Question
Since giving birth to my second child five years ago, I have suffered from chronic constipation. I often have to manually remove stool from my rectum by pushing it along with my finger through the inside of my vagina. What can I do?
Answer
The chronic constipation that you describe is likely due to a rectocele. A rectocele occurs when the front wall of the rectum bulges into your vagina. This forms a pocket just above your anus in which stool can become trapped. It makes perfect sense that you are able to push stool out in the way you have described — by pressing on the bulge on the inside of your vagina to release the trapped stool.
Pregnancy and delivery are common causes of rectoceles. This is because the muscles and ligaments that hold and support your vagina become stretched and weakened during pregnancy, labor and delivery.
Small rectoceles may cause no signs or symptoms and require no treatment. Large rectoceles may cause a noticeable bulging of tissue through the vaginal opening. When treatment of a rectocele is needed, self-care measures — such as increasing fiber in your diet and practicing Kegel exercises — are often effective. In severe cases, you many need surgical repair.
Regardless of the cause, chronic constipation should be evaluated by a doctor.
Last Updated: 03/16/2007
