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

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An impacted bowel is one of the more unpleasant digestive issues you can experience. Bowel obstruction symptoms occur 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 successful once the bowel obstruction problem and its severity have been identified. (See also our post Remedies for Constipation—Without Drugs.)

Symptoms of Impacted Bowel

The most common (and obvious) symptom of an impacted bowel: Being unable to have a bowel movement no matter how hard you try, with accompanying pain in the abdomen or back. Other symptoms include:

• Leaking of watery stool, especially when you cough
• Nausea
• Vomiting
• Headache
• Unexplained weight loss
• Poor appetite

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 may adjust itself and begin to depend on these laxatives in order to make a bowel movement. Instead of using laxatives regularly, be sure to eat a diet high in fiber. How much fiber? Between 20 and 30 grams of fiber per day is required to encourage proper bowel function. Unfortunately, most American diets contain only half of that amount, which can result in bowel impaction.

In certain cases, an impacted bowel or constipation may result from 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.

Diagnosis

If you have symptoms of chronic constipation or an impacted bowel, see your doctor. He or she may perform one or more tests to determine the severity of your fecal 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.

How to Treat an Impacted Bowel and Constipation

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

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

When receiving 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 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.

Preventing Impacted Stool

The best way to avoid impacted bowel issues is to make sure you don’t become constipated, taking these steps:

• 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 regular bowel movements.
• Lower your intake of high-sugar foods.
• Exercise; a regular routine can help your digestive system run smoothly.

RECOMMENDED FOR YOU

• Bristol Stool Chart: What It Can Tell You About Your Health
• What Helps Constipation? Know the Causes—and Find Relief
• Should You Use an Enema for Constipation?

Originally posted in 2016, this post is regularly updated.