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Digital Bowel Stimulationby
Veronica (Roni) Zieroff, RN, BS, CRRN When voluntary control of the anal sphincter muscle is absent (most often due to spinal cord injury or disease), "Digital Stimulation" is a technique often employed by a caregiver to induce relaxation of the sphincter and contraction of the colon, permitting scheduled evacuation of the bowel. There are basically two methods of performing this technique, 'standard' and 'scissor' methods. In the standard technique, the index finger is gloved, lubricated with water soluble lubricant jelly and gently inserted into the anal canal. The finger is then rotated against the sphincter wall. Imagine the sphincter as a circular band of putty, the center of which you are trying to enlarge. Relaxation of the sphincter generally takes between about 30 seconds and 2 minutes. As the sphincter loosens, the finger is removed. If evacuation of stool does not occur, the procedure is repeated. In the "Scissor Method", the gloved and lubricated index and middle fingers are gently inserted into the anal canal far enough to have the distal half of the fingers in contact with the anal sphincter. A scissoring motion of the fingers is used to "stretch" the sphincter open. Again, relaxation typically occurs within 30 seconds to 2 minutes. As the sphincter loosens, the fingers are removed. Autonomic dysreflexia is occasionally induced by digital stimulation. The risk of this uncomfortable and sometimes dangerous problem can be minimized by slower, gentler movements by the attendant during the stimulation maneuvers, use of Nupercainal (Dibucaine by CIBA) 1% rectal/topical ointment applied about 10 minutes before the procedure, or by use of Xylocaine Lubricant Jelly (also applied shortly before the procedure). The down side of using anesthetic ointment/lubricant is possible failure of the technique to lead to the desired enhanced colonic motility needed for evacuation. Last Updated:
09/07/05 |
©2005 Northeast Rehabilitation Health Network |