After a spinal cord injury, it is common to no longer feel the need to empty your bowel. You also might not be able to start your bowel movement like you used to. Digital stimulation (rectal touches) is a technique where a finger is inserted into the rectum. Gently touching (stimulating) the wall of the rectum can help trigger bowel movements. This helps move stool (feces, poo) out of your bowel. By using this technique, your bowel can be trained to go at specific times. This helps prevent bowel accidents and constipation.
Digital stimulation can be done alone on a regular toilet or commode. It can also be done while lying in bed. Depending on your set up, you can reach to the side or behind.
If you need to lie down, do it on your left side. It is more comfortable and easier due to the shape of your bowel. Sitting on a commode or raised toilet seat with a side cut out makes it easier to reach. Using this position, gravity helps with stool removal.
- Blue Pads (if in bed)
- Toilet paper and wet wipes
- Plastic bag for waste
- Wash your hands. Put a glove on your stronger hand
- If you are in bed, lay out blue pads under your hips and behind your bum
- Position yourself so that you are able to reach your anus
- Lubricate your index finger with lots of lubricant (about the size of a quarter).
- Gently insert your finger into your rectum.
- Move your finger in a circular motion against wall of rectum, for about 30 seconds.
- Remove your finger and wait for stool to pass. As stool comes out, it will go onto the pad.
- Repeat this procedure every 5-10 minutes until your bowel is empty. Finish when no stool comes out after two procedures 5-10 minutes apart.
- Clean your bum and anus with wet wipes or toilet paper.
- Place all used supplies into a plastic bag. Dispose of it into waste can.
You may need to start your bowel movement by inserting a suppository. This is often the case if your injury level is at or above T12. For a suppository to work, it needs to be touching the wall of the rectum. Before inserting, check to see if there is stool in the rectum with a gloved finger. If there is stool, remove some of it by gently hooking it with your finger. If you insert the suppository into the stool, it will not work.
To insert the suppository, lubricate it along with your gloved finger. Insert the suppository past the anal sphincter and against the wall of the rectum. Wait 10 to 15 minutes for it to take effect. Inserting the suppository in bed can be preferred. Inserting it while on a commode or toilet can cause it to fall out.
Eat fiber: Foods high in fiber help move stool through your bowel faster. It can also help keep stools well formed. Try to eat at least 15 to 30 grams of fiber each day.
Drink water: Drinking lots of water helps to move stool through your bowel more easily. Try to drink 2 to 3 liters of water each day.
Regular exercise: Regular exercise can help you stay regular and have easier bowel routines. Try to do at least 20 minutes of aerobic exercise two times per week. Also, do strength training at least 2 times per week.
Know your diet: Your diet can greatly affect your bowel routine. It often takes some trial and error to find out what works for you.
Changes in your bowel routine: Check your stool for colour, quantity, and consistency. Your bowel routine can be affected by your diet or your health. Speak with your doctor if you have major changes in your bowel routine or if you notice blood in your stool.
Hemorrhoids: A hemorrhoid is a small grape sized swelling of tissue around your anus. During digital stimulation, you may notice hemorrhoids. They can cause small amounts of blood on your finger or in your stool. If you have hemorrhoids, speak with your doctor.
Autonomic dysreflexia (AD): Having a full bowel or bladder are the main causes of AD. If you have a complete spinal cord injury at level T6 or above, you are at risk of having AD. AD is a dangerous rise in blood pressure and is a medical emergency. If your blood pressure rises 20-40mmHg and you have symptoms, you have AD. You need to do something right away. If not treated, AD can cause stroke, seizures, and death. To learn more, check out the Spinal Cord Essentials Autonomic Dysreflexia handout.
If you have symptoms of AD, you should empty your bladder and bowel as soon as possible:
- Pounding headache
- Sweating or flushing of the face
- Goose bumps
- Increased muscle spasms
- Metallic taste in your mouth
- Feeling of anxiety
- Nasal congestion
- Blurred vision
- Seeing spots
- Difficulty breathing
- Slow heart rate
Sometimes digital stimulation can cause AD. Using a numbing gel can help. Speak to your doctor about which gel is right for you.