Is the rectum usually empty?—A quantitative study in subjects with and without diarrhea

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Abstract
The frequency with which the rectum contains feces was investigated by recording the presence or absence of fecal contamination of the membrane or of discoloration by feces of the contents of dialysis bags placed in the unprepared rectum for 1 h. Feces were present in the rectum in 31% of 32 studies in normal control subjects, in 49% of 80 studies in obese subjects (P < 0.05 from controls), in 36% of 28 studies in patients with the irritable bowel syndrome and in 31% of 103 studies in patients with ulcerative proctocolitis, whether or not they had diarrhea. Fecal staining of the bag and its contents occurred much more frequently in 27 studies in subjects with various other diarrheal diseases (67%, P < 0.02 from controls), including 8 with steatorrhea (87%, P < 0.02 from controls). The frequency with which feces were present was unaffected by age, sex or time of day of the study. In subjects without diarrhea the rectum is usually empty. In patients with diarrhea or steatorrhea and no distal large intestinal inflammation, however, the rectum usually does contain fecal material.