Digital Stimulation (DIL)

Introduction

Digital stimulation is a way to empty the reflex bowel after a spinal cord injury. It may also be called a "dil." It involves moving the finger or dil stick around in a circular motion inside the rectum. By doing this, the the bowel reflex is stimulated and the rectal muscles open and allow the stool to leave the body.

This procedure is best done on people who do not have painful sensation in the rectal area. Pressure may be felt in the rectal area, but it should not be painful. The dil should be done at the same time every day or every other day to stay on a schedule and avoid bowel accidents. The time and how often a dil is done depends on the individual.

How to do a Dil (digital stimulation)

1. Gather supplies

  • Gloves
  • Dil stick (if ordered)
  • Lubricant
  • Soap, water, washcloth      
  • Toilet paper, underpads (if done in bed)
  • Plastic bag to throw away waste
  • Raised toilet seat, commode chair or shower chair if done in the bathroom

2. Wash hands

3. Prepare all needed supplies and place on a towel

4. Position yourself

If doing the dil in bed:

If doing the dil in bed, lie on the left side with knees flexed (right leg over left leg) and place disposable pad under the buttocks.

If doing the dil in the bathroom, transfer to appropriate bowel equipment (raised seat, Activeaid).

Perform the dil

Put gloves on both hands or place place dil stick in the hand.

Lubricate pointing finger or dil stick (whichever will be entering the rectum).

Gently put finger or dil stick into the rectum past the muscle.

Gently move the finger or dil stick around in a circular motion.

When the stool begins to empty from the rectum, move the finger or dil stick to one side or remove so the stool can pass.

Do this for at least 20 minutes if no stool is coming. If stool is produced, do the dil as long as the stool is coming dil and for five additional minutes afterward without getting any more stool.

You may need to gently remove stool from your rectum with your finger if it does not come out on it's own.

Finish up

When finished with the dil, wipe rectal area and buttocks with toilet paper; wash with soap and water; dry with a towel

Clean dil stick with soap and water; dry well

Throw out waste and wash hands

The dil may cause dysreflexia in persons with spinal cord injuries at T6 and above. Always observe for symptoms of autonomic dysreflexia:

  • Increased blood pressure
  • Headache
  • Blotchy skin 
  • Sweating
  • Stuffy nose

If the person experiences autonomic dysreflexia during the dil, then do the following:

  1. Stop the dil
  2. Sit up if not already doing so. Sit up in the bed or in the chair, depending on the location.
  3. Insert a local numbing agent like Nupercainal Ointment into the rectum

If dysreflexia goes away, continue the bowel program as planned. If dysreflexia continues or gets worse then proceed with the treatment plan described in the Autonomic Dysreflexia section.