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During extreme impaction constipation, enemas and oral laxatives must be used. Breakthrough occurs when you finally shit out the last of the acorns and the diarrhea from your oral laxatives finally breaks through the fist sized corm of fecal clumps you were trying to squeeze out of your dry, fissured anus, giving you that sweet relief of liquid diarrhœa. Usually accompanied by uncontrollable vomiting.
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