What Is Digital Evacuation?

gloved hand for medical procedure
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Digital evacuation 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 other health problem that results in a problem with defecation.

Digital evacuation may also be called:

  • DRF: digital removal of feces
  • Disimpacting stool with digital maneuvers
  • Disimpaction
  • Manual disimpaction
  • Manual elimination

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.

Dyssynergic Defectation and Digital Evacuation

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. Dyssynergic defecation is a 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.

Do You Need to Bring This to the Attention of Your Doctor?

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.

So yes, you should tell your doctor about your need to use digital evacuation in order to eliminate stool. Your doctor can do an assessment to figure out why your bowel movements are not occurring as they should. Your doctor will want to make sure that there is no disease process, structural defect, or obstruction causing the problem. If your doctor diagnoses you with dyssynergic defecation, they will work with you to help you to develop a proper treatment plan.

Manual Disimpaction and Spinal Cord Injuries

People who have spinal cord injuries may need manual disimpaction as part of their bowel management. 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. Manual disimpaction is a 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.

Araghizadeh, F. "Constipation and Functional Bowel Disease" Clinics in Colon and Rectal Surgery 2005 18:116-119.

"Manual Evacuation of Faeces" Spinal Cord Injury Research Evidence Website accessed January 25, 2016.

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