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June 13, 2010 12:17 AM   Subscribe

Adventures in fecal impaction. What's the next step?

So, for a good solid 48 hours until yesterday I was pretty sick, tried to sleep a lot and stayed in bed. Since then I've been feeling much better, but - to be blunt - I've got a large object of fecal matter that seems just about ready to come out every time I reach the toilet but never does. It certainly seems to be much more substantial than I would expect to pass without causing myself much injury or unpleasantness.

Meanwhile, much less solid matter builds up behind rather quickly and passes (around, I suppose) and I'm stuck there again on the toilet, finished with that quickly with the big object that I'm really, really to be rid of. Here's what I've done so far - not much. I've taken two (separated by 16 hours or so) glycerin suppositories, but what I've passed hasn't really been much different than without. I will say that over the last 24 hours or so, the large mass seems ever so slightly "closer" to coming out - but again I am well aware trying to force this is not a good thing at all, even though it always comes with this hopeful feeling...

What's my next step? Should I keep on with the suppositories for a few days and maybe this thing will wend it's way out? Or, should I see a doctor? I'm certainly interested in getting this thing sorted ASAP as it's starting to bother me in the same way as the guy from Look Around You who is afflicted with the permanent sensation of wanting to sneeze but never being able to.

I should clarify: I've never really had a problem with constipation or impaction before. Certainly nothing chronic, or even that I can remember at all.
posted by setanor to Health & Fitness (20 answers total) 2 users marked this as a favorite
Response by poster: Side question: Do you think I made a mistake by not asking this anonymously? I don't necessarily see a reason to mind, but I've been wrong before...
posted by setanor at 12:20 AM on June 13, 2010

setanor, couldn't care less whether you ask this anon or not, just really glad you asked it. There will be people horrified that you actually put your name to talking about faecal impaction but do you really care?

How sure are you that what you are sensing is actually impacted faecal matter? The ease with which other stuff can get around it is suggestive of a structural defect like some kind of herniation,although the fact that you're not straining is good, continue that!

(I'm no longer clinically active, I just teach now and IINYD and I don't know your history but) what I would try first is a warm colonic, your local pharmacy will have these over the counter. It's usually an amount liquid you warm to body temp and insert while you're lying on your side. One or two of these should work where glycerin suppositories don't, but seriously, if they don't you need to have someone manually remove the impacted matter so you don't cause major damage to the rectum and anus or check to see if something else is causing this sensation. Nurses and junior docs who deal with the elderly do this relatively regularly so I don't know the best way to go about this where you are.
posted by Wilder at 12:47 AM on June 13, 2010 [2 favorites]

For your information, you can use a plastic sports drink bottle (the type with the little pop up top) to give yourself an enema. I did this several years ago in one instance when I had a case of diarrhea that seemed to be burning inside me and it helped a lot.

I'm sure you have read the online sources on fecal impaction, so you can evaluate them and if they make you want to go with an enema then you can decide about water, salt, oil, etc. content. (My one sports bottle enema was just plain water).

But really, you need to see a doctor. Fecal impaction appears to be a recurring problem.
posted by MonkeySaltedNuts at 1:05 AM on June 13, 2010

Don't be embarrassed, setanor, the important thing is that you get some relief.

Here is an article that might help.
posted by amyms at 1:09 AM on June 13, 2010

If the impaction is further down in the rectum, you might try a lubricated latex-glove-covered finger to help it out. Bearing down while inserting the finger will make the process easier. Yeah, I know...ick. But it's better than the alternative. Be very careful, of course. You don't want to compound your problem with a perforated colon.
posted by rhartong at 7:49 AM on June 13, 2010

Stool softener together with a mild laxative; if you don't see an OTC medicine combining the two, use stool softener and in a couple of hours eat or drink something with a mild laxative effect, like coffee. (Do not use that "Smooth Move" tea you may see in the pharmacy aisle. That has senna, as does Ex-Lax, and senna is the absolute last thing you need.)

If you don't feel up to getting to the pharmacy by yourself, I hate to say it, but it's time for the doctor.
posted by Countess Elena at 7:58 AM on June 13, 2010

Also get hydrated and get more than hydrated. Push fluids, as they say -- drink something now while it's on your mind, then get two glasses of water, or an electrolyte-bearing sports drink if you can get it, once you have your medicine. You don't say how you were sick, but sickness often dehydrates.

The most important thing is to take it easy and not injure yourself. Actually, the most important thing is never to ask me how I have so much advice about this.
posted by Countess Elena at 8:02 AM on June 13, 2010 [2 favorites]

IANYD, but I would definitely try a coffee enema.
posted by Paris Elk at 9:13 AM on June 13, 2010

Like others, my recommendation is an enema. You can find it them in the drugstore, in the same aisle as the laxatives. It's not scary or painful, because you are just adding water to your intestine -- basically turning everything to liquid. It will take about 2 minutes from the time you use the enema to the time that you feel completely better.
posted by Houstonian at 9:15 AM on June 13, 2010

Walk up and down stairs a lot. then dance a little jig.
posted by serena15221 at 9:42 AM on June 13, 2010 [1 favorite]

Try getting up and moving around. Vacuum your living room and change the sheets on your bed. Then take a long hot bath. This has worked for me on more than one occasion to get things moving.
posted by TooFewShoes at 10:51 AM on June 13, 2010 [1 favorite]

As for not asking this anonymously, thank you for not doing so- this is part of what happens when you are human, so I guess you are. Good on you for pooping, or not, or trying to... or being human.
posted by TheBones at 11:43 AM on June 13, 2010 [1 favorite]

Power pudding These are the most popular recipes I've seen. Mostly fiber and prune juice. Nurses use this for patients who get regular bowel obstructions.
posted by wrnealis at 1:39 PM on June 13, 2010 [1 favorite]

Try Dulcolax suppository (a stimulant) and an oral stool softener, like Colace. Try milk of magnesia as a last resort, cause the stuff can be brutal. Drink A LOT of water, and try to move around. If it does not clear up in a day, see a doctor. After bowel surgery, I had a bout of constipation/impaction; the stimulant suppository, oral stool softener, water, and moving cleared it up in a day. I never needed to try an enema.

BTW, if you use a bulk forming laxative, you need to drink a lot of water. A friend of mine ended up with anal fissures from taking a bulk forming laxative and not drinking enough. I was told to avoid bulk forming laxatives.

Power pudding is suppose to work well, but I was told to drink a lot of water with it. Ah, the joy of pooping.
posted by fifilaru at 2:02 PM on June 13, 2010

Yeah, just go get a fleet enema or something similar. squeeze the fluid up your butt and when you sit on the toilet it'll help things move on out.
posted by gaspode at 4:58 PM on June 13, 2010

Response by poster: Hello! Thanks for all your suggestions...

How sure are you that what you are sensing is actually impacted faecal matter? The ease with which other stuff can get around it is suggestive of a structural defect like some kind of herniation

It just really has all the sensation of a really large piece of fecal matter that is just about to come out... seems to move a bit closer to the end when other things are going on but can never crest the exit.

Stool softener together with a mild laxative

Will the softener soften the stuff that's already right there at the end?

So, anyway, as an update, today was Sunday and the clinics were closed so I was on my own. It's not really that uncomfortable... I can sense it's there during the day, but it's more dread that approaches whenever I need to go evacuate and I knowing I'll be denied that "relief signal" of everything being moved. I got a fleet enema, and I tried that... I think I messed it up a little bit, maybe I'm just awkward, but I ended up with only half a bottle gone... a lot came out, and I think maybe a few chips off the big one, and it seemed closer than ever to wanting to come out (I got another one of those nerve signals - the 'cold sweat' one when something big is about to make a move) but nothing without force, and I'm not going there.

My plan right now is to do one more enema tomorrow, correctly, see what that does, and go to the doctor on Tuesday to clear anything up that's still going on. Does that sound reasonable?

Also, thanks for all the support re: posting with my name. I'm glad I did.
posted by setanor at 12:00 AM on June 14, 2010

It just really has all the sensation of a really large piece of fecal matter that is just about to come out... seems to move a bit closer to the end when other things are going on but can never crest the exit.

It could be just me, but this is exactly what my first Hemorrhoid felt like.
posted by Admira at 12:30 AM on June 14, 2010

Response by poster: It could be just me, but this is exactly what my first Hemorrhoid felt like.

Just curious, did this present any pain at all?
posted by setanor at 8:36 AM on June 14, 2010

At first, no ... later yes.
posted by Admira at 5:32 PM on June 14, 2010

I think hemorrhoid is a strong possibility, if another enema doesn;t give you relief, to rule it out, ask the phamacist for one of the suppoisitories that help reduce hemorrhoids, after a few days of using these if the sensation is still there, off to the doctor!
posted by Wilder at 10:56 AM on June 15, 2010

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