It’s morning. You have just fed the kids, and the little one is headed to the bathroom for her early morning visit. Everything is normal until…
1. You hear screaming coming from the bathroom, the unnatural, animalistic sort. This is followed by whining and moaning.
2. Enter the bathroom, slowly turning the doorknob. You are sure your child is fine, but those sounds…
3. You’re greeted by a pushing and grunting child. She is pale and hunched over. Something isn’t right. “Mommy, the poop won’t come out.”
4. You panic. Could it be? This has never been an issue before. Is she constipated? Bring your child water because that fixes everything.
5. The grunting noises continue, and they remind you of something. It takes you a moment, but now you are back to the four times you made those same sounds—the births of your children. And in a way, this painful endeavor probably feels equally as awful to your child.
6. Offer comfort with hugs and kisses. Yes, it is a bit weird to kiss and hug a child on the potty, but you’re a mother—what isn’t weird?
7. Look online and have your mind blown by the amount of suggestions to get a bit of poop to exit your tot’s digestive tract.
8. Realize how lucky you’ve been that after several children, this is the first time you’ve had to deal with this. You are a family who prides themselves on regularity.
9. Think back to the great C-section constipation of 2011 and the repeat in 2013. Pray for the sake of your child that this is nothing like that.
10. “What did it say online?” your child mumbles from the bathroom. You wish you had answers.
11. Reassure your child that all is well and Mommy will fix everything, even though you are sure this may turn into one of your biggest parenting fails ever.
12. She is crying again, but this time there are words: “Mommy, the poop is stuck.” “Stuck?” you ask, wondering if this is somehow worse than constipation and praying that it is not. “In my ass.” Damn, you have to stop swearing around her, a fleeting thought before you ask yourself an even more disturbing question: Will you have to pull it out the way you had to once (okay, so it was several times) for the dog? You used a stick, and it was disgusting. You are gagging now as you think about it.
13. Please, please don’t let it be stuck. I’ll be nice. I’ll start going to church. I’ll give money to the poor…please.
14. Realize you will have to examine your child’s back end. No biggie, you’ve done worse.
15. Panic when she continues to cry. Offer comfort again.
16. Tell her to take a break, because you could both use one.
17. Realize you have to use the toilet. Sit down. Hear child screaming that she has to use the toilet. Isn’t this the way it always goes? Get up quickly. Have another child enter the bathroom to hand you a Lego creation while the constipated child sits back on her royal throne hoping to make a gift for her kingdom. She asks for privacy. You leave the room.
18. After several minutes, enter bathroom wondering if you should advise your child to push. You decide against it as you imagine childhood hemorrhoids and wonder if that is even a thing. You vow to look it up online as soon as this ordeal is over. You should know in case this ever happens again. Child makes proclamation, “Mommy, it’s good news. My poopie that wouldn’t come out, came out.”
19. Child asks you to come see poopie. You get up and enter the bathroom for the umpteenth time this morning and realize you are examining poop for the second time today.
20. Feel grateful that her body did what it needed to so you don’t have to take additional measures (more Internet searching, home remedies, a doctor’s appointment or trying to dislodge the stuck perpetrator yourself). Your child wipes, washes her hands and flushes the toilet. All is well. Only eight more hours until your husband gets home and you can share the whole story with him.
- Why Do I Have Hard Bowel Movements and How Do I Treat It?
- What Is Fecal Impaction?
- Risk Factors
- Fecal Impaction Symptoms
- Fecal Impaction Treatment
- Fecal impaction
- What is Fecal Impaction?
- Symptoms of Fecal Impaction
- Medical Treatment for Fecal Impaction
- Can You Remove Impacted Stool at Home?
- Diet and Lifestyle Tips to Prevent Fecal Impaction
- So What’s the Best Way to Treat Fecal Impaction?
- Toilet positions
- Patient Education
- Fecal Impaction (Child)
- Home care
- Follow-up care
- Special note to parents
- Call 911
- When to seek medical advice
- Fever and children
- Digital Stimulation
- How to Deal with a Poo That Won’t Flush, According to Etiquette Experts
Why Do I Have Hard Bowel Movements and How Do I Treat It?
You can have hard stools for a lot of reasons. Sometimes, a combination of factors is to blame. Typically, a person’s stool is made from waste products and undigested food material that combines with water to be eliminated via the intestines.
This also requires motility, or gastrointestinal movement, to help stool move along the digestive tract for elimination.
A problem with any or several of these digestive processes can cause hard stool.
Sometimes hard stool is due to something you did (or didn’t) eat as well as medications you take. Examples include:
- aluminum- and calcium-containing antacids
- anticonvulsants to prevent seizures
- calcium channel blockers
- iron supplements
- medications used to treat depression
- medications used to treat Parkinson’s disease
- narcotic pain medicines
Diet-related causes of hard stools include dehydration (not drinking enough water) and a low-fiber diet. Some potential lifestyle-related causes of hard stool include:
- changes to one’s diet
- changing medications
- not engaging in regular physical activity
If a person frequently ignores the urge to have a bowel movement, this can cause stool to become harder to pass. This is because holding back bowel movements can make changes to the brain that affect the future urge to have a bowel movement.
Your stool can build up inside the digestive tract and become harder to pass.
Sometimes, an underlying medical condition can cause hard stools. Examples of these conditions include:
- anatomic problems with the digestive tract
- brain injuries
- celiac disease
- hormone-related conditions, such as hypothyroidism
- intestinal obstructions
- intestinal tumors
- Parkinson’s disease
- proctitis, an inflammation of the prostate gland
- spinal cord injuries
Some of these conditions, such as an intestinal obstruction, can be a medical emergency. Because stool can’t get out, a person can experience life-threatening complications if the bowel leaks into the intestinal lining.
Hard stool with blood
If your stool is especially hard to pass, it’s not uncommon to see some streaking of blood present in the stool. Hard stool can create irritation and micro-tears in the intestinal lining that cause bleeding. Also, you can experience bleeding from somewhere in the gastrointestinal tract that may mean you see blood in your stool.
If the blood is more than streaking or continues beyond a day, see a doctor to make sure the blood-streaked stool isn’t a sign of an underlying medical condition.
Hard Black stool
Sometimes hard stool may appear black and tarry. This could indicate the presence of bleeding in a higher area of the digestive tract, such as the stomach or esophagus. Some medications you take, such as iron supplements, can also cause dark stools.
Figuring out how to get rid of constipation isn’t the most delightful task. But since constipation can range from annoying to painful to seriously worrisome, it’s basically priority number one when it’s been days since you’ve gone number two. Here’s what you should know about why you may be constipated, plus when it’s time to call in medical reinforcements.
Contrary to popular opinion, constipation doesn’t just mean you can’t poop.
Constipation can indeed mean you’re struggling to poop, period. But the term also applies to going too long between bowel movements, per the Mayo Clinic. If either of these results in you pooping fewer than three times a week and having small, hard, dry poop when you do go, you can consider yourself constipated, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Doctors generally think of constipation in two ways: Occasional, meaning you experience it here and there, and chronic, which many professionals consider being backed up for three months or more, Kyle Staller, M.D., M.P.H., a gastroenterologist at Massachusetts General Hospital, tells SELF.
If your constipation is recent and annoying but NBD, there are a few things you can try before looping in a professional.
Eating enough fruits, vegetables, and whole grains should be your first line of defense, Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF. These foods contain fiber, which helps to keep your stool soft and easier to pass, according to the NIDDK. Women between the ages of 19 and 30 should try to get at least 28 grams of fiber per day, according to the United States Department of Agriculture’s Dietary Guidelines. That number drops to 25 grams between the ages of 31 and 50. Fiber can’t do its job without sufficient liquid, though, so make sure you’re drinking enough water every day.
You can also make it a point to avoid constipation-causing foods for a bit, especially if you’ve been eating them a lot lately. Some of the biggest culprits include cheese (the high fat content can bulk up your poop too much, making it hard to pass), white rice (it also bulks up your poop), and green bananas (they’re packed with starch, which moves slowly through your digestive tract), Christine Lee, M.D., a gastroenterologist at the Cleveland Clinic, tells SELF.
If you’re not already, being active is another way to get things moving. Exercise helps increase the motility in your colon and encourages regular bowel movements, Dr. Staller says.
In general, it’s also important to actually go (or try to, at least) when your body is telling you to, Dr. Staller says. Your GI tract has a circadian rhythm it likes to follow, which is why you probably feel the urge to go at certain times and not others (and why travel, or anything else that disrupts your routine, can make it harder to go). “Many people neglect their body’s call to defecate, and that can lead to constipation, especially if the call is ignored again and again over time,” Dr. Staller says.
With that said, there are a few sure signs you should see your doctor about constipation.
You shouldn’t hesitate to seek medical care any time you’re concerned, but doctors say there are certain times when constipation definitely requires a professional’s input.
1. You’ve been outside your range of normal for over a week: “Normal” poop schedules vary by person. For some people it’s going every day, for others it’s every three days, and some are in between, Dr. Bedford says. If you normally go pretty frequently and suddenly haven’t gone for longer than a week, it’s time to call your doctor, says Dr. Staller. This could be a sign of something like fecal impaction, which happens when hardened poop accumulates and gets stuck in your intestines, and which a medical provider may need to remove manually.
What Is Fecal Impaction?
When you have severe constipation, your feces can dry out and get stuck.
Fecal impaction occurs when a hard, dry plug of stool becomes stuck in the rectum and cannot be passed.
People with severe, long-term constipation may eventually develop a fecal impaction.
Although fecal impaction can develop in people of any age, it often strikes children and the elderly.
Children may get a fecal impaction when they withhold stool during toilet training, develop a fear of passing stool due to previous pain or discomfort, avoid using the bathroom because they don’t want to interrupt their play, or don’t drink enough fluids or eat enough fiber.
Older people may develop constipation and fecal impaction due to reduced mobility and weak abdominal muscles.
Some people may also be forced to hold their stool in for long periods of time because caregivers don’t take them to the bathroom regularly.
You are at greater risk for fecal impaction if you:
- Don’t drink enough fluids
- Have a low-fiber diet
- Have a history of frequent constipation
- Use laxatives frequently
- Have weak abdominal muscles
- Are very inactive
- Have a spinal cord injury
- Take medications that reduce intestinal movement, such as narcotic pain relievers, antacids, iron supplements, or calcium channel blockers (used to treat high blood pressure)
- Have a disorder of the large intestine and rectum, such as Hirschsprung’s disease or Chagas disease
- Have certain other medical conditions, such as a thyroid condition or depression
Fecal Impaction Symptoms
Fecal impaction can cause:
- Abdominal pain
- Nausea and vomiting
- Having to strain to pass stool
- Passing small, hard “marbles” of stool
- A sensation of incomplete emptying
- Bleeding from the rectum
- Stool leakage
- A feeling of pressure on the bladder
- Urine leakage
- Lower back pain
Your doctor will most likely examine your abdomen and rectum based on a description of the symptoms you’re experiencing.
In an abdominal examination, your doctor may notice an area of the intestine that feels full of stool.
An X-ray or CT scan of the abdomen may reveal the presence of a large amount of stool in the lower intestine.
Fecal Impaction Treatment
In some cases, a fecal impaction will have to be cleared by a healthcare professional who uses a gloved finger to sweep all the stool that can be reached out of the rectum.
Preparations to clear the rectum of stool may also be necessary, including enemas, suppositories, and oral solutions or medications.
In very rare instances, a surgical procedure may be required to clear stool from the intestine.
After a fecal impaction has been treated and the rectum has been cleared of stool, it’s important to carefully follow a bowel retraining program to prevent another episode.
You’ll probably be instructed to:
- Drink plenty of water
- Eat sufficient amounts of fiber
- Use the bathroom regularly
- Get regular exercise
Bowel retraining programs aim to help people condition themselves to pass stool at about the same time each day to avoid developing severe constipation again.
Treatment for the condition starts with removal of the impacted stool. After that, steps are taken to prevent future fecal impactions.
A warm mineral oil enema is often used to soften and lubricate the stool. However, enemas alone are not enough to remove a large, hardened impaction in most cases.
The mass may have to be broken up by hand. This is called manual removal:
- A provider will need to insert one or two fingers into the rectum and slowly break up the mass into smaller pieces so that it can come out.
- This process must be done in small steps to avoid causing injury to the rectum.
- Suppositories inserted into the rectum may be given between attempts to help clear the stool.
Surgery is rarely needed to treat a fecal impaction. An overly widened colon (megacolon) or complete blockage of the bowel may require emergency removal of the impaction.
Most people who have had a fecal impaction will need a bowel retraining program. Your provider and a specially trained nurse or therapist will:
- Take a detailed history of your diet, bowel patterns, laxative use, medicines, and medical problems
- Examine you carefully.
- Recommend changes in your diet, how to use laxatives and stool softeners, special exercises, lifestyle changes, and other special techniques to retrain your bowel.
- Follow you closely to make sure the program works for you.
Fecal impaction is fairly common, particularly in older adults and people who are bedridden.
In fact, one study found that 42% of seniors in a geriatric ward had experienced it (1).
It’s not usually a big deal once its resolved, but untreated impaction can result in very serious medical complications. It can also increase the risk of future impactions.
So what is fecal impaction, and can it be treated at home? Let’s take a look at the evidence.
What is Fecal Impaction?
Feces is the medical term for stool (poop).
It’s the waste product of digestion. When we eat, food is digested in the mouth and stomach before moving to the small intestine where nutrients are absorbed.
The indigestible parts of food move to the colon and are passed through the rectum and anus during defecation (pooping).
The human digestive system.
With fecal impaction (also called impacted stool, impacted bowel, and impacted colon), a mass of stool gets stuck in the bowel.
It’s a bit different and more serious than constipation. Constipation refers to fewer bowel movements than normal, or difficulty passing stool.
Impaction is often the result of unresolved constipation. With impaction, the bowels cannot be evacuated just by the normal muscle contractions that push stool out of the body. Medical intervention is usually needed.
Certain medical conditions increase risk for fecal impaction (2, 3, 4):
- Spinal cord injuries
- Alzheimer’s disease
- Parkinson’s disease
- Structural abnormalities in the anus, rectum, or colon
- History of intestinal surgery.
Those who’ve had fecal impaction are also more likely to have it again. One study found that 39% of fecal impactions occurred in those who’d had it before (2).
Most of the time though, fecal impaction is often the result of changeable lifestyle factors. Inadequate fiber intake, not drinking enough water, medications and unhealthy bowel habits (like delaying defecation when the urge strikes) all increase your risk.
Regardless of the cause, it’s important to address fecal impaction promptly. Unresolved impaction increases the risk for medical complications, including (3, 4):
- Bowel obstruction
- Ulcers in the bowel
- Perforation of the bowel
- Inflammation of the abdominal cavity (peritonitis)
- Damage to the neighboring organs, such as the bladder
- Heart attack.
It’s easy to brush off impaction due to its similarities to constipation; however, the outcomes can be quite serious.
Summary: Fecal impaction refers to a hard mass of stool that becomes stuck in the colon. It’s common among older adults and in certain medical conditions and is often the result of unresolved constipation and lifestyle factors. If left untreated, it can cause serious medical problems.
Symptoms of Fecal Impaction
The most obvious sign of fecal impaction is an inability to poop.
Other symptoms include (2):
- Abdominal pain
- Rectal pain
- Abdominal bloating
- Bowel incontinence, which typically occur when liquid stool leaks around the impacted stool
- Urinary frequency.
More severe cases of fecal impaction can cause symptoms in other parts of the body, such as rapid heart rate, fever and confusion (2).
If you have symptoms of fecal impaction, you should see your doctor for a physical examination.
Your doctor will feel your abdomen and listen to it with a stethoscope. He may also insert a lubricated, gloved finger into your rectum to feel for stool.
If impaction is suspected following a physical exam, your doctor may order blood tests and imaging studies, such as X-rays or CT scans (2).
Summary: Common symptoms of fecal impaction include abdominal pain and tenderness, difficulty moving the bowels and rectal pain. You should see your doctor if you are showing symptoms of impaction, and particularly more severe ones like fever and fast heart rate. Your doctor will conduct a physical exam and may order lab or imaging studies.
Medical Treatment for Fecal Impaction
Medical treatment for fecal impaction depends on the location and the severity of the blockage.
The first line of treatment is sometimes manual disimpaction, or breaking up the stool with a finger.
Your doctor will stick a gloved, lubricated finger in the rectum and try to dislodge any stool that’s stuck. You may feel a little bit of pressure or discomfort, but the procedure is generally well-tolerated (2).
Your doctor may also recommend medications or stool softeners that are inserted into the rectum in the form of suppositories or enemas.
These treatments may stimulate muscle contractions in the bowel walls or soften the stool. In some people though, they act quickly and don’t always have time to fully soften the stool (2).
More severe blockages may require treatment in the hospital. This may involve a period of no food or drink by mouth if eating or drinking would increase the risk of bowel perforation or other complications.
You may also need a tube down your nose to remove pressure from the abdomen. In some cases, surgery may be needed to clear the blockage and repair any damaged sections of the intestine (2).
Summary: If your doctor diagnoses an impaction, he or she will often see if it can be dislodged using a gloved and lubricated finger. Suppositories or enemas are typically a second line of treatment to soften any remaining stool. In severe cases, hospitalization and more aggressive treatment (like surgery) may be necessary.
Can You Remove Impacted Stool at Home?
If you suspect fecal impaction, the safest course of action is to visit your doctor.
You may be able to help move things along with enemas, suppositories, oral laxatives or other treatments.
However, these should be done with guidance from your doctor. Failure to treat impaction promptly can increase the risk of severe complications. Home treatments may also increase the risk of damaging the anus and rectum.
You can do quite a bit to prevent impaction with changes to your diet and lifestyle though.
Diet and Lifestyle Tips to Prevent Fecal Impaction
The best way to prevent fecal impaction is to have regular bowel movements.
In most cases, changes in diet and bowel routine including avoiding foods which cause constipation can prevent impaction.
Eat Enough Fiber
Fiber is a type of carbohydrate that can’t be broken down in the digestive tract.
There are two main types of fiber:
- Soluble fiber forms a gel-like substance when mixed with water. It helps draw water into the stool and makes it bulkier.
- Insoluble fiber does not dissolve in water. It helps soften the stool, which makes it easier to pass.
One review of five clinical trials found that fiber significantly increased stool frequency in those prone to constipation (5).
It makes sense, then, to aim for the recommended daily fiber intake each day:
- 25 grams for women younger than 50
- 21 grams for women 50 and older
- 38 grams for men younger than 50
- 30 grams for men 50 and older.
Food sources—like fruits, vegetables, legumes, and whole grains—are ideal. Supplements can be used if you have trouble meeting the daily goal.
You’ll want to gradually increase your intake of fiber-rich foods if your diet isn’t high in them already.
Sharp increases in fiber may worsen the problem or cause other uncomfortable digestive problems like gas and bloating. Add a serving of fiber-rich foods every couple of days until you reach your fiber goal.
Drink Plenty of Fluids
Water is often touted as a remedy to constipation, although the research isn’t very clear.
Studies have found those who drink less fluids throughout the day are more prone to constipation (6, 7).
However, no studies to date have been able to demonstrate that fluids alone prevent it. Most studies that have looked at fluid intake as a treatment for constipation have included laxatives or other treatments as well (8).
There’s some evidence that 1.5 to 2 liters of water per day may boost the laxative effects of fiber. But regardless, it makes sense to stay well hydrated (9).
Try Abdominal Massage
Abdominal massage is a technique that involves gently rubbing your belly to help move stool through the intestines.
Studies on it have been small, so it’s difficult to know for sure how helpful it is in preventing constipation. It’s shown some promise in kids with constipation and in adults with Parkinson’s disease (10, 11).
A medical professional can teach you to do abdominal massage. It’s safe in most cases and probably worth a try for preventing constipation.
But notify your doctor if you’ve been constipated and experience severe pain during massage—this could indicate impaction (12).
Move Your Bowels when the Urge Strikes
Most of us have delayed emptying the bowels at least once, either for convenience or concern for privacy.
This isn’t usually an issue if it’s done occasionally. However, chronically disregarding your body’s signals to poop can worsen constipation and increase your risk for impaction.
Withholding bowel movements can cause the bowel to become distended. This, over time, can lead to nerve damage. It becomes a vicious cycle, where you become constipated because of a loss of sensation in the colon (13).
As much as possible, go when you need to go. Everyone poops, and putting it off due to embarrassment or other concerns increases your risk for constipation and impaction.
Ask Your Doctor About Laxatives
It’s best to address constipation as soon as possible.
When other diet and lifestyle changes can’t ward it off, you may want to consider a laxative until the constipation resolves.
Laxatives are medications that help the bowels to move. They work in a few different ways. Some bulk up the stool. Others stimulate the bowel walls to contract or pull water into the stool, making it easier to pass.
Studies have generally found them to be more effective than placebo in relieving constipation. The best-studied has been polyethylene glycol (aka, Miralax), which pulls water into the stool (14).
Laxatives shouldn’t be a long-term solution for constipation in most cases, though. Some researchers have raised concerns that a person can become dependent on them to produce healthy bowel movements.
And interestingly, certain laxatives (especially stimulant laxatives) can increase the risk for fecal impaction, at least in older adults. That’s why it’s important to speak with a doctor before starting laxatives for constipation (15, 16).
Summary: The best way to prevent fecal impaction is to move the bowels. You can often ward off constipation and impaction with lifestyle changes. Be sure to eat enough fiber and to avoid dehydration. Abdominal massage may or may not work but won’t hurt to try in most cases. Move the bowels when the urge strikes, and ask your doctor about a laxative you can use for a few days if these treatments don’t work.
So What’s the Best Way to Treat Fecal Impaction?
Fecal impaction refers to a mass of stool that becomes stuck in the colon.
It can be caused by medical conditions but is often the result of lifestyle factors and unresolved constipation.
When fecal impaction occurs, it’s important to see a doctor. If left untreated, it can cause serious complications like bowel perforation or even death. Home treatments only increase the risk for this and may leave you susceptible to injuries of the anus and rectum.
The great news is it can often be prevented by:
- Eating a diet that’s adequate in fiber
- Drinking enough fluids
- Moving the bowels when the urge strikes
- Addressing constipation as soon as it hits.
Adopting a balanced diet and healthy bowel habit can lower risk in most cases.
Trying to maintain a good toilet position may be useful for people that find it difficult to pass a stool, who strain when defecating or who suffer from constipation. There is no right or wrong way to sit on the toilet; however the following pointers may help make emptying your bowels easier.
- Lean forward when you are sitting on the toilet with your hands resting on your thighs
- Make sure that you knees are bent and are higher than your hips (it may help to use a footstool if your toilet is high or you are not very tall)
- Make sure your feet are resting on the ground -(or on a footstool)
- Try to breathe to the bottom of your lungs with your mouth open to prevent straining and contracting your pelvic floor (diaphragmatic breathing)
- Bulge your tummy muscles forward as you take a deep breath in and then ‘brace’ your tummy to prevent it from bulging further forwards. Do not tighten your tummy.
- Relax your anal sphincter to open your bottom and let the stool out
- Use your deep breath to increase the pressure in your abdomen and push down towards your anus.
Only try this a maximum of 3 times. If it does not work, get up from the toilet and walk around. It may help to try having a warm/hot drink.
You may want to read our post on methods of encouraging a bowel movement if the above isn’t working for you.
Fecal Impaction (Child)
A normal stool is soft and easy to pass. But sometimes stools become firm or hard. They are difficult to pass. They may pass less often. This is called constipation. It is common in children.
If a child is constipated, stool can harden in the rectum. New stool will keeping forming in the colon but can’t pass the blockage. This is called fecal impaction. Fecal impaction can cause symptoms like:
Inability to pass stool
Passing only pea-sized stool
Uncontrolled watery diarrhea (if the bowel is not completely blocked)
Swollen and painful abdomen
Refusal to eat
Problems holding in urine
Painful bowel movements
Postures or behavior that show discomfort
Stool in child’s underwear
Painful bowel movements
Itching, swelling, bleeding, or pain around the anus
Fecal impaction from constipation can have many causes, such as:
Eating a diet low in fiber
Eating too many dairy foods or processed foods
Not drinking enough liquids
Lack of exercise or physical activity
Stress or changes in routine
Ignoring the urge to have a bowel movement or delaying bowel movements
Medicines like prescription pain medicine, iron, antacids, certain antidepressants, and calcium supplements
Dehydration from vomiting or diarrhea
Fecal impaction can also be caused by a child holding in stool on purpose. This may be out of fear of pain with their bowel movement. Some children hold in stool to avoid using public or school restrooms.
Your child’s healthcare provider may prescribe a stool softener. This will help your child have a bowel movement. In some cases, other methods may be advised to loosen hard stool. These may include a glycerin suppository or laxatives. You may need to use an enema or irrigation to loosen hard stool, which is then removed. Follow all instructions on how and when to use these products. It is no longer thought that laxatives can cause damage to the intestine. However, some are better choices for occasional and long-term use. Your healthcare provider will help with the decision on whether laxatives are necessary.
Food, drink, and habit changes
You can help treat and prevent your child’s constipation with some simple changes in diet and habits.
Make changes in your child’s diet, such as:
Replace cow’s milk with a nondairy milk or formula made from soy or rice. Discuss any change with your provider first.
Increase fiber in your child’s diet. You can do this by adding fruits, vegetables, cereals, and grains.
Some fruit juices, like pear and prune, can also be helpful.
Make sure your child eats less meat and processed foods.
Make sure your child drinks more water.
Be patient and make diet changes over time. Most children can be fussy about food.
If you are unsure about your child’s intake, try keeping a diary for a few days of everything he or she eats and drinks. This can help your healthcare provider determine if your child’s diet may be causing the constipation.
Help your child have good toilet habits. Make sure to:
Teach your child not wait to have a bowel movement.
Have your child sit on the toilet for 10 minutes at the same time each day. This helps to create a routine. Doing this after each meal can be very helpful. This helps create a routine and uses the body’s natural tendency to move the bowels after meals.
Give your child a comfortable child’s toilet seat and a footstool.
Talk with your child’s school. Ask them to allow your child use the restroom on a regular basis. If your child is not able to use a public bathroom, ask if the school may allow your child to use a private bathroom, if available.
Read a book or keep your child company, if that helps.
Follow up with your child’s healthcare provider. If X-rays were done, you will be told of your child’s results.
Special note to parents
Learn to be familiar with your child’s normal bowel pattern. Note the color, form, and frequency of stools.
Call 911 if your child has any of these symptoms:
Firm belly that is very painful to the touch
Loss of consciousness
Rapid heart rate
When to seek medical advice
Call your child’s healthcare provider right away if any of these occur:
Abdominal pain or swelling that gets worse
Fussiness or crying that can’t be soothed
Refusal to drink or eat
Blood in stool
Black, tarry stool
Constipation that doesn’t get better
Fever (see Fever and children)
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
Digital stimulation is a way to empty the reflex bowel after a spinal cord injury. It may also be called a “dil.” It involves moving the finger or dil stick around in a circular motion inside the rectum. By doing this, the the bowel reflex is stimulated and the rectal muscles open and allow the stool to leave the body.
This procedure is best done on people who do not have painful sensation in the rectal area. Pressure may be felt in the rectal area, but it should not be painful. The dil should be done at the same time every day or every other day to stay on a schedule and avoid bowel accidents. The time and how often a dil is done depends on the individual.
How to do a Dil (digital stimulation)
1. Gather supplies
- Dil stick (if ordered)
- Soap, water, washcloth
- Toilet paper, underpads (if done in bed)
- Plastic bag to throw away waste
- Raised toilet seat, commode chair or shower chair if done in the bathroom
2. Wash hands
3. Prepare all needed supplies and place on a towel
4. Position yourself
If doing the dil in bed:
If doing the dil in bed, lie on the left side with knees flexed (right leg over left leg) and place disposable pad under the buttocks.
If doing the dil in the bathroom, transfer to appropriate bowel equipment (raised seat, Activeaid).
How to Deal with a Poo That Won’t Flush, According to Etiquette Experts
I like to collect pooping horror stories in the way I like to collect friends: abundantly, and without assessing if they’re actually good for me or contribute anything to my life. I’ve listened to many poo stories in my life, and I’ll continue to push harder until I find that ultimate tale: the golden nugget, the poop story to end all poop stories.
So here’s one brown-plated gem, first reported by the BBC. In Bristol, England, a first date went disastrously wrong after a girl panicked, threw an unflushable poo out of the window, then got trapped upside down trying to retrieve it by climbing out of said window.
The case came to light after 24-year-old student Liam Smyth, her date, shared his story online while crowdfunding to replace a window that was broken during the ordeal.
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The girl, who has not been named, was in Smyth’s house after a successful date at a local restaurant. When her poop wouldn’t flush—a clear-eyed horror that all of us, if we’re being honest with ourselves, know well—she threw it out of his bathroom window, where it became trapped between an internal and external layer of glass like a flower pressed between the pages of a book.
“It was a panic response and within seconds I knew I’d made a terrible mistake,” she wrote in Facebook comments reported by The Sun. “I would have left, but I just couldn’t do that to him.”
Shakespeare wrote, “cowards die many times before their deaths; the valiant never taste of death but once,” but I say: Shakespeare lacked imagination. Only the truly valiant would admit to trapping a shit in a window on a first date. Death seems easier, if we’re being honest.
Photo by Liam Smyth
“It was one of the hardest things I’ve ever had to say,” she wrote. “I swear I was literally on my knees cringing and apologizing. He was so good about it though, just laughed with me rather than at me.”
Being an amateur gymnast, she was convinced that she could reach into the window and “pull the poo out,” Smyth explained on his funding page. “Unfortunately she couldn’t reach. She climbed further in and had the same problem. She called out to me to help her climb out from the window, I grabbed her waist and I pulled. But she was stuck.”
Once he composed himself—and took an obligatory photo—Smyth called the fire brigade, who rescued her. But what to do if you find yourself in a similar situation on date night back at his? How best to handle a poo that just won’t flush?
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“A way to handle the situation could have been to first cover it up with a small amount of toilet paper,” explains etiquette expert Elise McVeigh. “I would then come out of the restroom, and tell the home owner that you are having a hard time flushing the toilet. I would ask if there is a trick to it, or if he has had issues before. If he offered to go in there and look at it, I would stop him and say I would prefer to handle it myself if possible.”
When it comes to recalcitrant shits, time can help get rid of the problem. “If the date said he’s never had an issue with the toilet, and that he’d have to call a plumber, I’d go back into the bathroom 30 minutes later and try to flush it again, if I did not think that the toilet would overflow.
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“At the end of the evening if I did not have success in flushing completely, I would apologize without giving any details, and tell him that if a plumber thought I had something to do with it not flushing, then please send me the bill,” she goes on. “Part of good etiquette is acting like something did not happen.”
And what happens if the boot’s on the other foot? “We are all humans, and we all use the restroom! Situations can happen that are out of our control,” agrees manners expert Maryanne Parker. “A good host will have to be understanding about the needs of the visitors. If there are many people in the room the host should take the matter into consideration discretely, without making a big deal about it. This situation should be handled in an adult way.”
Also: buy a plunger.