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What to Do When You Have Impacted Stool
Posted by Dr. Ben Kim
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:
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:
Hope these tips come in handy.
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