What Is a Rectal Tube?

Erin J. Hill
Erin J. Hill
Rectal tubes are also called rectal catheters.
Rectal tubes are also called rectal catheters.

A rectal tube, also called a rectal catheter, is a long slender tube which is inserted into the rectum in order to relieve flatulence which has been chronic and which has not been alleviated by other methods. The term rectal tube is also frequently used to describe a rectal balloon catheter, although they are not exactly the same thing. Both are inserted into the rectum, some as far as the inner colon, and help to collect or draw out gas or feces.

A rectal tube is inserted into the colon to help release gas.
A rectal tube is inserted into the colon to help release gas.

The use of a rectal tube to help remove flatus from the digestive tract is needed primarily in patients who have had a recent surgery on the bowel or anus, or who have another condition which causes the sphincter muscles not to work appropriately enough for gas to pass on its own. It helps to open the rectum and is inserted into the colon to allow gas to move downward and out of the body. This procedure is generally only used once other methods have failed, or when other methods are not recommended due to the patient’s condition.

A rectal tube is inserted through the rectum.
A rectal tube is inserted through the rectum.

In some cases, a rectal tube refers to a balloon catheter, which is commonly used to help reduce soiling due to chronic diarrhea. This is a plastic tube inserted into the rectum, which is connected at the other end to a bag used to collect stools. It is only to be used when necessary, as the safety of routine usage has not been established. Serious complications have also been noted, and include rectal perforation and reduced sphincter muscle tone.

A rectal tube inserted into the anus opens the rectum and allows gas to pass more easily.
A rectal tube inserted into the anus opens the rectum and allows gas to pass more easily.

Use of a rectal tube and drainage bag does have some benefits for patients who are critically ill, and may include protection for the perineal area and greater safety for health care workers. These are not great enough to warrant use for most patients, but those with prolonged diarrhea or weakened sphincter muscles may benefit. Use of the rectal catheter should be closely monitored and removed as soon as feasible.

Insertion of a rectal tube must be done by a trained professional and it should be completed very carefully using a well-lubricated tube. Patients should be taken to a private area and relaxed for maximum benefits. The nurse or doctor will raise one cheek of the buttocks and carefully insert the tube into the colon. After a few moments, flatus may have exited through the tube, but if not, the procedure may have to be repeated at a later time.

Understanding Rectal Tube Usage

Medical professionals must exercise caution when dealing with patients that have had rectal treatments, including surgery, or if they suffer from inflammatory bowel conditions. Using their medical knowledge and expertise, the doctor should consider the effects and location of the inflammation before inserting the rectal tube. 

Patients who experience discomfort and are concerned with the possibility of using a rectal tube should express these thoughts to clarify what to expect. The use of a rectal tube where there aren't usually alternative options is with critically ill patients that have lost control of their bowels. In these cases, the doctors will try to make the process as painless and discreet as possible. 

Precautions

Doctors usually refrain from using rectal tubes in situations where the patient frequently bleeds from anticoagulant therapy or if they have another medical ailment that may interfere with the success of the tube. 

In cases of chronic bleeding from the rectum, the rectal tube gets removed immediately, and the doctor will determine if there's another way to offer waste removal. 

Patients with a history of spinal cord injury might not qualify for a rectal tube because they could develop autonomic dysreflexia. 

Sitting or lying down directly on the rectal tube could contribute to localized pressure damage, leading to restricted stool flow and breakdown of the peri-anal skin surrounding the tube. 

If patients are allowed to be seated for short periods, they must be closely and regularly monitored at all times. The time seated shouldn't exceed more than two hours.

Rectal tubes are not effective for those that have solid or softly formed stools, as they will obstruct the passageway. 

Patients should expect limited amounts of seepage or moisture near the catheter. Doctors and nurses can attempt to limit the irritation by instituting an appropriate skincare routine that keeps the area dry, clean, and moisturized with a substance such as petroleum jelly. 

When rectal catheters get blocked because of fecal matter, you can rinse them out with water through the irrigation port.

How Long Can the Rectal Tubes Stay In?

Nurses can use each tube for 29 days. Patients must have sufficient anal sphincter tone before inserting the tube. If a patient's anal tone is compromised, the balloon will dislodge and not remain in its original position.

How To Remove The Rectal Tube?

Doctors must deflate the retention balloon before removing the catheter from the rectum. Take a syringe, attach it to the inflation port, and withdraw all of the water from the balloon. Next, remove and dispose of the syringe. Grasping the catheter as close to the patient as you can be, slowly slide the catheter from the anus.

What Are Adverse Side Effects Of A Rectal Tube?

Potential side effects to look out for include infection, loss of anal sphincter muscle tone, anal mucosa, pressure necrosis of the rectum, etc.

Additional Warnings For Rectal Tube Use

  • Clinicians should know that there's very little data concerning the use of in-dwelling fecal management systems after 14 days have elapsed.
  • Other healthcare applications may be disconnected with connectors, such as driving gas systems, intravenous equipment, limb cuff inflation neuraxial devices, urethral/urinary, and other gastric and enteral applications.
  • Neglecting to follow directions strictly can significantly increase the probability of an adverse event occurring.
  • Patients have to be looked after daily, and someone must contact a physician immediately if any of the following happens: rectal bleeding, abdominal symptoms such as distension/pain, and rectal pain.
  • Overinflating the retention balloon can increase the risk of the following: bleeding, rectal pain, possible perforations, and ulcerations.

Alternatives To The Rectal Tube

There are other methods that those suffering with incontinence can utilize besides rectal tubes. Some alternative methods that are safer include incontinence pads, diapers, rectal pouches, and other devices that require more cleanup than the tube, but are also less painful. 

Oftentimes, patients don't want to feel humiliated by having to get cleaned off from loss of bowel control. The rectal tube is a way that they can retain a bit of integrity while still addressing their needs.

Discussion Comments

anon998186

The old method was effective for gas relief, e.g., a return flow enema. Put fluid in then drop the bag or bucket to pull out the gas. Course, it's not a long term solution.

anon997949

I was intubated about six months ago and put in a medically induced coma, and so required a rectal tube. When I woke up I continued to have it for about four more days. I never felt it, nor knew I had it, until I realized I did not have an urge for a BM. I was very alert (36 year old bed bound). My only complaint is that after it was removed, I couldn't tell when I went to the bathroom for about a week. (When the rectal muscles strengthened back up.)

anon996153

I had one but I don't think anyone knew what it was. It was very painful.

anon994993

My mom has had one in place for three days and she is complaining of burning and pain in her rectum. I think that also they didn't use any lubricant to insert it. I have called the nurse station and they are telling me that the doctor needs to determine if it's OK to take it out. I think that the patient's comfort comes above this. I feel bad for her. I don't know how long are these things supposed to be in for?

anon948176

How often do you change the rectal tube and the collection bag?

anon303529

Is it difficult to change a rectal tube that is torn? I was working at a hospital last week with a patient who had this and the tube leaked throughout the 12 hour shift.

I reported it to the nurse and said it needed to be changed because it was leaking all over the air mattress and the client's buttock was extremely red and excoriated. I'm a nursing assistant and wonder why no one wanted to change the tube. Is the procedure that difficult?

anon258854

I had one after a small bowel study because I have bad decubes on my butt and had the runs real bad. I had a nurse do it who I knew would be gentle. It wasn't too bad at all.

anon170029

Is this what patients in a coma would have?

anon168466

it does work quite quickly.

Erin Hill

It works, although nothing works for 100 percent of patients. Sometimes it has to be repeated more than once to allow the gas time to move farther down the digestive tract.

anon130714

well does it actually work?

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