Mako has not had a bowel movement for three days, and feels abdominal distension during class, so she visits the hospital. Dr. Kagami, a new female doctor, begins her examination under the guidance of Director Higashimoto. After removing Mako's skirt, she has her lie on her back on the examination bed and begins massaging her lower abdomen. By applying strong pressure to her large intestine, her intestines become active, and the sound of stool moving from Mako's stomach can be heard. Dr. Kagami then has Mako get into a crawling position on the examination bed and massages her anus. He relaxes Mako and carefully strokes the wrinkles of her anus with his fingers, which have been smeared with a large amount of Vaseline, and Mako lets out a sweet sigh from her lips. As he slowly moves his finger back and forth inside her anus, Mako's breathing becomes rough. Dr. Kagami's finger presses against the inside of her rectum, stimulating her bladder, causing her to lose urine. Having confirmed the activity of her rectum, he lets her breathe on her hands and knees. Every time Mako exerts pressure, her anus expands and turns over. By applying pressure to her lower abdomen, Mako loses control of her urine again. A brown object slowly appears from her anus, which expands and contracts repeatedly. Small, hard fecal masses fall in multiple batches onto the absorbent sheet on the examination bed. A urethral catheter is used to check if there is something wrong with Mako's bladder, which she lost control of during the anal massage. The tip of the catheter reaches her bladder, and dark-colored and fragrant urine drips into the glass container. The director, a veteran of anal examinations, continues to palpate her rectum. Mako lies on her back, hugs her knees, and assumes a lithotomy position, revealing her small bud-like anus. Receiving the man's thick finger in her anus gives her sexual pleasure, and she begins to moan sweetly. The man uses two fingers to expand her anus, which also serves as an anal dilation, and Mako's moans become more intense, and her anal sphincter tightens around the finger. As Mako's sexual response increases, Director Higashimoto's fingers move faster. As her moans reach their climax, she urinates like a fountain. Moreover, the white mucus that overflows from her vagina, mixed with the urine, accumulates in the director's palm. Next, he uses an anal dilation bougie to widen her anus and check her anal sensation. He gradually changes from a bougie thinner than her little finger to a bougie thicker than her thumb, stimulating Mako's anus. To check for stool remaining in her intestines, he inserts an anoscope to widen her anus, and it is confirmed that a mass of stool remains deep in her rectum. Dr. Kagami recommends an enema to cleanse Mako's intestines, who complains that her stomach is not feeling refreshed. He uses a special enema device with a wide nozzle hole that is inserted into the anus, and by adjusting the height of the irrigator, lukewarm water moves between the irrigator and the rectum. The 500cc of lukewarm water that flowed into Mako's rectum is returned to the irrigator by lowering the position of the irrigator. By repeating this process, the lukewarm water, which was previously clear, gradually turns brown. She is forced to wear a disposable diaper to help her hold in her excretion. Mako tries to endure the embarrassment of defecating in her diaper, but soon excretes a cloudy brown liquid with a loud gurgling noise. The brown liquid seeps into the white disposable diaper. As the final stage of intestinal cleansing, an enema of 1000cc of lukewarm water is administered, and Mako is forced to excrete several times to cleanse her intestines. The amount appears to have exceeded the limits of her body, and the cloudy brown liquid flows back into the irrigator. It appears that Mako had also reached her limit of endurance, as the moment the nozzle was removed from her anus, her anus burst and the cloudy liquid spurted out with great force.