Rectal Foreign Body Overview
The rectum is that part of the bowel leading to the anus, the opening stool passes through to move outside the body. Any object inserted or present in the rectum or anus should be removed to prevent serious complications.
Rectal Foreign Body Causes
The majority of objects found in the rectum have been introduced through the anus. But sometimes a foreign body may be swallowed, pass through the digestive tract, and eventually get stuck in the rectum.
Common examples found in the rectum include:
- Fruits and vegetables
- Objects designed to be placed in the anus (such as vibrators or dildos)
Foreign bodies may be found in the rectum:
- In children
- In psychiatric patients
- In victims of assault
- As a result of injury caused by medical practitioners (an example would be a broken enema catheter tip)
- As a result of an object being used for sexual gratification
Rectal Foreign Body Symptoms
The majority of people with an object in their rectum may have no signs or symptoms. This can make the diagnosis very difficult, especially with children and with psychiatric patients.
In some cases, especially if there has been a delay in seeking medical help, a complication may have developed that causes symptoms. The symptoms most likely to be found include:
When to Seek Medical Care
Seek emergency medical help if you think you have a foreign object in your rectum and you have abdominal pain, bleeding, or fever.
Otherwise, if you know you have an object in your rectum, or think you do, seek medical help to remove it as soon as possible.
It is likely that most doctors will not have the equipment in their offices that may be required to safely remove the object. So a hospital's emergency department may be the best place to go.
Exams and Tests
Most doctors will perform a careful history. They will do this in a non-judgmental way, but out of necessity will have to ask some very personal questions.
Doctors will particularly want to know:
- Exactly what the object is (or could be in the case of children or psychiatric patients who cannot give a history)
- How long it has been there
- What attempts have been made already to try to remove it
The doctor will also want to know about abdominal pain, fever or temperature, and whether there has been any evidence of rectal bleeding.
An examination will follow the history. This will include a careful examination of the abdomen and a rectal examination.
- The doctor will position you on your side and examine the anal region for evidence of tears, cuts, or bruising.
- A digital examination will then be performed. The doctor will use a gloved finger for this.
- Sometimes the doctor will use an object called a proctoscope, which is passed into the anus. This instrument is like a short, hollow tube that allows the doctor to look inside and actually see the object. Obviously, if the object is very fragile—a light bulb, for example—the proctoscope needs to be performed with a great deal of care, if it is done at all.
After the examination, the doctor may ask for an X-ray of the abdomen to see exactly where the object is. The doctor will also be looking to see that there is no "free air" in the abdomen, which would indicate that the bowel has been perforated. If you have abdominal pain, or bleeding, or fever, then an IV line would be started and you would have some blood tests done.
Rectal Foreign Object Treatment - Self-Care at Home
As a general rule, most people who have a foreign object in their rectum that cannot be seen or felt outside the anus need to seek medical attention. Many people, probably through embarrassment or fear of ridicule, will attempt to remove the item themselves. This is often very difficult and can only be accomplished by a doctor.
Most laxatives are too slow in onset to be effective. The sooner an object in the rectum is removed the better.
In some cases, the object is close enough to the anus that it can be removed in the emergency department. One of the big problems with trying to remove an object from the rectum, is that there is a strong suction between the object and the rectum walls.
- Sometimes the doctor will pass a tube between the object and the wall of the rectum to try to equalize the pressure as the object is removed. This is uncomfortable, and you will be sedated for this procedure.
- If the object is far into the rectum, its removal may need to be done in an operating room where you'll receive a general anesthetic.
- If there are signs of infection in the abdomen, a hole in the bowel, or heavy bleeding from the anus, you may need emergency surgery.
After the object has been removed, the doctor will perform an examination called a sigmoidoscopy, using a long, narrow tube (about 16-18 inches long and a little less than an inch wide) to look inside the anus and rectum. This is done to be sure there has not been any damage to the lining of the bowel, either from the initial insertion of the object or from attempts to remove it.
- With children, an examination should nearly always be performed under anesthesia. This is also true for uncooperative psychiatric patients.
- People who are victims of sexual assault should have a very careful examinations performed, to be certain there has been no injury to the wall of the bowel. This may be best done under general anesthesia.
Next Steps - Follow-up
Return to the doctor's office or emergency department if you develop any of these complications:
- Abdominal pain
- Rectal bleeding
There should be no limitations on general activity, unless you were sedated in order to remove the object. If so, do not drive for 24 hours afterward. Further rectal insertions should probably be avoided for a few days to allow bruising and swelling to settle.
If you engage in erotic play, then use a vibrator or erotic toy designed for the purpose of insertion into the rectum. These items usually come with a flange to prevent them from slipping into the anus.
Most people who receive treatment for an object in their rectum and will not have any long-term complications or problems.
A small number of people will have significant injury. This is seen particularly in cases where the diagnosis is difficult -- in the very young and in psychiatric patients -- or where the person has delayed seeking treatment. Complications may also be present when a violent sexual assault has occurred. In these cases,significant and severe abdominal injury and infection are possible. As a result, they may require a colostomy (where the bowel is brought up to the skin surface and the stool is passed into a bag). Or they may require antibiotics and a long stay in the hospital.
In very rare cases, the injury may be so severe that the person dies of the complications.
Media file 1: A vibrator in the rectum. The battery pack is clearly visible on x-ray, and the outline of a vibrator in the rectum can be seen. It was still vibrating when this person came to the emergency department.
Media type: X-RAY
Synonyms and Keywords
object in rectum, sigmoidoscopy, rectum, rectal foreign object, rectal foreign body, digital examination, proctoscope, anus, foreign body, rectal foreign body removal