jul;14(7):436-438.Karuppiah S, Pomianowski K.Rifaximin (Xifaxan) for irritable bowel syndrome.Am Fam Physician.2017;95(4):258-259.Kinsinger SW.Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights.Psychol Res Behav Manag. 2017;10(1):231-237. doi:10.2147/PRBM.S120817Additional ReadingShim SE, Jones M, Prott GM, Morris LI, Kellow JE, Malcolm A.Predictors of outcome of anorectal biofeedback therapy in patients with constipation.Alimentary Pharmacology and Therapeutics.2011;33: 1245-1251.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Choi YJ, Kim N, Yoon H, et al.Overlap between irritable bowel syndrome and functional dyspepsia including subtype analyses.J Gastroenterol Hepatol. 2017 Feb;32(9):1553-1561. doi:10.1111/jgh.13756Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016 Oct;22(4):558-574. doi:10.5056/jnm16001International Foundation for Gastrointestinal Disorders: AboutConstipation.org.Causes of constipation.International Foundation for Gastrointestinal Disorders.Chronic constipation.Centers for Disease Control and Prevention.Colorectal cancer basics.International Foundation for Gastrointestinal Disorders.Diverticulosis and diverticulitis.International Foundation for Gastrointestinal Disorders.Inflammatory bowel disease.International Foundation for Gastrointestinal Disorders.Motility disorders.International Foundation for Gastrointestinal Disorders.Dyssynergic defecations: About a common cause of constipation.Vahora IS, Tsouklidis N, Kumar R, Soni R, Khan S.How serotonin level fluctuation affects the effectiveness of treatment in irritable bowel syndrome.Cureus. 2020 Sep;12(8):c36. doi:10.7759/cureus.c36Dahl W, Stewart M.Position of the Academy of Nutrition and Dietetics: Health implications of dietary fiber.JAND. 2015 Nov;115(11):1861-1870. doi:10.1016/j.jand.2015.09.003Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul;22(3):423-435. doi:10.5056/jnm16060Riehl M.The emerging role of brain-gut therapies for irritable bowel syndrome.Gastroenterol Hepatol. 2018 Jul;14(7):436-438.Karuppiah S, Pomianowski K.Rifaximin (Xifaxan) for irritable bowel syndrome.Am Fam Physician.2017;95(4):258-259.Kinsinger SW.Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights.Psychol Res Behav Manag. 2017;10(1):231-237. doi:10.2147/PRBM.S120817
Choi YJ, Kim N, Yoon H, et al.Overlap between irritable bowel syndrome and functional dyspepsia including subtype analyses.J Gastroenterol Hepatol. 2017 Feb;32(9):1553-1561. doi:10.1111/jgh.13756
Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016 Oct;22(4):558-574. doi:10.5056/jnm16001
International Foundation for Gastrointestinal Disorders: AboutConstipation.org.Causes of constipation.
International Foundation for Gastrointestinal Disorders.Chronic constipation.
Centers for Disease Control and Prevention.Colorectal cancer basics.
International Foundation for Gastrointestinal Disorders.Diverticulosis and diverticulitis.
International Foundation for Gastrointestinal Disorders.Inflammatory bowel disease.
International Foundation for Gastrointestinal Disorders.Motility disorders.
International Foundation for Gastrointestinal Disorders.Dyssynergic defecations: About a common cause of constipation.
Vahora IS, Tsouklidis N, Kumar R, Soni R, Khan S.How serotonin level fluctuation affects the effectiveness of treatment in irritable bowel syndrome.Cureus. 2020 Sep;12(8):c36. doi:10.7759/cureus.c36
Dahl W, Stewart M.Position of the Academy of Nutrition and Dietetics: Health implications of dietary fiber.JAND. 2015 Nov;115(11):1861-1870. doi:10.1016/j.jand.2015.09.003
Rao SS, Patcharatrakul T.Diagnosis and treatment of dyssynergic defecation.J Neurogastroenterol Motil. 2016 Jul;22(3):423-435. doi:10.5056/jnm16060
Riehl M.The emerging role of brain-gut therapies for irritable bowel syndrome.Gastroenterol Hepatol. 2018 Jul;14(7):436-438.
Karuppiah S, Pomianowski K.Rifaximin (Xifaxan) for irritable bowel syndrome.Am Fam Physician.2017;95(4):258-259.
Kinsinger SW.Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights.Psychol Res Behav Manag. 2017;10(1):231-237. doi:10.2147/PRBM.S120817
Shim SE, Jones M, Prott GM, Morris LI, Kellow JE, Malcolm A.Predictors of outcome of anorectal biofeedback therapy in patients with constipation.Alimentary Pharmacology and Therapeutics.2011;33: 1245-1251.
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