18 Nursing Times 01.05.13 / Vol 109 No 17/18 / www.nursingtimes.net Nursing Practice Innovation Bowel care Author Wendy Ness is colorectal nurse specialist at Croydon University Hospital. Abstract Ness W (2013) Digital removal of faeces. Nursing Times 109: 17/18, Defecation is essential to enable us to eliminate waste and keep our bowels functioning. In some individuals, defecation is not possible without an intervention. This might be oral medication, such as laxatives to soften the stool and propel the faeces round the colon, or digital removal of faeces (DRF) by a competent health professional on a regular basis. This article considers who needs DRF, who can carry it out, the ethical and legal implications, and the importance of appropriate bowel care being carried out in all care settings. W ith newer bowel care techniques, such as transanal irrigation, digital removal of faeces (DRF) is not often needed. However, fora small group of patients – such as some who have sustained a spinal cord injury (SCI) or have a neurological condition such as multiple sclerosis – it is an essential part of their bowel-care routine (Box Aside from this, DRF may also be used as an acute intervention for patients who have impaction of stool that cannot be resolved with medication. Symptoms of impaction may include absent or reduced evacuation of stool abdominal bloating or distension nausea and pain. It maybe accompanied by overflow or spurious diarrhoea, in which looser stools leak around an unmoving faecal mass, often associated with faecal soiling (Multidisciplinary Association of Spinal Cord Injury Professionals, 2012).