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What to Do When You Have Impacted Stool

Never a comfortable topic to discuss, but it's good to have some idea of what to try if you or a loved one ever experiences hardened stool that won't come out on its own.

First, it's vital to remember that whenever you have the urge to have a bowel movement, it's best that you relax rather than try to force stool out with exertion.

Conscious relaxation is necessary for optimal function of your internal anal sphincter muscle, which is a ring of smooth muscle that helps keep your anal sphincter closed when you're not having a bowel movement, and also helps push stools out during defecation. Your internal anal sphincter muscle is entirely involuntary, meaning that it works without your conscious input. By consciously straining to eliminate stools, you can actually disrupt the natural activity of your internal anal sphincter muscle.

This is not to say that you shouldn't strain at all when having a bowel movement. Surrounding your internal anal sphincter muscle is your external anal sphincter muscle, which is under voluntary control; when you bear down, this is the muscle that you are using to generate momentum for defecation. When stools are healthy, you don't need to generate momentum for a bowel movement by contracting your external anal sphincter muscle, but when stools are harder than they should be, it can be helpful to consciously contract your external anal sphincter muscle to get things moving. The key is to stop consciously contracting and to relax once stools begin to pass, as this allows your internal anal sphincter muscle to contribute to expulsion of feces.

With all of that said, if hardened stool is stuck as it is exiting your anal sphincter, it can be helpful to apply a natural lubricant around your sphincter. It isn't a glamorous thing to do, but over the years, I've actually had a handful of parents successfully use this technique to help their young children pass hard stools that were firmly wedged in place.

While wearing a disposable glove, beyond lubricating the anal sphincter with a natural lubricant like coconut oil, it might also be necessary to use a finger to manually remove bits of stool. By generously lubricating before you do this, you can reduce risk of creating an anal fissure.

This is one of a few reasons why I think it's a good idea to keep a box of disposable exam gloves around. The kind that I keep in my office can be found here:

SafeTouch Nitrile Exam Gloves, Non Latex, Powder Free

Back when I ran our residential fasting program, I would sometimes have to manually disimpact people who were severely constipated, as extended water-only fasting can lead to even further hardening of stools, so it's always best to try to have a solid bowel movement before embarking on a long water-only fast. Most of the people that I had to do this for were sufferers of chronic constipation, and usually had weakened smooth muscle tone for a variety of reasons.

Regular intake of highly processed and refined foods - typically those made with flour and sugar - is arguably the most common cause of chronic constipation.

Regular straining to try to force hardened stool out invariably leads to weakened smooth muscle tone in the lower colon.

And resorting to regular use of enemas is often the final step that leads to significant loss of smooth muscle tone in the anal, rectal, and lower large intestinal regions.

The good news is that I have seen people who were completely dependent on enemas to have bowel movements restore full motility. This kind of reversal doesn't typically happen within a few days; it takes weeks, months, or sometimes even years of allowing the smooth muscles that line your colon to recover optimal tone, which requires improvement within your enteric nervous system, a portion of the autonomic nervous system that regulates your bowel movements.

For more suggestions on how to have healthy bowel movements and a healthy colon, be sure to review the following articles:

How to Have Healthy Bowel Movements

Are Enemas Good for Your Health?

Hope these tips come in handy.


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Oh my goodness. Why didn't you just give your impacted patients some Docusate? Next time, you might want to do what I did, as follows:

Anyway, I had this problem once. I don't know the cause, must've eaten something odd; but "it" was hard as a rock I just couldn't go. I was getting scared; it had been 3 days where pushing like crazy didn't do a thing. Probably made the situation worse. The solution was to put a hot wet facecloth down there, ie., hot compress, for several minutes, over & over, and voila. The deed was done.

An impaction means that the stool has solidified and hardened and NO amount of pushing will ever dislodge it. It is stuck in the anal canal. My mother suffered a stroke and I had to disimpact her on a regular basis. There are also illnesses where constipation is a recurrent problem, nothing moves. Docusate and other pills frequently do not work at all. This is an excellent article. Thank you Dr.Kim

I just passed the most stubborn turd I've ever encountered.
I didn't rub lube on it. Just pushed until I myself a headache.
One of the most rewarding poops ever.

I frequently have stubborn stools, ones that are hard/dry/thick and just don't want to come out even though I have to go really bad with a strong urge. I always carry disposable gloves in my purse as I travel a lot for my job. In public restrooms I can be discreet with the gloves on and reach down and help it along (I know it sounds gross). And yes these are quite rewarding poops when they finally come out.

I used to 'put it off' for around four weeks when I was a child. As a teen, before I used an enema (which is rare), I had to try very hard, and often had burst blood vessels on my face, around my eyes mostly, due to the build-up in pressure.

After I moved out of a house where I regularly argued, my BM's changed drastically, and I've only had to use an enema once since then. It did take them months to get back to normal, but considering that I had been dealing with it for so long, it seemed like a quick change.

I have this problem. Was it painful? I'm tempted to go to the doctors and have it removed. It's getting BAD

Mine is getting bad too. I need it removed but I am scared of the cost.

I learned a while ago that our annus and rectum are not lined up when we sit down. So having a bowel movement in that postition generally requires some pushing. In the beginning of time people squated to do their deed ;) But since the invention of toilets we all sit down now. But if you can put a 'wooden block' or stool in your bathroom and raise your legs close to your buttocks while you go, it makes the movement much smoother as that mimics the 'squating' position, doing a better job of lining up the annus and rectum. Dr Kim, you know the human body well, this works for me and all my family members, would you agree with this?

Ihave to agree with you, I have had this problem recently for the first time and took your advice, and placed a plastic bag on the floor and squatted, I noticed movement but it took to long so i place my arms behind me and lent back, arms holding me up, the motion came and the relief, I had not realised how much had been trapped in there. Thanks for your advice.

Nothing beats squatting. After trying to remove bits and pieces with a gloved hand lubricated, which took me forever, I placed plastic and tissue on the floor, squatted, and viola....So much relief.

We have many men from India working at my work. One time someone didn't use the toilet, I found it amusing. Then once I was out for a long hike and needed to go, dug a little hole and it's just so natural. Don't forget about the squatty potty, easy to make your own, I just kept pulling the skillsaw out until I got mine set to the right height and use it pretty often now. Get more soft vegetables into your diet.

I know someone who is completely dependent on enemas and wont have a bowel movement for up to a month or more. It is very scary, I want to help them before this kills them but their smooth muscles are apparently very weak. Once they do have a bowel movement they can continue having a normal bowel movement for about a week or two but then it builds back up. Laxatives, fiber, and different diets don't help. Multiple doctors continue to give those same methods as advice but they don't help. What can this person do to gain back smooth muscle strength, otherwise I fear the worse. They are only 21 :( Please Help!

i have been completely dependent on colonoscopys. What i mean is.. sometimes i go only 1 WEEK without a bowel movement and im backup. What i mean by backup is i have a stool stuck in my butt, THAT even with an enema, magnesium centrate, go lytly, miralax, any laxative u can think ... nothing budges the stool that wants to come out, but its like my anal says NO ! I usually am admitted threw the e.r and a doctor does a colonscopy and removes the harden stool... that seems to be the only thing to help me relieve ; because i can NOT do it on my self. I pray to find a doctor that can help me with my problem . I am 24 and been dealing with this since 7 years old. I am tired and disgusted. I want a regular life :(.

You should really check into colon hydrotherapy, also known as colonics

Try a vegetarian diet with raw fruits and vegetables for one month and notice the difference. Your stools will be normal again. Juicing is also important; juice raw beets, celery, carrots, cucumbers, dandelions, turmeric, and ginger. Best of luck.

Christine, you may also explore other options like fennel, cardamom, and Carica papaya.. good to have people using nature's gifts.. might as well share the herbs that were effective for my chronic constipation. Take care :)

Try to avoid eating breads, rice, potatoes and pastas as they build bulk.

I'm so glad to have found this website. I'm right in the middle of my problem and I well understand what some of you have gone through. I normally take Konsil every day and for some reason quit doing it. And now I'm paying the price. A few years ago I had an anal fissure and thought it was hemorrhoids. When the doctor told me what it was I wanted to cry. I did not want to have surgery because the results would be questionable. That's when I started using Konsil on a regular basis. This product has more fiber per teaspoon than any of the other products. If you use it make sure you drink lots of water with it.

I too suffer. I don't go poo for upto 11-12 days and is scary. I get regular bouts of peritonitis and need hospitalisation for intravenous antibiotics and aeveral doses of antisickness injections. Mine is worse since ive been taking morphine for other chronic pain illnesses. Ive no miracle cure to share but totally sympathise with all who suffer.

Not having regualr bowels is not something you want to brush aside. My daughter is 13& she suffered the same issue. I had Dr.'s telling me about Fiber, regular diet& exercise. Regular fiber intake is critical. Sprinkle Benefiber on your food or mix in drink; it's tasteless. Also, sit in the bathroom everyday giving yourself time to go along with cutting out processed foods & sugars & replacing with foods/ fruits rich in protein and fibers. You don't want to end up like my aunt. She actually died from colon cancer. She never took it seriously that she rately moved her bowels until it was too late. Also, get in with a Gastroenterologist. Take this very seriously because you could die!

Anybody with constipation issues should find a doctor that will do an iodine load test. Iodine has been removed from bread and animal feed. The removal has caused people to be hypothyroid. The thyroid gland needs iodine to be able to produce thyroid Hormones. Without a proper functioning thyroid gland the colon doesn't have the strength to do peristalsis.
Research iodine supplementation because it might be the answer for not needing enemas.

had this happened for the 1st time in my life.. always been healthy... I wanted to go poop and the "poop" was there ready to come out but it woudn't.. i didn't pay much attention to it bc it never got to a "serious" level but after 30 min nothing.. i started getting nervous and it got to the point where I was in the toilet unable to move, not move. i wasn't alone so i got some meds.. i wouldn't had been able to do anything if i woul'da been alone. I got laxative which it did nothing, and had a rectum liquid that did the job..
im eating a better diet and exercising again.. i don't want to go through that ever again..

I was classified as constipated since 3 years of age and usually pass one hard round table tennis ball of poop once a week until when I was 25 yrs old when I found out that 8 to 10 pints of beer gave me relief the following morning. This lasted a few years and I went back to once a week poop until recently when I took herbal slimming tea to soften my stool, but still had to agitate my lower belly and strain strenuously to get relief. From my IPad (safari) I now realize that my condition is due to intusussception which is enveloping a part of my colon ( like a telescope).i am now 84 yrs old and healthy, but have decided to live with it for whatever years I have left. I hope my comments can help younger people who have my ailment.

Hot shower was the best solution for me. Bend over and just let the water flow, push when the urge strikes. You are in the shower and can clean it later if needed. You will know when to step out to use the toilet though.

Hope this helps. ;)

I usually come across this problem and it is a bit frightening. However, one could apply pressure at the base of the spinal cord between the anus and the base of the spinal cord using a finger. This helps to constrict the size of the poo. Movement is then restored without further damage.

Oh my goodness. Thank you all for your posts. I endured it, but was very close to going to the ER.Here is what worked for me. After pushing for an hour, trying to manually remove small amounts at a time, I began to have some mucus type sepage and a lot of pain. I found some glycerin, KY jelly for lubricant.Didnt work then either. I drank about 2 cups of milk as I am generally lactose intolerant.Tried taking a long hot shower as I was getting nervous to the point of shaking At this point, I couldnt urinate,
Which I suspect pressure on my ureter. (I was NOT dehydrated, I suspect this was a bad combo of phenergan and hydrocodone I had taken for muscle spasm/ neck injury).Sent hubbie to WM for 2pk Fleet saline enemas. .I laid down in the tub on top of the plastic bathmat and tried the enema. I suspect I had a tear, because it was burning a lot to use the enema.I took the previous post advice to use two fingers in a V formation, I supported the external muscle my pushing towards my body externally. I had a hand held shower massager with warm water nearby to spray the anal area to relieve the burning while insering and apllying the saline enema. I probaly had torn tissue from pushing. After emptying the first enema, I refilled it with warm water and used that also. Within 15 to 20 minutes, the intestinal pressure pain really became intense .And finally the involuntary muscle kicked in and had as someone else posted"the best poop of my life" The immediate relief was almost orgasmic. I pray that is the first and last time I ever have an impacted stool. Gross, without a doubt, but if you live long enough, painful and gross things happen. Two lessons learned, No amount of straining will help, and get in the tub lie down when you use the enema . Wary today that it doesn't happen again. Vowing to take better care of my diet and fluid intake so it NEVER happens again!

I have had impacted stools once or twice a year for several years now.

Back when I was about 23 I had one so bad that I sat in the toilet for 4 hours with no avail. I finally told myself I would force it out no matter the pain - and I did.

It hurt bad. Turns out I got an anal fissure as a result of what I did. No meds. No stool softener. Nothing. I also had eaten lots of peanuts and so when it came out the peanuts were on the side of the stool and like razor sharp blades cut my internal parts badly on the way out.

For years I have now had to be careful as even the slightest bowel movement would reopen the cuts that took months to heal and would cause me lots of bleeding.

In 2014, I had to take some hydro codone medicine which had OxyContin in it to help my lung inflammation heal. Unknowingly, this medicine gave me the thickest, hardest, driest stools imaginable. For 2 days straight I suffered. Even with stool softener and lots of fluid. When it came out, I was super relieved .... But my anal fissure would return again.

Most recently (today) I had another bout of constipation (impacted stool) that was tough. I literally was at the point of crying ... I took the stool softener the day before but my muscles kept trying to push something out that wasn't coming out. I did everything to no avail. Finally, before I would try to go to the ER or urgent care for help, I cried out to God (Jesus Christ) for help.

Now call it what you will.... But .... In the next minute..... I finally was able to pass the stool. And it didn't hurt. And it came out easily. I'm shocked and amazed....and I had changed nothing. It just happened.

So to any believers out there, call upon God in your moment of need and ask for help. I don't know about the rest of you. But it helped me and I know 100% it was His doing. I was saved from so much pain.

God bless you all.

Thanks for your post. Just want you to know that you are right. Our lord is careful over his own and will help when we call. Praying for my 3 year with this problem. I know the resolution is on the way. Thanks again and be encouraged!


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