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Chronic constipation

Chronic constipation is also known as faecal impaction. It happens if you are regularly constipated for long periods of time. 

What is faecal impaction?

A faecal impaction means having a large amount of dry, hard poo (stool or faeces) in the back passage (rectum). Doctors also call this chronic constipation. The diagram shows the parts of the bowel, including the rectum.

Diagram of the bowel

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 stools around the poo. The watery stools pass round the blockage and out of your rectum. The leakage can soil your underwear and appear like diarrhoea. 

Doctors call this overflow diarrhoea. In this situation you shouldn't take anti diarrhoea medicines. So if you’ve had severe constipation and then develop diarrhoea, you must talk to your doctor or nurse before taking anything.

Causes of faecal impaction

The main causes of impaction are similar to those of constipation. They include:

  • side effects from painkilling medicines
  • lack of exercise over a long period of time
  • a low fibre diet
  • long term use of laxatives
  • depression and anxiety

Symptoms of faecal impaction

The symptoms of 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)
  • high or low blood pressure
  • a fast heart rate
  • dizziness
  • sweating
  • a high temperature (fever)
  • confusion
  • explosive diarrhoea or diarrhoea that you have no control over
  • feeling and being sick
  • severe abdominal pain
  • dehydration

Treating faecal impaction

Doctors usually treat impaction by moistening and softening the poo with an enema or suppositories. It is very important that you use enemas carefully and only as prescribed by your doctor or nurse. 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 it from your back passage. Understandably, you may find this procedure uncomfortable and embarrassing. But it is very important to clear the bowel.

Let your doctor or nurse know if you have any changes in your bowel habits. If you think you have an impaction, don’t take any laxatives without first discussing it with your doctor or specialist nurse. Laxatives that stimulate the bowel can cause severe cramping and might damage your bowel.

Last reviewed: 
08 Aug 2019
  • Constipation - Clinical Knowledge Summaries
    National Institute for Health and Care Excellence, 2016

  • Management of Constipation in Adults
    Hull and East Riding Prescribing Committee guidelines, May 2016

  • Diagnosis, assessment and management of constipation in advanced cancer: ESMO Clinical Practice Guidelines

    P.J Larkin and others

    Annals of Oncology, 2018. Vol 29, Supplement 4.

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