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Dr. Shustina is an incredibly knowledgeable doctor who truly takes time to find root cause.
RG
Rochel Gordon
Condition · Gastrointestinal
Incomplete Evacuation
Feeling like you haven't fully emptied your bowels can be frustrating and uncomfortable, often pointing to underlying issues like slow gut motility, pelvic floor dysfunction, or imbalances in gut flora. This persistent sensation—medically referred to as the feeling of incomplete evacuation—leaves many people returning to the bathroom repeatedly, straining, or never feeling truly finished, even after a bowel movement.
At Whole Gut Health and Wellness, we focus on uncovering these root causes through comprehensive diagnostics and a personalized approach. Our integrative therapies, including tailored nutrition plans and targeted supplements, aim to improve bowel function, alleviate symptoms, and restore overall digestive balance for lasting relief. Rather than masking the sensation with laxatives or fiber alone, we work to understand why the signal is there in the first place.
What Exactly Is Incomplete Evacuation?
Incomplete evacuation is the persistent feeling that the rectum has not been fully emptied after a bowel movement. It is a symptom rather than a diagnosis in itself—a signal that some part of the complex, coordinated process of defecation is not working as it should. Normal bowel emptying depends on well-timed cooperation between the colon, the rectum, the pelvic floor muscles, the anal sphincters, and the nerves that coordinate them. When any of these links is disrupted, the body may register the bowel as still full even when little or no stool remains.
Because the sensation can arise from very different mechanisms—slow colonic transit, difficulty relaxing and coordinating the pelvic floor, altered gut flora, or heightened rectal sensitivity—effective care begins with identifying the specific cause rather than simply treating the feeling. Understanding which mechanism is driving the symptom is what allows us to choose a treatment that actually restores normal, satisfying bowel function.
Why You Feel Incompletely Emptied
The sensation of incomplete evacuation almost always has a root cause somewhere along the digestive and neuromuscular pathway. Slow gut motility can leave stool sitting in the colon too long, becoming hard and difficult to pass fully. Pelvic floor dysfunction—where the muscles that should relax during a bowel movement instead tighten or fail to coordinate—can trap stool in the rectum and create the constant feeling of unfinished business.
Imbalances in the gut microbiome, including dysbiosis and bacterial overgrowth, can alter stool consistency, gas production, and the way the gut communicates with the nervous system, all of which influence how complete a bowel movement feels. Heightened rectal sensitivity, chronic stress, and the gut–brain connection also play a role, since the same nerves that govern digestion respond to emotional and lifestyle factors. Identifying which of these mechanisms—or which combination of them—is at work is the foundation of lasting relief.
Common Causes of Incomplete Evacuation
Incomplete evacuation can stem from a range of overlapping factors. During your evaluation we work to determine which of these are contributing to your symptoms so treatment can be directed at the true source.
Slow gut motility (delayed colonic transit)
Pelvic floor dysfunction and dyssynergic defecation
Chronic constipation and hard, difficult-to-pass stools
Gut microbiome imbalances (dysbiosis and SIBO)
Heightened rectal sensitivity and the gut–brain connection
Dietary factors, low fiber, and inadequate hydration
Sedentary lifestyle and disrupted bowel routines
Chronic stress, anxiety, and unresolved emotional factors
Structural or anatomical contributors affecting the rectum and anus
Common Signs and Associated Symptoms
Incomplete evacuation rarely occurs in isolation. It often travels alongside other digestive symptoms that point back to the underlying imbalance. Common signs include:
A persistent feeling that the bowel is not fully emptied
Returning to the bathroom repeatedly for small or unproductive movements
Straining or a need to use manual maneuvers to pass stool
Hard, lumpy, or difficult-to-pass stools
Abdominal bloating, fullness, or discomfort
Constipation or irregular bowel habits
A feeling of pressure or blockage in the rectum
Gas, belching, or changes in stool consistency
Fatigue, low energy, or a general sense of sluggishness
Diagnostic and Screening Options at Whole Gut Health
Comprehensive evaluation of incomplete evacuation goes beyond the symptom itself to identify the specific mechanisms and root causes driving it. We take the time to understand your unique situation, listen to your concerns, and conduct thorough evaluations to determine the underlying causes of your symptoms.
Depending on your history and presentation, assessment may include:
Detailed history of bowel habits, diet, lifestyle, stress, and prior treatments
Comprehensive Stool Analysis to assess gut microbiome balance and digestive function
SIBO Breath Testing to identify bacterial overgrowth that may affect motility and stool consistency
Applied Kinesiology or Muscle Testing to help identify root causes, triggers, and direct optimal treatment
Pelvic floor assessment when dyssynergic defecation is suspected
Functional lab work to evaluate thyroid, nutrient, and metabolic factors that influence motility
We customize testing based on your symptom pattern, medical history, and previous treatment responses to ensure a comprehensive and personalized evaluation.
Our Treatment Approach
At Whole Gut Health and Wellness Center, we believe in taking a holistic approach to gastrointestinal health. We recognize that symptoms are not isolated occurrences but manifestations of underlying imbalances within the body. We strongly stand by the “food is medicine” approach and guide each patient with clear, simple, and strategic dietary changes to support and heal the gut and the rest of the body. By addressing the root causes and considering the interconnectedness of the body, mind, and environment, we can provide comprehensive and personalized care to our patients.
Dr. Alexandra Shustina, a Board-Certified Gastroenterologist, and the team at Whole Gut Health combine the best of conventional medicine with evidence-based natural therapies and lifestyle interventions. Our integrative care for incomplete evacuation typically unfolds across three phases:
Phase 1 — Assessment and Root-Cause Identification
- Comprehensive diagnostic testing to determine the mechanisms behind incomplete evacuation
- Detailed analysis of dietary, lifestyle, and stress factors
- Evaluation of gut microbiome imbalances such as SIBO and dysbiosis
- Assessment of pelvic floor coordination and motility
- Identification of dietary triggers and nutritional deficiencies
- Addressing stress and emotional root causes with energy medicine
Phase 2 — Targeted Intervention
- Treatment of underlying bacterial overgrowth or gut microbiome imbalances
- Optimizing motility with visceral manipulation and cranial osteopathy
- Targeted, strategic dietary modifications and elimination of triggers
- Support for pelvic floor coordination when dyssynergic defecation is present
- Curated, personalized supplement regimen to support gut function
Phase 3 — Rebuilding and Prevention
- Comprehensive gut microbiome restoration and maintenance
- Long-term dietary strategies supporting regular, complete bowel movements
- Lifestyle optimization including movement, hydration, and stress management
- Healthy bowel routines and mind–body practices to sustain progress
- Ongoing support to maintain natural bowel function and prevent recurrence
Treating the Person, Not Just the Symptom
We treat the person, not just the symptoms. We know that symptoms are fire alarms alerting us to the root cause. If we merely turn off the alarm, we may feel better temporarily, but the cause of the alarm has not been removed—the house is still on fire. We examine the symptoms, lifestyle, personal history, and life traumas, shedding light on the potential causes, associated conditions, and effective treatment approaches.
By focusing on the root causes rather than just symptom management, we aim to restore balance and promote optimal digestive health. Our goal is not only to alleviate symptoms but also to enhance overall well-being and quality of life. We believe in empowering our patients with the knowledge and tools they need to actively participate in their healing process, and the tools we provide can benefit you for a lifetime.
Expert-Led, Personalized Care
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist specializing in complex digestive disorders, gut health, and the gut–brain connection. Drawing from both conventional gastroenterology and integrative medicine, she takes a comprehensive approach to uncovering the underlying factors contributing to illness and guides patients toward lasting wellness.
At Whole Gut Health, every patient receives highly personalized care rooted in a deep understanding of digestive health, nutrition, the gut microbiome, and the interconnected systems that influence overall well-being. By combining evidence-based medicine with a thoughtful, individualized approach, we help patients move beyond symptom management and create a clear path toward long-term healing and vitality.
Our approach
Why Whole Gut Health is different.
At Whole Gut Health, we go beyond conventional symptom management and traditional functional medicine protocols. We trust your body's innate ability to heal itself when given the right support.
In Dr. Shustina's many years of practice, she has seen that many digestive diseases have their root cause in emotional traumas and unhealed wounds. When these underlying causes are healed, the body can heal from the inside out in a lasting way.
We focus on the mind-gut connection, incorporating energy healing techniques, personalized nutrition that evolves as you heal, and integrative approaches addressing mind, body, and spirit. If this resonates with you, contact our office to schedule your consultation and take the first step on your healing journey.
Frequently Asked Questions
Common questions, answered.
What is incomplete evacuation?
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Incomplete evacuation is the persistent feeling that the bowel has not been fully emptied after a bowel movement. It is a symptom rather than a diagnosis, signaling that some part of the coordinated process of defecation—involving the colon, rectum, pelvic floor muscles, and nervous system—is not working as it should. It often points to underlying issues such as slow gut motility, pelvic floor dysfunction, or imbalances in gut flora.
What causes the feeling of incomplete evacuation?
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The sensation can arise from several overlapping mechanisms, which is why identifying the specific cause matters. Common contributors include:
- Slow gut motility that leaves stool in the colon too long
- Pelvic floor dysfunction and difficulty coordinating the muscles used to pass stool
- Gut microbiome imbalances such as dysbiosis and SIBO
- Heightened rectal sensitivity and the gut–brain connection
- Dietary factors, low fiber, inadequate hydration, and a sedentary lifestyle
- Chronic stress and unresolved emotional factors
What other symptoms can occur alongside incomplete evacuation?
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- Returning to the bathroom repeatedly for small or unproductive movements
- Straining or needing manual maneuvers to pass stool
- Hard, lumpy, or difficult-to-pass stools
- Abdominal bloating, fullness, or discomfort
- Constipation or irregular bowel habits
- A feeling of pressure or blockage in the rectum
- Gas, changes in stool consistency, and low energy
How is incomplete evacuation evaluated?
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We look beyond the symptom to identify the specific mechanisms and root causes. Evaluation may include:
- A detailed history of bowel habits, diet, lifestyle, stress, and prior treatments
- Comprehensive Stool Analysis to assess gut microbiome balance and digestive function
- SIBO Breath Testing to identify bacterial overgrowth affecting motility and stool consistency
- Applied Kinesiology or Muscle Testing to help identify root causes and direct optimal treatment
- Pelvic floor assessment when dyssynergic defecation is suspected
- Functional lab work evaluating thyroid, nutrient, and metabolic factors
Testing is customized based on your symptom pattern, medical history, and previous treatment responses.
What does treatment for incomplete evacuation involve?
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Our integrative approach addresses the root causes across three phases:
Phase 1: Assessment and Root-Cause Identification
- Comprehensive diagnostic testing to determine the underlying mechanisms
- Analysis of dietary, lifestyle, and stress factors
- Evaluation of gut microbiome imbalances and pelvic floor coordination
Phase 2: Targeted Intervention
- Treatment of bacterial overgrowth or gut microbiome imbalances
- Optimizing motility with visceral manipulation and cranial osteopathy
- Strategic dietary modifications, trigger elimination, and a curated supplement regimen
Phase 3: Rebuilding and Prevention
- Gut microbiome restoration and long-term dietary strategies
- Lifestyle optimization, healthy bowel routines, and mind–body practices
- Ongoing support to maintain natural bowel function and prevent recurrence
Why is it important to find the root cause instead of just treating the symptom?
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Because incomplete evacuation can stem from very different mechanisms—slow transit, pelvic floor dysfunction, microbiome imbalance, or heightened sensitivity—each responds to a different treatment. We treat the person, not just the symptoms. Symptoms are fire alarms alerting us to the root cause; simply turning off the alarm without removing the cause leaves the underlying problem unresolved. Addressing the true source is what allows for lasting relief and restored digestive health.
Who provides care for incomplete evacuation at your practice?
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Dr. Alexandra Shustina is a board-certified gastroenterologist and internist who serves as NYC's and Miami's premier gut health specialist. She has training in both conventional gastroenterology and functional gut health, with expertise in the gut microbiome and its role in health and wellness.
How do I get started?
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The first step is scheduling a comprehensive consultation where we will:
- Review your symptoms, medical history, and current treatments in detail
- Determine the most appropriate testing strategy for your specific case
- Develop a personalized treatment plan based on your underlying causes
Contact our office to schedule your initial consultation and take the first step toward comfortable, complete, and natural bowel function.
Reviews
The body remembers when it's finally heard.
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Dr. Shustina goes to the root level of the issue, not only superficial, so there's healing.
LG
Leah Glickman
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She has significantly improved my health. I was suffering from Ulcerative Colitis and now live normally.
ML
Monica LaBadia
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Dr. Shustina has helped me change my lifestyle and heal my gut in a way I thought impossible.
DL
Dalit Lonstein
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She listens to patients and treats conditions, not symptoms.
GS
Gabriela Salazar
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Dr. Shustina is the best doctor I have ever been to. She assesses the root of the problem.
MS
M. S.
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She is an outstanding doctor who understands the body's ability to heal itself and holistic remedies.
SS
Sibel Sebi Sharabi
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Dr. Shustina has a wealth of knowledge and is helping me heal years of gastrointestinal issues.
DC
Daniela Chaparro
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Dr. Shustina is an amazing doctor. She diagnosed my cancer early and saved my life.
MW
Mordechai Weinstein
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After one session with Dr. Shustina, my digestive pain went away.
TP
Taryn Parascand
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Doctor Shustina is the absolute best. She has helped me resolve numerous issues other doctors dismissed.
RS
Rachel S.
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Dr. Shustina is a fantastic doctor who truly cares. Her holistic approach attacks the root cause.
CS
Clay Simonsen
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