Fecal impaction is when a hard, dry mass of stool becomes stuck in the colon or rectum. If laxatives and suppositories do not help, enema, water irrigation, or manual evacuation may be necessary.

Prompt medical help for constipation can avoid fecal impaction, which can lead to damage in the rectum and other complications. If fecal impaction occurs, there are several treatment options.

Here, find out about the options for treating a fecal impaction.

something dissolving in water signifies a fecal impactionShare on Pinterest
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A doctor may recommend oral laxatives, such as polyethylene glycol (MiraLax) or bisacodyl (Dulcolax).

A person should take the tablet as the doctor, pharmacist, or instruction leaflet advises.

Polyethylene glycol comes as a powder to dissolve in water or another drink. A person may need to take it for 2–4 days to produce a bowel movement. It makes the colon produce more water, which softens the mass, allowing the body to pass it through and excrete it.

A person should take bisacodyl tablets with water and can expect a bowel movement in 6–12 hours with bisacodyl. It is a stimulant which triggers the rectum to move the feces forward.

Laxatives are available over the counter, but it is best to check with a doctor before using them. They may not be safe to use with certain conditions, such as a bowel obstruction.

What is the difference between a stool softener and a laxative?

People can buy glycerin and bisacodyl suppositories over the counter, without a prescription. A person will need to insert the suppository into the rectum and wait for it to act.

Glycerin appears to work by stimulating an osmotic effect, drawing water into the rectum to soften the mass of stool. There should be a bowel movement in 15–60 minutes. They may not be suitable for children aged under 2 years.

Bisacodyl triggers defecation by acting on neurons in the rectum. A bowel movement should occur within 15–60 minutes. These suppositories are not suitable for children under 6 years of age.

Always follow the directions on the packet or a doctor or pharmacist’s instructions.

If laxatives and suppositories do not help, a person can use an enema. In an emergency, a doctor may do this.

In an enema, a person will insert a fluid into the rectum that softens the stool and makes it easier to push out. The fluid may be a saline solution or a solution of water and one of the following ingredients, depending on where the impaction is:

The process of applying an enema is as follows:

  1. The person will insert a tube into the anus.
  2. They will administer small amounts of enema to help reduce discomfort.
  3. The person should try to hold in the fluid for 1–5 minutes to allow the feces to dissolve.
  4. The individual may then massage the lower abdomen gently to encourage the fluid and feces to leave the body.
  5. A person may need to have several enemas until the liquid leaving the body is clear.
  6. An enema may be uncomfortable but should not be painful. If there is pain, the person should tell the doctor.

After removing impacted stool, a person may need to take additional laxatives or fiber supplements and to drink extra water to prevent a recurrence.

There are many types of enema, but people should check with a doctor before using any type.

During water irrigation a doctor will insert a small hose into the rectum and flush the area with water, encouraging the stool to soften and break down.

A doctor may massage the rectum after this procedure to help the stool move through, before removing it via another tube.

If an enema fails to work, it may be necessary to break the stool down and remove it by hand. Removing the stool should result in a person’s bowel movements returning to normal, and any side effects should go away.

A doctor will likely:

  • apply lubrication
  • use the index finger to gently break up and remove the impacted feces
  • use equipment such as an anoscope — to see inside the rectum — and suction, if necessary

In severe cases, a doctor may need to carry out this process in a surgical setting.

People with a fecal impaction should not try to remove the mass by themselves or wait for it to go away.

Instead, they should seek medical advice. A doctor will advise them on the best approach.

After treatment for fecal impaction, a person may experience:

Not seeking prompt treatment for fecal impaction can lead to:

People should seek help if they have a change in bowel movements lasting longer than 2 weeks or if they use any type of laxative for more than 1 week without constipation resolving.

Anyone who suspects they have a problem with their colon or digestive health should speak with a doctor as soon as possible.

A diet that promotes healthy bowel movements will be high in fiber.

It may include:

Other strategies that can help prevent or manage constipation include:

  • taking regular exercise
  • avoiding processed foods
  • doing bowel training to establish regular bowel habits
  • speaking with a doctor about the possible side effects of any new medications

Fecal impaction can result from severe or untreated constipation. Not treating it can lead to severe complications.

Prompt treatment will minimize discomfort and the risk of complications and may lead to the diagnosis of an underlying condition that needs treatment.

Diet and lifestyle changes can help prevent constipation and avoid a reoccurrence.