Thanks for your reply. I wanted to wait a few days to give you an update and then ask further advice.
I understand that fecal impaction is uncommon in younger patients where the cause is chronic,untreated constipation. This would clearly be unlikely in my case since I have never suffered with constipation before last Saturday, even throughout the entire course of my three pregnancies. However I have also read several studies (eg here, here and here) online about the potential of certain types of seed to form a lump (or bezoar) in the rectum, stomach or large intestine. It is this that concerns me since the day before eating the pumpkin seeds I had absolutely no symptoms of constipation, and within a few hours of eating them I was almost totally unable to have a bowel movement, and passing blood (I've never had haemorrhoids before either).
Also I am not really responding to the laxatives or suppositories as I am straining to produce even a small amount of stool. I have been taking the laxatives for six days now, and I have also used one bisacodyl suppository. I still feel that there is a large blockage that I cannot pass, however much I strain. I am able to pass gas and I have had on average one or two small bowl movements per day, but they are very much reduced in size and quantity compared to normal. Other symptoms: bleeding from the rectum after trying to pass stools, some muscular aching especially in the arms and shoulders, some itching on my arms and legs, minor headaches which seem to come and go. No pain or abdominal discomfort except when I am trying to pass a stool.
My obgyn has only prescribed laxatives and suppositories so far. He has not carried out a digital rectal examination or performed any kind of scan (I would have to go to see a specialist at another hospital for this). He says he could perform an enema, but warned me that this carried significant risk of inducing labor ( which I find unacceptable because I am only 37 weeks and wish to carry the baby to term unless it really is an emergency).
I have about three weeks left of the pregnancy if I go into labor close to my due date (as I did with my previous two pregnancies) .Should I just wait it out, using home remedies such as prune juice, a high fibre diet, and over the counter drugs such as Colace, and then have tests done after the baby is born? Or should I go to a larger hospital straightaway for further testing? I discussed this with my obgyn, who said that there would be very little they could do at a larger hospital- I can't have an Xray or CT scan since I'm pregnant, and even tests such as as a sigmoidoscopy typically require an enema to be carried out beforehand. I'm concerned however that the waste building up in my body even from a partial impaction could lead to serious consequences.
I'd like to know your opinion on this. If I went to a larger hospital, would there actually be anything that they can do (given that I don't want to risk inducing labor at 37 weeks by having an enema).Are there any scans or tests that can be used safely in pregnancy to check whether there is a fecal impaction?I'd also like to know how serious you think my situation is, based on the description I have provided.Could I be in danger of developing a complication such as sepsis or peritonitis due to fecal build up, despite the fact that I am passing small amounts of stool every day. In that case maybe the benefits of having a CT scan, X ray or enema outweigh the risks.
Thanks very much for your advice.