Gloves
lubricant
underpads/chucks
toilet paper/wipes/washcloths
bag for waste
Wash your hands
Prepare all necessary supplies and place within reach of where you normally do your bowel program (e.g. bed, commode chair, or toilet)
Place pads/chucks as needed to keep area clean from stool
Position yourself either on the chair/toilet or on laying on your left side with your knees slightly bent if in bedÂ
Don gloves and apply lubricant (or lidocaine gel if using) to the finger you are performing the stimulation with
Insert finger into rectum and gently clear out any stool EASILY within reach of your finger, DO NOT be overly aggressive as this can cause unnecessary irritation/bleeding
If using a suppository or mini-enema, go ahead and insert it taking care to place it within contact of the side wall of the rectum. The suppository will not be as effective if inserted dead center into the rectum or into the middle of stool. Wait 10-15 minutes for medication to work.
After waiting, insert your finger into the rectum and past the sphincter. Gently move your finger in a circular motion, gently stretching the sides of the rectum, you may feel the sphincter or rectum relax while you do this. Continue for 20-60 seconds or until stool appears, remove finger as needed to allow stool to pass.
If no results after 1 minute of stimulation, stop and wait 5-10 minutes before re-attempting digital stimulation again
If stool stops passing when stimulation is stopped, continue stimulating until no more stool passes
When stool no longer passes, wait 5-10 minutes and perform one last digital stimulation. Bowel program is done when additional digital stimulation attempts produce no more stool or only mucus comes out. Most patients require 2-3 rounds of digital stimulation. Avoid stimulating more than 4 times as you risk irritating the rectum and may cause bleeding.
Clean up
It is sometimes helpful to put on 2-3 layers of gloves in the beginning and peel off the soiled layers as needed
Some people respond best if they time their bowel program to be after a meal or after drinking a warm beverage like tea or coffee
The first few days after a change in your bowel program or medications can cause constipation and/or diarrhea but we recommend you keep doing your program as prescribed for at least 1-2 wks to give your bowels a chance to adapt to the new pattern
You can help stimulate your bowels both before your bowel program and while waiting in between digital stimulation attempts by massaging your belly in a clockwise direction