Introduction
An impaction is hard stool that is stuck in the bowel. It is caused from untreated constipation. Impactions can cause dysreflexia in someone with a spinal cord injury at T6 or higher. This lesson will review the causes, signs, treatments and prevention of impactions.
Causes
Untreated constipation
Signs
- No stool for four days or longer when attempting bowel program
- Hard, tight or bloated abdomen
- No appetite
- Loose stool leaking out of rectum
- Small amounts of blood in stool
Treatment
- Call the doctor as soon as possible
- Take the special laxative that the doctor orders
- Once the laxative begins to work, begin to manually remove the hard stool out of the rectum (see below for how to do this removal)
Removing an Impaction
1. Gather supplies:
- Gloves, lubricant
- Plastic bag to throw away waste
- Soap, water, washcloth and towel
- Toilet paper, underpads
- Raised toilet seat, commode chair or shower chair
Consider having someone help with this procedure even if you do your own bowel program normally.
2. Wash hands
3. Prepare all supplies
Do procedure in bed or in the bathroom on commode chair, Activeaid or raised toilet seat (location of usual bowel program)
4. Put gloves on both hands
5. Place a generous amount of lubricant on tip of finger (you may need to use a numbing gel to prevent dysreflexia).
Insert finger into the rectum and gently remove pieces of hard stool
After the impaction is removed, do the regular bowel program
When finished with the bowel program, wipe rectal area and buttocks area with toilet paper, clean with soap and water and dry well.
Wash hands
Stop this if dysreflexia occurs.
Treat dysreflexia.
