How to Treat an Impacted Bowel

This common problem of constipation often needs medical help to remove, but you can take measures to protect yourself from future episodes.

impacted bowel

Hard, dry stool that won't pass can result in painful bowel obstruction.

© Mathias Rosenthal |

An impacted bowel is one of the more unpleasant digestive issues you can experience. Bowel obstruction symptoms occurs when a mass of dry, hard stool will not pass out of the colon or rectum. Bowel impaction can become a serious issue if not treated, and in extreme cases may even result in death. However, treatment is often easy once the bowel obstruction problem and its severity have been identified.

Symptoms of Impacted Bowel

Common symptoms include being unable to have a bowel movement no matter how hard you try, and pain in the abdomen or back. Other symptoms include:

  • Difficulty passing regular bowel movement
  • Having fewer than usual bowel movements
  • Leaking stool, especially when you cough
  • Nausea
  • Vomiting
  • Headache
  • Unexplained weight loss
  • Poor appetite

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More serious symptoms that could require immediate medical attention include:

  • Breathing problems
  • Rapid heart rate
  • Fever
  • Incontinence (uncontrollable urination)
  • Confusion
  • Agitation
  • Dizziness

Impacted Bowel Causes

One of the most common causes of an impacted bowel is an overuse of laxatives. Higher doses and repeated use can make the colon less able to naturally respond to the body’s need to have a bowel movement. When taking laxatives on a regular basis, your body can adjust to depend on these laxatives in order to make a bowel movement. Instead, those affected by constipation or an impacted bowel should be sure to have a diet high in fiber. About 20 to 30 grams of fiber per day is needed to encourage proper bowel function. Unfortunately, most American diets only contain half of that amount. In certain cases, an impacted bowel or constipation may be caused by a more serious condition, such as irritable bowel syndrome, diverticulitis, and even colon cancer. It’s important to check with your doctor if you are suffering from what you believe to be an impacted bowel.

Other causes include:

  • Constipation that goes untreated.
  • Little or no physical activity over a long period.
  • Diet changes that may include less fiber.
  • Opioid pain medicines.
  • Inadequate fluid intake.
  • Travel and schedule changes.
  • Pain or discomfort around the anus.
  • Ignoring the initial urge to defecate.

Diagnosing an Impacted Bowel

If you have persistent symptoms of constipation and/or the main symptoms of an impacted bowel have become more severe, see your doctor. He or she may perform one or more tests to determine the severity of your bowel obstruction symptoms. For example:

  • X-rays of the abdomen.
  • Digital rectal exam (DRE) . The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for a fecal impaction, lumps, or anything else that seems unusual.
  • Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum and into the lower part of the colon to look for fecal impaction and abnormal areas.

Treatment: Constipation and Impacted Bowel

The main treatment for impaction involves softening the stool so it can be removed or passed out of the body. If the bowel is palpable, your physician may be able to manually disimpact the bowel. This process involves inserting a lubricated, gloved index finger in the rectum to gently soften and break up the stool, according to an article in Clinics in Colon and Rectal Surgery. The finger, bent slightly, can then remove and extract the stool. This process is repeated until the rectum is cleared of any hardened stool.

An impacted bowel can also be removed through enemas and suppositories prescribed by your doctor. Enema solutions usually contain water and some sort of osmotic agent which act to soften the impacted stool. The additional volume of liquid also promotes the stool to evacuate the body.

When being administered an enema, patients are placed in the Sims’ position and the enema is passed through a rubber catheter into the patient’s anus. The pressure and volume of enema administration is determined by the size of the patient and how impacted the stool is in the patient’s body. After the enema is administered, patients usually wait a few minutes for the solution to mix and soften the stool. A massage of the lower abdomen can help the process until the patient voluntarily releases the impacted stool and solution. The process can be repeated until the symptoms are clear. Too many enemas, however, can damage your intestine.

Oral lavages may also be used to soften or wash out impacted stool. A laxative such as oral sodium phosphate can be prescribed to help soften and clear out an impacted bowel. Side effects such as nausea, vomiting, or significant abdominal discomfort may occur and should cease oral laxatives to treat an impacted bowel.

Impacted Bowel Prevention

The best way to prevent an impacted bowel is to avoid becoming constipated. Steps you can take:

  • Drink plenty of liquids daily to reduce your risk of dehydration.
  • Consume more high-fiber foods (such as whole-wheat bread, oats, and vegetables) to promote more frequent bowel movements.
  • Lower your intake of high-sugar foods.
  • Exercise; a regular routine can help your digestive system run smoothly.

Originally posted in May 2016 and updated.
  • madan g.

    really excellent article. congratulations to authors and thanks

  • Usually about 3 to 4 times a week I have a large dry stool, I have gas almost every day my dry stool spears to be made up of small marble size stool compacted in one large one usually about the size of a tennis ball.

  • Rex K.

    If you have a bidet, you can squirt it up your rectum and flush everything out of your descending colon; if not, you can use your shower hose in the shower, to do the same, and flush the stool down the drain.

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