Digital Disimpaction and How It's Done

Relief for Constipation

Digital disimpaction is the use of fingers to aid in the removal of stool from the rectum. This may be done by a person who is experiencing constipation or by a medical professional who is assisting a person with a spinal cord injury or another health problem that results in a problem with defecation.

A particular form of digital evacuation in women is called vaginal splinting. This is when a woman massages the inside of her vagina in order to encourage the passage of stool from her rectum.

Related behaviors to digital evacuation include massaging the inside of the rectum, or for women, the perineum, in order to stimulate a bowel movement. Disimpaction is a treatment for fecal impaction, which can occur with some frequency in people who are pregnant, ill, or in a nursing home.

Also Known As

Digital disimpaction may also be called:

  • Digital removal of feces (DRF)
  • Disimpacting stool with digital maneuvers
  • Digital evacuation
  • Manual disimpaction
  • Manual elimination

Dyssynergic Defecation

People who experience chronic constipation due to a condition known as dyssynergic defecation appear to be most likely to engage in digital evacuation. In this condition, the nerves and muscles of the pelvic floor do not work together smoothly so as to produce a comfortable, normal bowel movement.

doctor putting on latex gloves
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Dyssynergic defecation is considered to be a type of pelvic floor dysfunction. Biofeedback or physical therapy may be recommended as a way to address the symptoms of dyssynergic defecation.

When to Talk to Your Healthcare Provider

It is not recommended that you use digital evacuation on a regular basis for evacuating stool. You run the risk of injury or of further contributing to any existing defecation dysfunction.

You should tell your healthcare provider about your need to use digital evacuation in order to eliminate stool.

Your healthcare provider can do an assessment to figure out why your bowel movements are not occurring as they should. Your healthcare provider will want to make sure that there is no disease process, structural defect, or obstruction causing the problem.

If your healthcare provider diagnoses you with dyssynergic defecation, they will work with you to help you to develop a proper treatment plan.

Spinal Cord Injuries

People who have spinal cord injuries may need manual disimpaction as part of their bowel management. Manual disimpaction is considered to be a widely used procedure as part of the care of people who have spinal cord injuries. In these cases, manual disimpaction appears to reduce the possibility of fecal soiling.

In this procedure, a single finger of a gloved hand is lubricated and inserted into the rectum of the patient. The stool is gently broken up and pieces are removed until the rectum is empty. This procedure is considered safe when conducted by a trained health professional.

Frequently Asked Questions

  • What is digital disimpaction?

    Digital disimpaction, also known as manual disimpaction, is the removal of stool from the rectum using a finger. It may be used in people with fecal impaction when all other conservative methods fail.

  • When is digital disimpaction needed?

    Digital disimpaction is typically used when laxatives or enemas are unable to resolve fecal impaction. This includes people who cannot pass stools due to a spinal cord injury, older adults with dehydration, obese persons in traction, and people who experience impaction as a result of a barium enema.

  • How is digital disimpaction performed?

    Digital disimpaction is performed by lubricating the anus and using a gloved index finger to break up and remove stool in a scooping motion. It may or may not involve sedation. General anesthesia is rarely used unless other organs are severely affected by the impaction.

  • What are the side effects of digital disimpaction?

    Digital disimpaction should only be performed by a medical professional as there are risks associated with the procedure, including rectal bleeding, anal fissures, rectal perforation, anal sphincter damage, urinary tract obstruction, and, in rare instances, fatal heart arrhythmias (typically in chronically ill older adults).

  • What other methods are used to treat fecal impaction?

    Prior to considering digital impaction, a healthcare provider will typically use enemas, osmotic laxatives, and Miralax (polyethylene glycol) to treat fecal impaction. Pulsed irrigation evacuation (PIE) is another method in which a patient rests in bed while pulsating water gently breaks up and dislodges the fecal mass. Severe cases may require surgery.

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