Hi, thanks for your question, I have read it and understand your concerns. Short answer: There are two aspects of fecal impaction management. First part is to remove the impacted fecal matter. This could be done by using an enema which is given in the back passage. If that does not work, then manual removal will be attempted where doctor will use their fingers for the purpose. A doctor has to perform a rectal examination to confirm if there is fecal impaction, before trying the above-mentioned procedures. They will also look for any tear (anal fissure due to hardened faeces) which might be the reason for the pain you have during defecation. The second part of the management is to avoid constipation and to prevent the stools from getting impacted. This could be done by taking enough water and staying hydrated, keep moving around e.g. walking, jogging, other exercise etc. and taking fresh fruits and vegetables. If constipation occurs, laxative medications should be used to relieve it. Hope this helps. Please feel free to contact me for any further clarification.