What Is Rectal Foreign Body Removal Procedure?

The doctor will take the patient’s complete history to know if the cause of the problems is a rectal foreign body.

The Rectum is the part after your bowel where the stools get collected before expulsion from the anus. 

A rectal foreign body is an object that has been introduced manually through the anus and that gets stuck in the rectum. It is quite rare that an ingested object passes through the entire gastrointestinal tract and gets stuck in the rectum.

Examples of rectal foreign bodies include:

• Bottles
• Sex toys like dildos and vibrators 
• Fruits and vegetables
• Balls
• Toothbrushes
• Sports equipment
• Cell phones
• Wooden rods
• Aerosol canisters
• Christmas ornaments
• Cocaine pockets
• Thermometers

The reasons for the insertion of objects in the anus include:

• Autoeroticism: Sexually arousal by oneself.
• Concealment: Drug addicts conceal the drugs in their anus during police raids.
• Attention-seeking behavior: Usually found in psychiatric patients.
• Accidental: Objects may be inserted out of shame or guilt, rectal thermometer while checking the temperature. 
• Assault: Objects may be inserted into the victim’s anus during sexual assaults.

Most of the people who have a rectal foreign body do not experience any signs or symptoms. 

Some patients present to the clinic immediately after they realize that they cannot remove the rectal foreign body by themselves, whereas others turn up to the clinic when they start facing the following problems:

• Rectal pain
• Abdominal pain
• Constipation
• Obstipation (unable to pass stools and gas)
• Bleeding through anus
• Bowel incontinence

The doctor will take the patient’s complete history to know if the cause of the problems is a rectal foreign body.

The doctor will perform the following examinations on the patient:

• Abdominal examination. The abdomen will be checked if there are any complications due to the object.
• Digital rectal examination. Fingers will be inserted in the rectum to feel the object.

If the patient says he/she has inserted an object in his/her rectum, but above examinations do not yield any sign of the object’s presence, the doctor will ask for an X-ray of the abdomen to visualize it.

Once the presence of the rectal foreign body has been confirmed, the doctor will attempt at removing it in the emergency department. This can only be done if the object is felt by the digital rectal examination or is within 10 cm of the anal margin.

• Painkillers or sedatives will be given to the patient so that he/she feels less pain throughout the rectal foreign body removal procedure.
• A local anesthetic (lignocaine jelly) that numbs the anus will be applied just before inserting fingers or any instrument into the patient’s anus.
• The doctor will insert one or two of his fingers into the anus and gently move them toward the rectum until he feels the rectal foreign body (digital manipulation) and removes it.
• If the foreign body cannot be removed from the rectum with digital manipulation, the doctor will insert a special instrument known as a retractor or speculum device.
• If the foreign body cannot be visualized with a retractor or speculum instrument in place, the patient will be asked to bear down. This will help in visualizing the foreign body and smoothen the removal procedure.

If the foreign body cannot be removed safely, the patient needs to consult a surgeon. The surgeon may advise the patient to go for removal of the foreign body either by inserting a long tube into the anus which goes into your intestine (colonoscopy) or by opening the abdomen (laparotomy) 

Delay in the removal of rectal foreign bodies can turn out to be very risky. The risks include:

• Perforation (hole in the rectum or bowel)
• Infection or sepsis (organ failure due to widespread infection)
• Ulcerations, lacerations, or swelling in the rectum or bowel
• Obstruction in the rectum or bowel
• Bleeding in the rectum or bowel
• Peritonitis