# Question regarding impaction-Kathleen? Anybody. Need an answer.



## Rose (Mar 25, 1999)

*HI,*

*I have had IBS C for as long as I can remember. Over the past few years, it has gotten worse, but as long as took my Fiber/Senna combo I could "Live" with it, some days being better that others, but I could carry on my daily life, work etc. The past few months have been different. I am still taking my fiber/senna and I am able to move my bowels, but things feel "different", plus I have pain that I never had before. What I have been noticing is that my bowel movements are somewhat looser, not Diahhrea, but loose and I do not seem to "go" as much as I used to. It almost feels like I am able to empty my rectum but it feels like there is more, much higher up in the intestinal tract that might be hardened stool and unable to move, such a an impaction. Is it possible to move your bowels and yet have an impaction further up, that won't move and causing pain? It seems like years ago, I remember reading on this board, that somebody was told by their doctor that the loose stool they were having was due to hardened stool that wasn't moving and the loose stool was moving around the hardened stool and expelling, but the hardend stool needed to move in order to get relief. Anybody who has any thoughts on this, I would appreciate it very much.*

*Thanks,*

*Rose*


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## annie7 (Aug 16, 2002)

HI Rose--that's a good question.

i have a similar situation. i have colonic inertia, a "twisty" (gastro's words--lol) colon and a rectocele so i'm on --per gastro's advice--milk of magnesia and dulcolax nightly to hep me go. my stool is usually quite loose because of the laxatives and i manage to go everyday but some days i don't go much at all and then it feels --and sounds (sloshing etc)-- that there is stool trapped in my transverse colon by the splenic flexure.. this is quite painful. i also get extreme bloating with it as well. sometimes if i press down with my abs--kind of a pilates maneuver i learned during pt for my back--i can actually push this stool out and then there is quite a bit of it.

also-- when problem occurs, my rectum is empty--that's not the problem--the problem is getting stool down to the rectum to begin with.

i've wondered if it's a spasm that's trapping the stool and keeping it from moving along properly?

i have asked my gastro and his PA as well about this. they mentioned that yes some people have trouble with the splenic flexure area and also mentioned hypersensitivity in colon. but they didn't really have any solution for it.


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## annie7 (Aug 16, 2002)

also--i have had abdominal x-rays done a couple times when this happened and they did not show an impaction--no solid hardened stool trapped in there.. i did ask my gastro if these x-rays show if very loose/liquid stool is trapped up in there and he said no they don't.

but in your case maybe it is an impaction--hardened stool trapped. i have read the same thing that you mentioned--that when an impaction occurs, often a loose type, diarrhea stool moves around the hardened solid stool...


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## Rose (Mar 25, 1999)

*Thanks, Annie,*

*Yes I forgot to mention, I have terrible bloating along with the pain. It honestly feels like there is trapped stool high up and won't move. The pain is on my left side, where I believe the transverse colon is located. I often lay on my right side and try rubbing and pushing on my left side to make it move. Sometimes I am able to get a little more stool out, but not enough to make me feel much better. I know I don't have an obstruction, because I do "go" and I am able to push out gas, but feel there is some stool impacted up there. I see my GI on the 26th, so I will ask her, but she usually feels my belly and looks at me like it's all in my head. This pain and bloat is NOT in my head. I think I will insist upon an xray, if for no other reason than to relieve my mind.*


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## Kathleen M. (Nov 16, 1999)

Usually an impaction causes watery stools, not loose stools (for me loose means mostly solid but in pieces, rather than mostly water with a few bits), if they are solid they really don't slip past the impaction that much and I dunno if it would be high enough that you would be able to form stools from liquid or not.

Most of what I read has it being watery stools with impactions, not loose or soft.

Loose stool may be able to flush out hard to pass stool that well can still move, but not immovable stool that well can't move at all, I would think. I call the first constipated stools as they often are hard to move where it isn't moving at all is an impaction. But your mileage may vary.

Hard to move stool is not the same, IMO as cannot move without medical intervention stool. And when people are backed up from constipated stool (rather than impactions) the body will use looser stool to try to "flush" it out as solid stool can move it even if it needs to be soft/loose to lubricate things. If you can flush it out, it isn't an impaction, IMO. Others may have a different defintion.

I don't know that impactions always cause a lot of pain and nothing else would. After all IBS can be very painful if you have diarhhea all the time and some people with complete and total impactions have no idea until they start vomiting feces, so hard to know if your pain could only be an impaction and nothing else.

That being said, new pain (new location, new intensity) should be checked out by your doctor and they can figure out if it is from an impaction and can get it cleared out for you, or if something else is going on that could cause pain that isn't IBS or an impaction. If you stop passing everything including gas also see a doctor ASAP as that is a sign of a full impaction.

Usually a BM empties the rectum, you should not be dumping the whole colon or even much of the colon every BM. It is kind of like a conveyor belt and if you over dump then you don't have enough and can then end up constipated from the too empty part not moving as well. So I don't know how empty you should feel other than the rectum and maybe the last little bit of the sigmoid colon.

ETA: was writing while you were posting.

Decending colon is on the left, Transverse is across the top under the diaphram, Acending is on the right, Sigmod is between the Decending and the rectum.

The splenic flexure is between the transverse and the Decending and sometimes things have trouble getting around the bend.

Bloating also has a lot of causes. Severe bloating needs to be reported to your OB-GYN especially if it doesn't tend to come and go. Abdominal symptoms are not always GI related.


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## Rose (Mar 25, 1999)

*Thanks, Kathleen.*

*I have recently had a compete physical, blood work, pap smear, internal exam etc. My last colonoscopy was June, 2011 and showed no problems other than a couple of benign polyps and diverticulosis, which I have had for years. I know you mentioned the OBGYN, thinking of the possibility of ovarian cysts or ovarian cancer. Believe me I alway think of that also, but it's not that. The pain I have is not constant. It is almost totally relieved when I lay down. There are some days when I barely notice the pain and other days when it is really bad. Passing gas or having a BM helps relieve the pain somewhat, which makes me believe it is all colon related. Perhaps my use of the transverve colon was incorrect. The bloat and pain is more in the decending colon, as if it gets to a point and won't move one more inch into the rectum so I can let it out. I tried the new drug, Linzess and it worked the 1st day it took it. I moved my bowels, had no pain, just some gas, but not painful gas. I thought I Had finally found something to help, but the second day I took it, it did not work as well and I had gas pains all day. By the third day, it worked even less and I had to leave work doubled over with gas pains. I am really ready to give up. I was so hoping this drug would be the answer. I am beginning to feel there will never be an answer for me.*


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## annie7 (Aug 16, 2002)

HI Rose.

i often try lying on my back with a microwaveable heating pad on my belly to help relieve the pain. sometimes i massage my colon through the heating pad starting on the right side and massaging it across to the left side--and sometimes down the descending colon as well. or i'll just massage the part of the colon that hurts and where it feels like there's a spasm or where everything is trapped--usually the transverse colon and the splenic flexure area.

sometimes i can get some relief--or at least pass some gas--if i lie on my left side. i'm thinking (??) maybe gravity helps move gas down from the transverse area down to the descending colon and out and that's why this works for me.

yes by all means ask your gastro about it. if you get a chance, please let me know if she has any helpful input. and yes---have the gastro set you up for an ab x-ray so you can go in and get one the next time it gets really bad. i always feel it helps to know what's going on in there. good luck with your visit.

and oh yes--sometimes i get the "it's all in your head look" too

.

i had the same thing happen to me with linzess. it worked at first then as the days went on days my "results" went down and the bloating and ab pain went up. i finally quit taking it--it was making me so sick and not doing anything.

wishing you all the best...


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## annie7 (Aug 16, 2002)

Kathleen--thanks so much for your--as always--very helpful and informative response.


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## Kathleen M. (Nov 16, 1999)

Sometimes Zoloft will help keep things moving and can reduce pain, and I haven't heard many people it works for say it only works for one day.

That passing gas/BM relieves the pain does point to IBS. I'm just concerned that the new pain has been since you have been seen, rather than you had the tests while the new pain was going on.

Does abdominal massage help at all? Gentle circles starting on the lower right and coming up the ascending colon on the right, across the transvers colon and then down the decending colon on the left. That sometimes will help things move along.


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