Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency care if constipation or suspected impaction occurs with:
Severe or rapidly worsening abdominal pain
A markedly swollen, hard, or very tender abdomen
Repeated vomiting or inability to keep fluids down
Inability to pass both stool and gas
Fainting, severe weakness, or new confusion
Heavy rectal bleeding or black, tar-like stool
These symptoms can suggest complete bowel obstruction, significant bleeding, perforation, or another serious condition.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Arrange prompt medical assessment if you have persistent rectal pressure, watery leakage with constipation, repeated unsuccessful attempts to pass stool, or several days without a bowel movement accompanied by discomfort.
New constipation should also be assessed if it follows a medicine change or is accompanied by unexplained weight loss, ongoing bleeding, or a lasting change in bowel habits.
3
Does any of this apply?
Book an appointment
Routine follow-up is appropriate after treatment to review bowel habits, medicines, diet, mobility, and any need for continuing laxatives.
Contact your care team earlier if symptoms start returning.
Every sign above is quoted from the sofidex article on Fecal impaction. If you are not sure, err upward — it is always reasonable to be checked.