Faecal impaction

Faecal impaction means having a large amount of dry, hard poo in the back passage (rectum). Long term or chronic constipation can lead to faecal impaction.

Chronic constipation means difficulty having a poo that can last for several weeks or longer.

Overflow diarrhoea

One main symptom of faecal impaction, is overflow diarrhoea. The constipated poo in your bowel is so hard that you can’t push it out. So your bowel begins to leak out watery poo. The watery poo passes around the blockage and out of your bowel opening (anus). The leakage can soil your underwear and appear like diarrhoea.

Causes of faecal impaction

The main causes of faecal impaction are similar to those of constipation. Some of these include:

• side effects from painkilling medicines such as opioids
• lack of exercise over a long period of time
• too little fibre in your diet
• not drinking enough fluids
• long term use of laxatives
• depression and anxiety

Symptoms of faecal impaction

The symptoms of faecal impaction are similar to the symptoms of constipation. But other more serious symptoms can occur. These include:

• back pain due to the mass of poo pressing on the nerves in your lower back (the sacral nerves)

• a swollen tummy (abdomen)

• a high or low blood pressure

• a fast heart rate

• dizziness

• sweating

• a high temperature (fever)

• severe diarrhoea that you have no control over

• feeling and being sick

• severe tummy pain

• dehydration - you may feel dizzy, light-headed, or tired, or have a dry mouth, lips, and eyes, and pass small amounts of pee infrequently (less than three or four times a day)

• swelling around the rectum

• a numb feeling around the anus

• bleeding around the anus

Treating faecal impaction

Your doctor or nurse will assess you first before they treat you.  The usual treatment for faecal impaction is a laxative. There are different types and ways of having them.

One type is a laxative to help soften the poo to make it easier to pass. This is usually a macrogol such as Movicol or Laxido. You drink these types of laxatives.

Other laxatives you might have to treat faecal impaction, are an enema or suppository. These work by moistening and softening the poo. It is very important that you use enemas carefully and only as prescribed by your doctor. Too many enemas can damage the bowel.

If the enema doesn't move the poo, a trained nurse or doctor might need to physically remove the hard poo from your back passage. You should not do this yourself. Understandably, you may find this procedure uncomfortable and embarrassing. But it is very important to clear the bowel.