Faecal impaction

What is faecal impaction?

Faecal impaction is when poo gets stuck somewhere along your gut. It can happen after you’ve suffered from a period of severe constipation, as the poo becomes drier and harder. Poo can clump together in a large mass which is hard to pass. New poo is produced behind it but can not get past the blockage. Faecal impaction can cause tummy or lower back pain and you may feel bloated.  

What are the symptoms of faecal impaction?

There are many things someone with faecal impaction may experience. Some of the more common include:

• Bleeding from your bottom

• Small or partially formed poo, sometimes like rabbit droppings

• Loose poo as some might manage to get past the blockage

• Straining hard trying to poo

• Explosive poos after a period of constipation

• Tummy cramping

• Tummy pain or bloating (this can also be in your lower back) 

• Nausea and vomiting

• Headaches

• Loss of appetite

It’s important to remember that not everyone will experience every symptom, and different people will feel a different amount of symptoms.

How common is faecal impaction?

Anyone can get faecal impaction, but it’s most common in older people, especially older women. Young children, most commonly between the ages of 2 and 4, may also suffer due to holding in their poo.

What causes faecal impaction?

The main cause of faecal impaction is constipation. Some causes of this are:

• A diet without enough fibre – around 30g a day is recommended to keep your poo soft. Fibre can be found in fruit and vegetables

• Drinking too little fluids

• Lack of exercise – exercise will keep muscles strong that prevent impaction

• Lack of movement – movement helps your bowels push poo through your system

• Medication such as antipsychotics

• Medical conditions such as anal fissures, haemorrhoids, irritable bowel syndrome (IBS), diverticulitis and colon cancer

• Some medications such as codeine, calcium channel blockers, antacids and iron supplements

How is faecal impaction diagnosed?

Whilst there are several ways faecal impaction can be diagnosed, the most common is with a digital rectal examination. This is where a healthcare provider inserts a gloved finger into your bottom to see if they can feel a hard lump of poo. If they think the impaction could be located higher up, they may request an X-ray of your abdomen to check.

How is faecal impaction treated?

The most frequent treatment is oral laxative, a medication that softens your stool to help you poo. An enema, where a doctor will insert fluid into your bottom to soften the poo may also be used.

How long does it take to clear faecal impaction?

After you start treatment, such as a laxative, a very watery poo should pass after 2-7 days. Do not carry on with treatment with laxatives for longer than 2 weeks, see your GP again. 

How do you know when faecal impaction has cleared?

There may be small lumps of poo of any shade of brown if the treatment has been successful. If your child is suffering from faecal impaction, you can give them some sweetcorn. If it appears in your child’s poo within 24 hours, the impaction has cleared. 

When should I speak to a doctor?

If you’re experiencing any of the symptoms previously mentioned alongside constipation, speak to a GP. If you have bloating, vomiting and severe abdominal pain, go to hospital as you may have a bowel obstruction which can be an emergency.

How can Livi help? 

A Livi doctor can talk to you about your symptoms and give you advice on the next best steps.