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Background: Difficulty with evacuation (DWE) is a major problem after spinal cord injury (SCI). Stimulation of the anal canal and lower rectum, accomplished using a gloved finger (so-called digital rectal stimulation or DRS) is often used as an adjunct to laxatives and enemas to facilitate bowel evacuation. Definition. Neurogenic bowel (NB) is the impairment of the gastrointestinal and anorectal There is loss of voluntary control of the external anal sphincter (EAS), thus Digital stimulation is not effective; manual evacuation may be necessary.