Obstructed Defecation

For chronic constipation, talk with a doctor about prescription drugs to regulate bowel activity. If you have an underlying gastrointestinal condition, treating it can help relieve constipation.

What to Do When Your or Your Child’s Poop Is Stuck Halfway Out

A stool that gets stuck halfway out can be a sign of constipation or fecal impaction. Walking around, drinking water, or taking a laxative can often help you pass a hard stool. But some signs can point to a medical emergency.

Squirming to pass a stool is anything but pleasant. You feel the urge to go, yet nothing comes. Or the poop makes its way to the opening of your anus, but gets stuck halfway out.

This happens to a lot of people. It’s even common in babies as they switch from a liquid diet to solid foods.

Impacted stool can cause poop to get stuck. But having your poop stuck halfway out doesn’t always point to impaction. Every day constipation is another possible culprit.

Poop stuck halfway out your anal canal is an awkward feeling, but it isn’t necessarily an emergency. Some causes might require medical treatment, while others will resolve with home remedies.

Common causes of your poop stuck halfway out include:

Constipation

Constipation refers to passing fewer than three bowel movements a week or having difficulty fully passing stool. Symptoms include:

• hard, dry stools
• straining
• feeling that you haven’t emptied your rectum fully

Constipation can be chronic or infrequent, but is typically not a medical emergency. The only exception is when a blockage causes constipation, leading to impaction. This might include an intestinal blockage caused by:

• colon cancer
• rectal cancer
• another condition affecting your digestive tract

Since constipation causes stools to move at a slower pace, poop can get stuck halfway out.

Impacted stool

Impacted stool can also cause poop to get stuck. Also known as fecal impaction, this condition causes dry, hard stools too. It often results from prolonged constipation, which blocks stools in your rectum.

Impacted stool is a more serious condition. In fact, although extremely rare, it can be life threatening if left untreated and lead to a colon obstruction. Other signs of fecal impaction include:

• abdominal pain
• bloating
• diarrhea
• thin and bloody stools

Other medical conditions

Keep in mind that some gastrointestinal conditions have constipation as a symptom. If left untreated, these can also lead to impacted stool. Impaction might occur if you have:

• irritable bowel syndrome
• Hirschsprung’s disease
• Parkison’s disease
• inflammatory bowel conditions
• hypothyroidism
• nerve injury

Lifestyle and diet

Lifestyle habits can contribute to poop getting stuck halfway out. Some dietary and daily habits can cause constipation, such as a sedentary lifestyle and eating a low fiber diet.

Not drinking enough water also causes stools to become dry and hard, potentially causing poop to get stuck halfway out.

You can blame this discomfort on shifting hormones during pregnancy. An increase in the hormone progesterone relaxes your body’s muscles, causing stools to move slower through your intestinal tract.

The increase in progesterone often leads to constipation in pregnancy, causing poop to become stuck. Other causes also include:

• being less active while pregnant
• not drinking enough water
• eating too little fiber

During the first several months of life, a baby eats a liquid diet before transitioning to solid foods.

Sometimes, the transition from liquid to solids is a shock to their systems. And as a result, their poop becomes hard and dry until they adjust.

Home remedies and medical treatment can relieve poop that’s stuck halfway out. Possible solutions include:

Home remedies

Oftentimes, the condition is dry, hard stools, and not a medical emergency. Start by increasing your fiber intake, which makes it easier to pass tools. This includes eating more:

• fruits
• vegetables
• whole grains

You can also increase your water intake to keep stools soft, as well as increase physical activity. Exercise stimulates intestinal movement, making it easier to pass stools.

Over-the-counter medications

If you experience constipation, it might take a few days for home remedies to take effect. But the following over-the-counter medications (OTC) may relieve symptoms:

Use laxatives as directed by your doctor, and for no more than 2 weeks. Overuse can worsen constipation.

Medical treatment and prescription medications

For chronic constipation, talk with a doctor about prescription drugs to regulate bowel activity. If you have an underlying gastrointestinal condition, treating it can help relieve constipation.

If prolonged constipation causes fecal impaction, a doctor may prescribe or recommend a suppository or enema to soften any stool present in your rectum.

Your doctor might even recommend a colonoscopy to look for possible blockages in your colon. If that’s the case, you might need surgery to remove the blockage.

If you have poop that’s stuck halfway out, avoid worsening the situation. Here’s what not to do:

Digging the stool out with your fingers

When your stool is stuck halfway out, manually removing it from your rectum might seem like a simple solution. But don’t insert your finger in the rectum.

Digging out the stool can damage the soft tissue at the opening of your anus, resulting in anal tears and bleeding. Only a doctor should manually remove poop from the rectum.

Forcing it out

You might feel the urge to strain and force the stool out. However, straining to empty your rectum can cause other conditions like hemorrhoids and anal fissures. These can cause bleeding and rectal pain.

Obstructed Defecation

Obstructed defecation syndrome (ODS) is a functional pooping disorder. People with ODS have trouble evacuating their bowels, resulting in constipation. It may be for a variety of reasons, both mechanical and psychological. Treatment is usually conservative and holistic, but sometimes surgery is needed.

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Overview

What is obstructed defecation syndrome?

Obstructed defecation means difficulty pooping. This can be for a variety of reasons, both mechanical and psychological. People with obstructed defecation syndrome (ODS) feel that they can’t poop when they want to, they aren’t pooping often enough or they aren’t pooping everything out all the way. They suffer from constipation, but also sometimes from fecal incontinence, when backed-up poop overflows. They spend a lot of time on the toilet, waiting or straining to poop (defecate). Over time, excessive straining and passage of hard stools can deteriorate the muscles and nerves involved, which adds to the problem.

How does this condition affect my body?

ODS is a broad umbrella term describing a range of conditions that involve constipation and difficulty defecating. What they have in common are the symptoms of constipation.

Diagnosis of constipation requires two or more of the following symptoms, consistently for 90 days:

• Straining on more than 25% of bowel movements.
• The feeling that you didn’t completely empty your bowels (incomplete evacuation) on more than 25% of bowel movements.
• Hard stools on more than 25% of bowel movements.
• Needing to use your fingers to help pass stools more than 25% of the time.
• Fewer than three bowel movements a week.

These symptoms may only be the tip of the iceberg, however. They often result from underlying conditions that have yet to be discovered.

Having chronic constipation for a long time can also cause its own set of problems. Sometimes, it’s hard to tell what the original cause was and what the effect was.

People with obstructed defecation might also have:

• Pelvic floor dysfunction. The muscles and nerves in your pelvic floor can’t coordinate correctly to make a bowel movement.
• Organ prolapse. One of the pelvic organs, such as the bladder, uterus or bowel, has fallen out of place and is bulging into another organ or falling out of the body.
• Rectal hyposensation. A loss of the ability to sense stool in the rectum or the need to have a bowel movement.
• Pooping anxiety. They might have a conscious or unconscious habit of guarding against hard, painful stools by stopping bowel movements.

How common is this condition?

About 18% of the population suffers from the broad range of conditions known as obstructed defecation syndrome. It’s especially common in women and after middle age.

Symptoms and Causes

What are the symptoms of obstructive defecation syndrome?

Obstructed defecation feels like:

• You need to poop but can’t.
• It’s hard work and/or painful to poop.
• You can’t poop everything out all the way.
• Something is blocking your poop from coming out.

You may need to:

• Strain hard to poop.
• Wait for a long time for poop to come out.
• Use your fingers to help poop come out.
• Use laxatives or enemas to poop.

• Constipation.
• Fecal incontinence.
• Constant discomfort.
• Anxiety or depression.

Common complaints include:

• Inflamed or swollen rectum.
• Abdominal pain and distension.
• Anal pain.
• Nausea, feeling tired and lack of appetite.

Why can’t I poop?

ODS has many causes, both organic and functional. Organic, mechanical causes include things like anatomical defects and physical blockages. Functional causes involve things like the brain and nervous system. Often both kinds are involved, and one kind may have caused another kind.

Mechanical causes of ODS include:

• Perineal hernia. When organs in your abdomen or pelvis bulge through your pelvic floor.
• Pelvic organ prolapse. When one of your pelvic organs has fallen out of place, intruding on your rectum or anus (rectal prolapse, rectal intussusception, rectocele).
• Solitary rectal ulcer syndrome. One or several ulcers in your rectum.

Functional causes include:

• Anismus (dyssynergic defecation). Inability to relax your sphincter muscles and/or push adequately to evacuate your bowels.
• Rectal hyposensitivity. Loss of sensation in your rectum, possibly due to nerve damage.
• Psychological disorders. Anxiety, depression, phobias, OCD (obsessive-compulsive disorder) and eating disorders.

Any of these may be either primary causes or secondary effects of obstructed defecation.

They may also have been caused by:

• Pregnancy and childbirth.
• Surgery in your pelvic region.
• Traumatic injury or abuse.

Diagnosis and Tests

How is obstructed defecation syndrome diagnosed?

Your healthcare provider will begin by asking you about your symptoms. They may use a scoring chart like this to rate how severe your symptoms are:

Symptoms	0	1	2	3	4
Straining to poop	Never	Rarely	Sometimes	Usually	Always
Incomplete evacuation	Never	Rarely	Sometimes	Usually	Always
Using fingers to poop	Never	Rarely	Sometimes	Usually	Always
Abdominal discomfort	Never	Rarely	Sometimes	Usually	Always
Use of enemas or laxatives	Never	Rarely	Sometimes	Usually	Always

Your score would range from 0 to 20, with 20 points indicating severe symptoms.

A high score indicates chronic constipation, but to diagnose ODS, your healthcare provider will need to rule out simple causes. They’ll do this through evaluation of your medical history and testing.

What tests will be done to diagnose this condition?

Once your healthcare provider understands your symptoms, they will recommend tests to learn more. These might include:

• Digital Rectal Exam. This first line of testing is usually a physical exam using lubricated gloved fingers. Your healthcare provider can look for blockages, causes of pain and signs of organ prolapse, as well as test your muscle reflexes.
• Defecography. X-ray or MRI imaging of your insides while you try to poop. Your healthcare technician will inject a medical substance into your anus for you to push out like you would a stool. You’ll do so in a private photographic chamber while they watch your organs on a computer screen outside.
• Anorectal Manometry. This test measures how well your muscles and nerves work together to push poop out. A catheter with a balloon attached is inserted into your rectum and the balloon is inflated with warm water. The other end of the catheter is attached to a machine that will measure your muscle activity.

Management and Treatment

How is obstructed defecation syndrome treated?

Because its causes tend to be complex, with many factors involved, treatment is often conservative and holistic. It’s rarely as simple as corrective surgery. Even when surgery is recommended, and even when it’s successful in correcting an anatomical problem, it doesn’t always lead to lasting relief. Symptoms may persist or come back. There are often still other factors to address, perhaps undiscovered yet.

For all people, healthcare providers begin by recommending:

• More dietary fiber, with a goal of 30 to 40 grams per day.
• More water intake, with a goal of more than 2 liters per day.
• Stool softeners or laxatives, home enemas and colonic irrigation.
• Yoga and guided relaxation techniques.

For neurological and psychosomatic symptoms, which affect up to two-thirds of people, they recommend:

• Biofeedback therapy, especially for anismus and pelvic floor dysfunction.
• Psychotherapy, when needed.

For anatomical problems such as organ prolapse, healthcare providers may recommend surgery when other treatments fail. Possible procedures include:

• Posterior colporrhaphy for rectocele, to push your fallen rectum back into place.
• Stapled transanal rectal resection (STARR) for rectocele and intussusception, to reinforce the anterior anorectal junction wall.
• Rectopexy for rectal prolapse, restoring your rectum to its normal position, often with mesh to support it. Sometimes, this also involves the removal of part of your colon.

Outlook / Prognosis

What is the outlook for people with this condition?

Conservative treatments show improvement in 30% of people. Lifestyle changes and home remedies like laxatives and enemas may be needed indefinitely, but they can offer real relief. Therapies such as biofeedback and psychotherapy require time and commitment to yield results, but they can offer lasting improvements. Surgery has uneven results. It seems to be most successful when combined with other treatments.

A note from Cleveland Clinic

Obstructed defecation is an urgent problem, but understanding what’s causing it can be difficult. You might be surprised to learn how many different body systems are involved in pooping — not to mention the brain. Fortunately, many of the treatments healthcare providers recommend for ODS can apply to anyone suffering from constipation. You can begin implementing lifestyle changes, home remedies and therapy techniques immediately. But it’s still a good idea to see your healthcare provider for testing. They’ll need to rule out or address any contributing diseases or structural problems, and they can talk you through the diagnosis after learning more about your condition.