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Medical Author:

Martin J Carey, MD, MPH, BCh

Medical Editor:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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In some cases, the foreign object is close enough to the anus that it can be removed in the emergency department. There are a variety of ways for health care professionals to accomplish this. One of the big problems with trying to remove rectal foreign bodies is that there is a strong degree of suction between the object and the walls of the rectum.

• Sometimes a tube is passed between the object and the wall of the rectum to try to equalize the pressure as the object is removed. This is uncomfortable, and the patient will be sedated for the procedure.
• If the object is far into the rectum, it may be necessary for the patient to undergo surgery in order to have a general anesthetic to enable the object to be removed.
• If the patient has evidence of infection in the abdomen, a hole in the bowel, or heavy bleeding from the anus, they may need emergency surgery. In this case the patient would be admitted to the hospital.

In all cases, after the foreign body has been removed, the doctor will perform an examination called a flexible sigmoidoscopy. The doctor uses a long, narrow tube (about 16-18 inches long and a little less than an inch wide) to look inside the anus and rectum. This is done in order to be sure that there has not been any damage to the lining of the bowel, either from the initial insertion of the foreign body, or from attempts - both by the person at home and at the hospital - to remove the item.

• In the case of children, an examination should nearly always be performed under anesthesia. This is also true for uncooperative psychiatric patients.
• People who are victims of sexual assault should have very careful examinations performed, to be absolutely sure that there has been no injury to the wall of the bowel. Depending upon the patient, this may be best done under general anesthesia.