Table of ContentsView AllTable of ContentsReasons for Digital DisimpactionProcedureRisks and ConsiderationsAlternative Treatments
Table of ContentsView All
View All
Table of Contents
Reasons for Digital Disimpaction
Procedure
Risks and Considerations
Alternative Treatments
Digital disimpaction is used whenlaxativesorenemasare unable to resolve fecal impaction. For this procedure, a single finger of a gloved hand is lubricated and inserted into the rectum. The stool is gently broken up and removed in pieces until the rectum is cleared.
This article explains how digital disimpaction is done and the cases in which it’s most often helpful. It also discusses the risks, as well as offering some alternatives to digital disimpaction.
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Also Known AsDigital disimpaction may also be called:Digital removal of feces (DRF)Disimpacting stool with digital maneuversDigital evacuationManual disimpactionManual elimination
Also Known As
Digital disimpaction may also be called:Digital removal of feces (DRF)Disimpacting stool with digital maneuversDigital evacuationManual disimpactionManual elimination
Digital disimpaction may also be called:
Here are three reasons why digital disimpaction may be needed.
Fecal Impaction
Fecal impaction is a solid stool that is “stuck” in the rectum, typically as a result of chronic constipation. In addition to pain and bloating, fecal impaction can cause theoverflow of diarrheaas fluids build behind the blockage. If left untreated, it can lead to ulcers, bleeding, and even tissuenecrosis(death).
Causes and risk factors of fecal impaction include:
Dyssynergic Defecation
People who experience chronic constipation due to a condition known asdyssynergic defecationare most likely to require digital evacuation.
Dyssynerigic defecation occurs when the nerves and muscles of the pelvic floor do not work together smoothly so as to produce a normal bowel movement.Essentially, the organs that facilitate a bowel movement are “out of sync.”
Also known asanismus, dyssynergic defecation is considered a type ofpelvic floor dysfunction. Since defecation requires the voluntary contractions of theanal sphincter, the condition generally stems from the inability to voluntarily control these muscles.
Causes include:
Biofeedbackand physical therapy may also be recommended as a means to relax and better focus on anal sphincter control.
Spinal Cord Injuries
People withspinal cordinjuries may need digital disimpaction as part of their daily bowel management. Manual disimpaction is considered a standard practice of care for people with severe injuries.
Motor vehicle accidents and severe falls are the most common cause of spinal cord injuries, but they can also be the result of a degenerative spinal condition, orspinal lesionsand tumors.
The loss of bowel function occurs in 68% of people with spinal cord injury and 100% of those with permanent full injuries.
Paralysis
How to Perform Digital Disimpaction
A digital disimpaction is usually done daily or every other day, depending on the individual. The first step is to gather needed supplies, including:
Sterile gloves are key to personal hygiene and avoiding infection, and should be changed after use.The next steps of a digital disimpaction are as follows:
When to Call a Healthcare Provider
The Different Types of Endoscopy Procedures
It is not recommended that you use digital evacuation on a regular basis. You run the risk of injury, includinganal fissuresor rectal perforation, as well as hemorrhoids and infection. It can also worsen your condition if the anal sphincter is damaged.
In rare instances, fatal heart arrhythmias (irregular heartbeats) have been known to occur, most often in chronically ill older adults.
Your healthcare provider can do an assessment to figure out why your bowel movements are not normal. They will identify the underlying cause—whether it be a disease, structural defect, or obstruction—in order to determine the appropriate short- and long-term solutions.
How Constipation Is Diagnosed in Adults
Pulsed irrigation evacuation (PIE) is a method in which a person lies in bed while pulsating water gently breaks up and dislodges the fecal mass. It can be used with a balloon attachment that creates a seal when a speculum is inserted into the rectum, allowing water to stay in for a short time. It also is used to remove fecal matter ahead of a colonoscopy.
A particular form of digital evacuation in women is calledvaginal splinting. This involves massaging the inside of the vagina to encourage the passage of stool from the rectum.It may also help to massage the inside of the rectum orperineumin order to stimulate a bowel movement.
Summary
Digital disimpaction is the removal of stool from the rectum using a gloved finger. It is used when a person is unable to pass stools due to severe constipation, fecal impaction, dyssynergic defecation, and spinal cord injuries.
Digital disimpaction is considered a short-term solution when all other reasonable options have failed. The regular use of digital disimpaction can cause hemorrhoids, anal fissures, rectal perforation, infection, and the worsening of defecation problems.
12 Sources
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Pepe J, Murphy MM, O’Connell KP, Zabbo CP.Fecal impaction with multisystem organ involvement.Clin Pract Cases Emerg Med,2017 Mar;1(1):56-8. doi:10.5811/cpcem.2016.12.32754
University of Iowa Hospitals & Clinics.Dyssynergic defecation.
Rao SS, Patcharatrakul T.Diagnosis and Treatment of Dyssynergic Defecation.J Neurogastroenterol Motil. 2016 Jul 30;22(3):423-35. doi:10.5056/jnm16060.
Abedi A, Kohli P, Montero S, Morales L, Ha N, Abedi A,et al.Content, face, and construct validity of the Irritable Bowel Syndrome Quality of Life (IBS-QOL) as a measure of bowel-related quality of life in spinal cord injury.Neurourol Urodyn. 2023 Aug;42(6):1362-1373. doi:10.1002/nau.25201.
Shepherd Center.Manual Evacuation.
Piga E, Öberg S, Andresen K.Christmas article: Active fingers during manual disimpaction makes gloves permeable to smell.Ugeskr Laeger. 2020 Dec 7;182(50):V71107. PMID: 33280656.
Thomas MJ, Nanagiri A, Duvidovich S, Levy L, Bamji N.Mission Disimpaction: Endoscopic Management of Stercoral Colitis in an Adolescent.JPGN Rep. 2023 Mar 9;4(2):e300. doi:10.1097/PG9.0000000000000300.
Alburakan A, Alshunaifi A, AlRabah R, Alshammari S, Alnasser S, Nouh T.Chronic constipation that resulted in fecal impaction and colon perforation: A case report.Medicine (Baltimore). 2022 Aug 26;101(34):e30206. doi:10.1097/MD.0000000000030206.
Leung AK, Hon KL.Paediatrics: how to manage functional constipation.Drugs Context. 2021 Mar 26;10:2020-11-2. doi: 10.7573/dic.2020-11-2.
Canakis A, Guo L, Parsons D, Shah H, Jacobson BC.Use of a Second-Generation Irrigation Device May Shorten Time to Successful Inpatient Colonoscopy: A Case Series.ACG Case Rep J. 2022 Sep 14;9(9):e00861. doi: 10.14309/crj.0000000000000861.
Abbott R, Ayres I, Hui E, Hui KK.Effect of perineal self-acupressure on constipation: a randomized controlled trial.J Gen Intern Med. 2015;30(4):434-9. doi:10.1007/s11606-014-3084-6
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