Digital stimulation, also known as digital rectal stimulation (DRS), is a medical procedure that involves inserting a finger or dilator into the rectum and applying circular motions to stimulate the bowel reflex. This procedure is performed to empty the reflex bowl and promote bowel evacuation in individuals with spinal cord injury (SCI) who have neurogenic bowel dysfunction (NBD).
The Procedure
The procedure is typically performed by a healthcare professional, such as a physician, nurse, or colorectal surgeon. It can be done in an ambulatory surgical center or hospital outpatient department. During the procedure, the individual lies on their left side with their knees bent, and a disposable pad is placed under their buttocks to provide comfort.
A dilator, which is a finger or a lubricated, flexible tube, is inserted into the rectum. The dilator is moved in a circular motion to stimulate the wall of the rectum. The procedure is usually performed slowly and with gentle pressure to avoid injury to the rectal mucosa.
After the procedure, the individual may experience a sensation of increased rectal pressure or discomfort due to the stimulant effect of the procedure. The procedure is generally well-tolerated, and most people do not experience severe side effects.
Efficacy and Outcomes
Digital stimulation has been studied extensively in individuals with SCI and NBD. Studies have shown that digital stimulation can be an effective method of treating neurogenic bowel dysfunction in SCI patients. The procedure can help promote regular bowel movements, reduce constipation, and improve quality of life.
One study found that digital stimulation resulted in a significant increase in colonic transit time, which indicates that the procedure can aid in the movement of stool through the large intestine. Additionally, digital stimulation has been shown to reduce the severity of constipation and the need for enemas in individuals with SCI and NBD.
Indications and Contraindications
Digital stimulation is typically contraindicated in individuals with a history of fecal incontinence or in those with a significant decrease in rectal tone. It is also generally not recommended for individuals who have a history of radiation therapy to the pelvis.
Safety and Complications
Digital stimulation is generally considered safe when performed by an experienced healthcare professional. However, as with any medical procedure, there is a risk of complications, including rectal irritation, bleeding, or tear in the rectal mucosa.
If complications do occur, treatment typically involves management of the complaint. Digital stimulation should not be initiated in individuals with severe rectal inflammation or infection.
Conclusion
Digital stimulation represents a safe and effective option for managing neurogenic bowel dysfunction in individuals with spinal cord injury. It can promote regular bowel movements, reduce constipation, and improve overall quality of life. However, the procedure should be performed by experienced healthcare professionals, and individuals should be made aware of the potential risks before undergoing the procedure. Further research is needed to better understand the long-term effects of digital stimulation on the spinal cord injury population as a whole.
