Large Colon
Pelvic flexure impaction
A relatively common form of colic, that is often associated with a recent change in diet, management or exercise levels. Pain is moderate, and often persists despite adequate analgesia, a sign more commonly associated with colic of a surgical nature. However, rectal examination provides a definitive diagnosis, with a large, doughy structure occupying much of the pelvis. Treatment involves encouraging fluid output into the large colon, to help soften the impaction, firstly by ensuring adequate hydration with intra-venous fluids, and sometimes by administration of sodium chloride and sodium sulphate orally, to create an osmotic gradient. Large volumes of water, sometimes with Magnesium Sulfate with or without liquid paraffin (Mineral oil) are also given by naso-gastric tube, to help soften the impaction and encourage its movement.