From the Research
A rectal tube is primarily indicated for the management of severe fecal incontinence, particularly in patients with spinal cord injury or other neurological impairments, as evidenced by a recent study published in 2024 1.
Indications for Rectal Tube
The use of a rectal tube is considered in the following situations:
- Severe fecal incontinence
- Abdominal distention or discomfort caused by excessive gas accumulation
- Bedridden patients who cannot effectively expel gas on their own, such as those who are postoperative, have neurological impairments, or are critically ill
Insertion and Management
When inserting a rectal tube, a 14-28 French catheter lubricated with water-soluble lubricant should be used, inserted 10-15 cm into the rectum, and secured to the buttock with tape 1. The tube should generally not remain in place for more than 30 minutes at a time to prevent mucosal damage, though protocols may vary by institution. Regular repositioning of the tube can help prevent pressure injuries.
Contraindications
Rectal tubes should be avoided in patients with recent rectal surgery, rectal bleeding, or inflammatory bowel conditions affecting the rectum, as they may cause further trauma or complications 2.
Additional Considerations
Other management strategies for fecal incontinence, such as dietary management, biofeedback therapy, and oral medications, should be considered in conjunction with or instead of rectal tube use, depending on the individual patient's needs and circumstances 3, 4.