It all starts when something triggers a long-term disorder in your digestive system

For fecal impactions to occur, there first has to be something that causes your digestive tract to start working improperly. This “something” is called an initial trigger.

There are 11 main triggers that start this process of digestive malfunction in our body:

• Old age
• Poor diet (low fiber, inadequate water intake)
• Immobility (sedentary life style, postsurgery, strokes)
• Medications (opioids, antihistamines)
• Neurological conditions (Parkinson’s, dementia)
• Psychological conditions (depression, anxiety)
• Metabolic problems (hypothyroidism, diabetes)
• Cancers
• Inflammatory bowel diseases
• Infections (chagas disease)
• Functional diseases (IBS

What these initial triggers have in common is that they all slow down your large intestine – this is called colonic hypomobility and it is at the root of fecal impactions.

The continued slowdown of your GI movements eventually causes your digestive tract to become permanently sluggish.

• Your colon muscle contractions become weaker
• These contractions happen much slower
• These contractions don’t last that long
• These contractions happen less frequently

Your large intestine becomes unable to move the stool along normally and you end up with something called a functional bowel disorder, a serious condition that can last a lifetime.

As you’re about to see, once this bowel disorder takes a foothold in your gut, it continues to get worse even if you take away the initial trigger. In other words, the initial trigger’s job is to simply start the disorder. Once this disorder is already underway, it will continue to get worse on its own (even if you treat the initial trigger).

The digestive slowdown causes your stool’s consistency to change

It may not even be noticeable when you first develop a bowel disorder. Your GI tract’s peristaltic motions become very feeble but your bowel movements still seem normal on the outside.

However, at this stage your gut is already beginning to experience damage from changes in your stool’s size and hardness.

As your digestive tract slows down, your stool spends more time in the colon before it is expelled. This delay in the stool’s transit through the large intestine lets more of the fecal mass gather into a solid bulk and allows the colon to absorb more water from this solid bulk.

This causes the fecal mass to get bigger and drier. As the fecal mass becomes bigger and drier, it moves even slower which in-turn makes your stools grow even larger.

You can see how the gut disorder has now created a self-propelling cycle of damage – the colon slowdown creates bigger stools and bigger stools slow down your colon even more.

The colon’s healthy bacterial balance gets thrown off from the prolonged stool presence. This effects your gut-brain communication, which further impairs the function of your large intestine.

Your stools eventually get so big that they get stuck at the sigmoid colon

So far, three things have been progressively worsening the function of your gut:

• Your colon muscles have been getting increasingly weaker
• Your stools have been getting bigger, drier and harder
• Your stools have been moving slower and slower through your large intestine

However, at this stage the situation reaches a critical tipping point…

Your growing stools have finally gotten so big that they can no longer pass through one particular region of your digestive tract – the sigmoid colon.

The sigmoid colon is the last portion of your large intestine and there are 3 reasons why this region is prone to fecal impactions:

• The colon is at its narrowest point here
• Your stool reaches its hardest consistency at this point
• The colon makes sharp s-shaped turns here

While the colon is about 3 inches wide through most of its span, at the sigmoid region it suddenly narrows down to only about a 1-inch width.

Now imagine your bulk stool growing bigger as it travels along the length of your large intestine and suddenly encountering the sigmoid colon.

Your digestive system has no choice but to push this fecal mass into this tiny section of your intestine. Now the hard mass not only has to squeeze through this narrow passage, it also has to make the sharp turns along its path.

You can see why the stool being both large and hard can make this an almost impossible task.

Your stools go from moving increasingly slower in the previous stages to now getting stuck in the sigmoid colon.

This sets off the next stage in the disease process where your digestive tissue begins to quickly breakdown from the inside-out…

The stuck stool chokes-off the blood flow inside your sigmoid colon

The delicate tissue of our intestines contains tiny capillaries that supply it with blood using a process called capillary perfusion. The pressure inside these capillaries is maintained so low that even a small push against the insides of your colon can cutoff the blood flow within it.

Also, it just so happens that the sigmoid colon has a poorer blood supply to begin with compared to the rest of your large intestine. This makes the sigmoid extremely vulnerable to interruptions in blood flow.

When an oversized stool from your colon is forced into the much narrower sigmoid region, it pushes so hard against the inner lining that the capillaries get closed-shut (vascular compression).

This starves your digestive tissue of its vital oxygen supply (ischemia) and begins the next stage of fecal impaction damage where the colon’s inner lining gets severely injured.

Your sigmoid colon develops ulcerations

By this point in the disease process, your stools are beginning to get stuck so badly in your colon that the intestinal lumen (inner lining) is actively breaking down.

At first, the high intraluminal pressures lead to an extreme inflammation of this sensitive inner lining (stercoral colitis). This inflammation then leads to necrosis, where the tissue in the most distended regions of your colon begins to die.

Eventually, the sustained high pressures from your stools cause deep ulcerations in your sigmoid colon. Now your condition has reached another grave milestone where your chances of a serious complication have gone up substantially.

Studies have shown that 57% of all patients that need emergency surgery show damage to the intestinal lumen and 28% of the deaths that occur from fecal impaction have a damaged intestinal lumen.

Your colon wall loses its structural integrity and starts breaking down

This outer wall gives your intestine its strength. It is made up of a thick muscular layer and it is the last line of defense protecting you from a potentially fatal colon rupture.

When a large fecal mass gets stuck in your sigmoid colon, the prolonged distension begins to damage the outer wall. As a natural defense, the damaged bowel wall responds by becoming thicker. This further narrows the inner passage and makes your situation even worse.

When a large fecal mass gets stuck in your sigmoid colon, the prolonged distension begins to damage the outer wall. As a natural defense, the damaged bowel wall responds by becoming thicker. This further narrows the inner passage and makes your situation even worse.

Finally, the prolonged inflammation causes a complete failure of the colon wall structure where the digestive tract can no longer provide counter-resistance against the hard stools.

In this situation a colon tear becomes imminent and your risk of hospitalization drastically increases.

Studies have shown that once your colon wall starts getting affected, the mortality rate from a fecal impaction goes up significantly. Of all emergency surgeries done on fecal impaction patients, 79% show damage to their colon wall and 32% of the deaths that occur from fecal impaction have a damaged colon wall.

Your rectum and internal anal sphincter get severely impaired

Normally when your stools make it all the way to the end of the large intestine, they enter the final section of your digestive tract – the rectum.

Once enough stool has collected in your rectum, its stretch receptors get activated and an automatic reflex causes the fecal mass to be pushed forward. The internal anal sphincter (IAS) then relaxes and the stool is expelled out of your body.

However, during fecal impaction two things happen that disrupt your ability to have a normal bowel movement:

• Your rectum stays empty for long intervals because your stools stay stuck at the sigmoid colon
• And when your stools do finally make it past the sigmoid colon, they now get stuck in your rectum

In both cases your rectal tissue and your internal anal sphincter (IAS) experience long-term damage and you lose your ability to defecate.

Let’s see how…

During a fecal impaction, when your stools are stuck at the sigmoid colon, your rectal muscles stay relaxed for a prolonged period. Like any muscle, by not being used for so long, their muscle tone gets reduced. The longer you go without stools entering your rectum, the weaker it gets.

When your stool does eventually manage to squeeze past the sigmoid colon and get into the rectum, your body has a hard time pushing it out because the muscles responsible for emptying your bowels have weakened so much.

This creates a second, much bigger problem…

Once you become unable to effectively push the stools out of your body because of a weaker rectal muscle tone, your rectum begins to accumulate excessive fecal matter. This is called rectal overload and it damages your internal anal sphincter (IAS) that is responsible to expelling your stools.

Without a properly functioning internal anal sphincter, you become unable to evacuate your bowels. This creates another vicious cycle of damage where your stools keep collecting in the rectum and damaging the internal anal sphincter and that in-turn causes more stool to collect in the rectum.

Finally, the persistent rectal strain from the buildup of fecal mass causes permanent muscle dysfunction. At this point your rectal tissue becomes so vulnerable to a rupture that any bowel movement can cause a potentially fatal tear in it.

Nerve damage deadens your rectal sensations, taking away your natural urge to pass stool

A key part of having a bowel movement is being able to automatically sense when your rectum is full. One nerve in particular is crucial for providing rectal canal sensations and regulating bowel expulsion – the pudendal nerve.

When your rectum gets overloaded with stools, the fecal mass pushes so hard against this nerve that it experiences compression damage (neuropathy).

Pudendal nerve neuropathy diminishes your rectal sensations. This causes your lower rectal threshold to go up, which essentially means you lose the ability to sense when it’s time to go to the bathroom.

Now your condition has taken the final major step towards catastrophe because you no longer feel the urge to defecate. It is ironic that just when the damage is at its worst, the disease goes completely silent.

Without any way of clearly sensing the damage inside, the next time you might notice any symptoms may only be after a devastating internal injury has already taken place. Which brings us to the next and last stage…

Sudden colon trauma turns into a life-threatening emergency

This final stage is responsible for many of the fecal impaction related deaths we see worldwide each year. You may have noticed that once the disease process starts, it relentlessly damages multiple parts of your digestive system:

• Your colon experiences ischemia, colitis, necrosis, ulcerations and bowel wall damage
• Your rectum weakens to the point where it can no longer push your stools out
• Your internal anal sphincter gets so damaged that you lose the ability to have a normal bowel movement
• Your pudendal nerve suffers such severe injury that you permanently lose the urge to defecate

However, at this stage your fecal impaction goes one step further and shifts from just damaging your digestive system to actually endangering your life.

At this point, your gut has finally reached its absolute limit of how much damage it can endure without experiencing catastrophic failure. Now, even the slightest additional tissue injury can cause a sudden rupture in your colon or rectum and quickly turn into a fatal body-wide infection (sepsis).

In essence, this is last stage of the disease where a lethal digestive tear can happen at any moment.

Astonishingly, even at this late stage, you may not necessarily feel any significant pain or discomfort and might be completely oblivious to an impending rupture.

And this is what makes a fecal impaction so dangerous – the silent nature of its damage.