Are your bowels ever completely empty?

Your bowels work hard to eliminate waste from your body. This involves a complex process of digestion, absorption of nutrients, and elimination of indigestible material as stool. But even when you have a bowel movement, you may wonder if your bowels are ever truly empty. There are several factors that impact whether your bowels feel empty or not. Let’s explore this topic in more detail.

What is considered a normal bowel movement?

Normal bowel habits vary quite a bit from person to person. Generally speaking, most people have a bowel movement anywhere from three times a day to three times a week. Stools should pass easily and be a medium brown color. The texture is soft but formed, similar to a banana. You should not have to strain or experience pain when having a normal bowel movement.

The amount of stool passed also varies. Anywhere from 4 ounces to a pound and a half of stool can be considered normal on a given day. Anything outside of your personal normal range may indicate a problem with digestion or absorption.

Why might your bowels not empty completely?

There are several reasons why you might not feel completely empty after a bowel movement:

Constipation

Constipation occurs when stool passes through the large intestine too slowly. This causes an excessive amount of water to be absorbed from the stool, making it hard, dry, and difficult to pass. Stools may be small and you feel unable to completely empty.

Diarrhea

On the other end of the spectrum, diarrhea means stool passes through the colon too quickly. This prevents the colon from absorbing enough water, resulting in loose, watery stools. The urge to go is frequent and urgent. Although you may go several times in a short period, you might still feel like you were unable to completely empty.

Hemorrhoids

Swollen veins in the anus and rectum can protrude and block stool from passing. The pain and pressure this causes can prevent complete evacuation. Hemorrhoids may also cause mucus discharge, causing the feeling of incomplete emptying.

Pelvic floor dysfunction

The pelvic floor muscles support pelvic organs, including the bladder, uterus, and rectum. Weakness in these muscles can prevent complete emptying of the bowels. Straining or pushing does not always fully help. Pelvic floor physical therapy can be beneficial.

Rectal prolapse

A rectal prolapse is when the rectal lining slips down and protrudes from the anus. This can create a physical obstruction preventing complete emptying. Mild prolapse may not show externally, but you can still feel like stools are trapped internally.

Anal fissures

Anal fissures are small tears in the lining of the anus. These can cause pain and spasm of the anal sphincter muscle. Trying to avoid this pain can prevent complete bowel emptying. Fissures typically heal within a few weeks.

Nerve damage

Nerves control the contractions of intestinal muscles that move stool through your bowels. Neurological conditions that affect these nerves can impair normal function. Damaged nerves may not properly signal when the rectum is full, resulting in incomplete evacuation.

Colorectal polyps or cancer

Colorectal polyps are growths that form on the lining of the colon and rectum. While often non-cancerous, large polyps can obstruct the passage of stool. Colorectal cancer can also block the bowels, leading to feelings of incomplete emptying.

Enlarged prostate

In men, an enlarged prostate can press on the rectum, preventing it from fully emptying. Urinary symptoms are also common. Medications, surgery, or other treatments can help shrink the prostate.

Rectocele

A rectocele is a bulge or pocket that forms in the front wall of the rectum. Stool can get caught in this bulging area, making you feel like you can’t empty completely. They are more common in women who have had children.

Scar tissue

Past injuries, radiation treatment, or surgery on the colon, rectum, or anus can cause scar tissue. This may make the opening of the rectum narrower or less elastic, impairing complete bowel emptying.

Obstructed defecation

In some cases, the structure of the anus and rectum may simply make it anatomically difficult to empty completely. This includes impaired relaxation of the puborectalis muscle or anismus. Biofeedback training can retrain muscles.

How can you tell if you are emptying completely?

It’s not always easy to know if your bowel movements are eliminating all contents from your colon and rectum. Signs of incomplete evacuation include:

– Feeling like you still need to go after a bowel movement

– Straining but only passing small amounts

– Passing stools frequently without relief

– Abdominal pain or bloating

– Hard, dry, or pellet-like stools

– Thin, ribbon-like stools

– Incomplete bowel movements for several days

– Gas, mucus, or liquid discharge after a bowel movement

– Tenesmus – a constant urge to pass stool but inability to

If you regularly experience these symptoms, see your doctor to identify any underlying causes. You may need testing such as a colonoscopy to visualize the rectum and rule out blockages.

Tips for more complete evacuation

If you feel like your bowels never empty completely, there are some techniques you can try at home:

– Go to the bathroom when you feel the urge, don’t hold it

– Take your time to allow full elimination

– Try resting your feet on a step stool to straighten your posture

– Lean forward to open up the rectum more

– Gently press on the abdomen and perineum to aid evacuation

– Splash some warm water on the anus to stimulate bowel movements

– Lightly massage around the anus after bowel movements

– Stay well hydrated to keep stool soft

– Increase fiber intake to add bulk to stool

– Consider glycerin suppositories as needed to stimulate bowel movements

– Practice pelvic floor exercises to strengthen rectal muscles

Medical treatments for incomplete emptying

If lifestyle and at-home remedies are not effective, there are several medical options to improve bowel emptying:

– **Laxatives and stool softeners** – Osmotic laxatives pull fluid into the bowels, while stimulant laxatives increase muscle contractions. Both can aid complete emptying.

– **Fiber supplements** – Adding bulk and softness to the stool makes bowel movements easier. Psyllium husk is a common choice.

– **Biofeedback training** – This helps retrain pelvic floor muscles and improves coordination of rectal emptying.

– **Surgery** – Those with structural abnormalities of the colon, rectum, or anus may benefit from surgical repair.

– **Botox injections** – Paralyzing muscles that impair emptying with Botox can provide temporary improvement.

– **Sacral nerve stimulation** – A small device implanted in the sacral nerves helps control rectal function.

– **Colonic irrigation** – Also called colon hydrotherapy, this flushes the colon with water to clean out all contents.

Are complete bowel evacuations necessary?

Many people do feel the urge to have bowel movements daily. But is this really necessary or even possible? Not necessarily.

The gastrointestinal tract is a very adaptable organ system. Your colon can compensate for variations in frequency of bowel movements. Stools can accumulate for 2-3 days without significant problems in most people.

The key is paying attention to the trends in your own regularity and consistency. As long as stools remain soft and evacuate with relative ease every couple days, your bowels are likely emptying sufficiently. Straining excessively or experiencing discomfort are signs to seek evaluation.

Mild sensations of incomplete evacuation after bowel movements a couple times a week is usually not concerning. The average person may pass just 4-6 ounces of stool per movement. So feeling somewhat empty may be the norm. Just communicate with your doctor if this sensation becomes constant.

When to see a doctor

Make an appointment with your healthcare provider if you experience:

– Chronic constipation or diarrhea
– Daily abdominal pain and bloating
– Bleeding from the rectum
– Prolapse of rectal tissue
– Tenesmus or excessive straining
– Changes in stool caliber
– Unintentional weight loss
– Persistent sensation of incomplete evacuation

Sudden onset of severe symptoms may warrant going to urgent care or the ER instead. Bleeding, obstructions, perforations, or impaction can be medical emergencies needing swift care.

Evaluation typically begins with a medical history and physical exam. Your doctor may perform a digital rectal exam to feel for masses, pain, or blockages. Blood tests look for markers of inflammation or malnutrition.

You may be referred to a gastroenterologist for further procedures like:

Diagnostic Test Purpose
Anoscopy Examines the anus and anal canal
Colonoscopy Visualizes entire rectum and colon with a camera
Sigmoidoscopy Views the rectum and lower colon
Balloon expulsion test Assesses ability to push out an inflated balloon
Anorectal manometry Measures pressure and muscle contractions
Defecography Obtains x-rays during the defecation process

Treatment will depend on the specific cause found but can include medications, supplements, biofeedback, and surgery. Getting to the root of the problem is key for restoring healthy and comfortable bowel function long-term.

When to worry

Occasional minor discomfort or feeling of incomplete bowel emptying after a movement is normal. However, you should consult a doctor if you experience:

– Persistent sensations of blockage after multiple movements
– Abdominal pain or bloating that worsens
– Bleeding from the rectum
– Prolapse of tissue through the anus
– Dizziness, weakness, or fever
– Vomiting unable to keep food down

These may indicate a partial or complete bowel obstruction that requires prompt medical attention. Severe pain with inability to pass stool at all could mean bowel perforation or impaction.

While extremely rare, neglected colonic obstruction can sometimes progress to bowel rupture or sepsis. So don’t delay seeking evaluation if symptoms are severe or persist longer than a couple days.

Prevention

You can help prevent problems with incomplete bowel emptying by:

– Drinking plenty of fluids, especially water
– Eating enough fiber – 25-30 grams per day
– Avoiding straining during bowel movements
– Not using laxatives too frequently long-term
– Doing regular physical activity
– Managing stress appropriately
– Practicing good posture while on the toilet
– Giving yourself adequate time for bowel movements
– Communicating with your doctor about changes

Maintaining regular bowel habits and healthy evacuation helps reduce your risks of needing extensive treatment down the road. Catching problems early improves the chances of addressing them effectively.

Conclusion

Feeling like your bowels never fully empty is fairly common. Causes range from mild issues like constipation or hemorrhoids to more serious conditions involving obstructions or nerve damage.

Pay attention to the frequency, consistency, and comfort of your bowel movements. Note any worrisome changes to discuss with your doctor. Simple home remedies are often effective for mild symptoms. But significant or persistent problems usually need medical evaluation.

With proper treatment guided by testing, most causes of incomplete evacuation can be successfully managed. Be patient through the process, as restoring normal rectal function can take some trial and error. But you should be able to regain comfortable and complete bowel emptying.

Leave a Comment