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It can occur due to general anorectal muscular weakness as a result of chronic constipation, laxative use, severe hemorrhoids, rectal prolapse, or fecal impaction (UMMC 2014)

It comes from repeating the same motion, adjusting slightly each time slightly based on how you feel

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[1] It is used as a diluent to dissolve or dilute medications for intravenous (IV), intramuscular (IM), or subcutaneous (SQ) injection according to the instructions of the specific drug being prepared

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