Causes And Treatments for Leopard Gecko Impaction

Bowel impaction is a potentially fatal health condition in leopard gecko and other reptiles. Find out how to prevent it and treat it.

Leopard gecko impaction care

Leopard gecko is considered an ideal beginner pet reptile. One of the reasons is that leos are hardy and it is relatively simple to keep them top health.

However, did you know that there is one preventable, but potentially deadly leopard gecko health issue that remains commonly seen in the leopard gecko community?

Bowel impaction is a condition that occurs when a fecal mass, or indigestible material, blocks the lizard’s tiny bowels. If the impaction is not treated, the entire digestive system collapses, leading to organ failure and, eventually, death.

The best way to cure impaction is to make sure it doesn’t happen. If it still does occur, it is crucial to know how to recognize it and subsequently treat it, efficiently and safely. The good news is you can avoid impaction by providing proper leo husbandry.

What Causes Impaction?

Causes of impaction can be many:

  • Too large and/or hard feeder insects
  • Overfeeding with hard-to-digest feeders
  • Loose substrate
  • Low temperatures
  • Dehydration
  • Parasites

> Learn more about the proper Leopard Gecko diet here

Can Sand Substrate Cause Impaction in Leopard Geckos?

One of the most common causes of impaction is the use of sand as a substrate in a leo tank. Guided by the misconception that leopard geckos are desert creatures, pet shop personnel and uneducated breeders have recommended sand as a natural substrate for years. That resulted in a significant number of unnecessary vet interventions leo deaths.

The use of calcium sand is particularly tricky. Leopard geckos, and especially those who are calcium deficient, will be tempted to consume the larger-than-usual amounts of the substrate if they sense it contains calcium. Although calcium sand is labeled as digestible, it often clumps together when wet – and that’s precisely what can happen inside your pet’s bowels.

I acknowledge that some people keep leos on sand and that their pets remain healthy. However, the risk is still too high, especially since there are many suitable alternatives. Leos originate from predominantly rocky and not sandy areas anyway.

Substrates And Impaction – A Deeper Perspective

Why do some geckos get impacted by sand while others do not? The answer may lie in a hidden health condition. For example, leopard geckos with vitamin and mineral deficiencies may try to make up for the missing nutrients by consuming the substrate.

Also, low tank temperatures can lead to impaired digestion, causing the amount of substrate that would otherwise be passed normally to create a blockage.

While you may think, “My gecko is in perfect health, so why not keep him on sand?”, the truth is that we can never know if our pet’s health is going to be jeopardized for any reason. That makes sand – or other hard, loose substrate – an accident waiting to happen.

If your leo survived through substrate impaction, examine what could be the underlying cause of his need to consume large amounts of the substrate (but ditch the substrate anyway).

Leopard Gecko impaction

Is My Leopard Gecko Safe If I Use Paper Towels Instead of a Substrate?

The truth is your leo will be much safer if you use paper towels, but still not 100% safe.

Freakish cases of impaction – from paper towel pieces, eco earth, or peat moss are rare, but have occurred! We have to be mindful and not exclude the possibility of impaction simply because we have the right substrate.

The substrate that is the least prone to causing bowel impaction is slate or ceramic tile. It looks and feels quite natural too.

Can Mealworms Cause Impaction?

The opinions on mealworms and impaction continue to be divided. While some people in the hobby still strongly advise against mealworms due to their hard exoskeletons, enthusiasts like the legendary Ron Temper have been using mealworms as a staple diet for his leos for decades.

I never had issues with feeding mealworms. If your leo has no underlying health issues, and you have proper temperatures in the tank, he should be able to eat them safely. Size is the key – never give your leo mealworms that are too large from him. A mealworm that takes more than three bites to swallow is probably too large for your leo.

On the other hand, you should never give your leo mealworm beetles or any other beetle species. Their hard shells undoubtedly increase the risk of impaction.

Symptoms: How Do I Know If My Leopard Gecko Has Impaction?

There are several common signs of leopard gecko impaction. I have listed them according to their severity – from those occurring in light impaction to those occurring in late or severe stages.

  1. Constipation
  2. Cloaca licking
  3. Appetite loss
  4. Lethargy
  5. An unusual dark spot on the underside of the belly
  6. Weight loss
  7. Bloating

The first and most apparent sign of impaction is constipation. It is essential to clean your leo’s potty corner daily, so you can track if he is passing his stools.

Lack of appetite usually goes hand in hand with constipation. Since his bowels are not functioning, leo will be reluctant to take in any new food.

As impaction continues, emaciation and bloating take place. The dark spot on the underside of the belly is another sign of persistent impaction. However, a dark patch on the abdomen can appear for other reasons too – enlarged liver, for example, so this single symptom doesn’t automatically mean impaction.

Impaction Treatments

There are a couple of first-line home treatments for impaction. If they fail, head for the reptile vet’s office ASAP.

Warm Bath

Giving your leo a warm bath is the first line of treatment when you suspect impaction. Baths are comfortable, pretty stress-free, and surprisingly efficient in solving uncomplicated cases of impaction.

Here is how to do it:

  • Take a plastic tub or dish that has a well-fitting lid.
  • Create ventilation holes
  • Fill it with water. The temperature should match your terrarium’s warm area, or be in the upper range of official recommendation for leos (86 degrees F/30 degrees C).
  • The water level should be high enough for it to cover your leo’s belly, but the water level must not pass the height of your leo’s shoulders.
  • I recommended giving your lizard two baths a day, each lasting about 30 minutes, 3-4 days in a row. During the bathing, massage his belly gently, moving your finger from throat to the tail base every five minutes or so.
  • Monitor your leo at all times to avoid water asphyxiation.
  • If he passes poop, inspect it for traces of substrate or other hard particles to determine the cause of impaction.

Leopard gecko taking warm bath

Olive Oil

Another home remedy for impaction is giving your leo a drop of olive oil, or mineral oil. Oil won’t harm your leo as long as you administer it carefully and take care it doesn’t get into his nostrils. Put an oily drop in front of his mouth, lightly touching them. He will most likely lick off the droplet. You can use this remedy together with baths.

I advise using oil only coupled with the baths, and not after the bating method has failed. There is anything particularly risky about the oil itself. Still, if the bathing has failed, it is highly likely that impaction is severe and that your pet needs urgent veterinary care. In a situation like that, you don’t want to waste precious time to see if another light technique will work. Time can make a difference between life and death.

> Further reading: Dying signs in leopard geckos

Veterinary Intervention And Surgery

If the home remedies fail, you have to take your leo to an experienced reptile vet.

At the vet’s, the impacted leo will probably get an X-ray so the doctor can see what’s going on in his belly. After that, the vet will prescribe a laxative (usually the one used for cats, or medical paraffine), try to flush out the impaction using the procedure called enema, or proceed to do a surgery.

Take care!

I hope this article has helped you gain an in-depth perspective on bowel impaction in leopard geckos. I wholeheartedly hope that you won’t ever need to use my advice on the topic. However, considering that impaction is still common and deadly, every leopard gecko owner should know how to prevent it and treat it.

Has your leo had a case of bowel impaction? How did you treat it? Help other reptile enthusiasts by sharing your experience in the comments.

Picture of Katarina Samurovic

Katarina Samurovic

Katarina is an environmental analyst and has been involved in herpetology research. She's been keeping reptiles for 20 years, mostly different species of turtles and leopard geckos. Her 2 lovely leos, Sonya and Mia are 21 and 20 years old.


  1. Thank you so much for this post! I think it probably saved my son’s juvenile leo. She’s given us lots of steep learning curves as a much more finicky gecko than the one I had years ago. We began giving her some giant mealworms (she’s a super picky AND lazy eater so we’ve had to try many things) and she LOVED them, but we were unaware of the impaction risk. Once she started acting off and quit pooping for several days, I found this article and we were able to do 4 baths with the oil over a span of 3 days. This morning during the belly rub while she sat in the bath (the easiest way for me to reach her belly), she finally pooped! She is also a critter who doesn’t love handling, but it was worth the bit of stress she obviously felt for her to get the help she had to have.
    I am curious if its ok to give her an occasional giant mealworm if she’s also eating other things? I’m not sure how long it takes for poop to get through the system, but according to her feeding log, i think the problem came several days after she ate 2 in the same feeding and had a shed.
    Thanks again!

    1. Hi Aubree,
      I am so glad that your ordeal has had a happy ending. I would avoid giant mealworms if the gecko is still a juvenile. Another option is to cut them in half and offer them with tweezers or just cut off the head and the legs. The head is the hardest part of the mealworm’s body and the one most likely to cause digestive issues. Of course, cutting up worms is quite gruesome (please don’t let your son do it), and it is perfectly fine to skip giant mealworms for now altogether.

  2. Hi,
    I’ve tried giving my geckos baths but I dont understand how to keep them in it for more than a few minutes since the water goes cold. I’ve tried mixing in warmer water but I’d think the variation in temps would be stressful and bad for them… How do I keep the temp consistent without using an uth or something 🙂

    1. Hi Jenna,
      First of all, I need to clarify you don’t have to give your geckos regular baths unless you suspect impaction or another issue such as a stuck shed. To keep the water temperature right, make sure you are performing the bath in a chilly room. Also, try adding the water at the desired temperature, not much warmer, and don’t wait for the bath water to get fully cold before adding the warmer water. I would suggest you keep the heated water at the right temp in a thick steel cooking pot or a similar insulating material. Water cools down gradually, and small temperature variations are not important. Also, know that checking the water temperature with your fingers can be deceiving – if you are overly worried, get a small aquarium thermometer to check the exact temperatures.

  3. I’m not sure of my gecko is impacted. She is normal energy and activity, plump, and otherwise healthy but will not eat. Unsure if she is pooping. What are some other signs?

    1. Hi Grace,
      I’m sorry you’re having trouble with your leo’s appetite. It’s one of the most common issues in leopard gecko keeping. The only part I don’t get is that you’re “unsure” about the poop. It is quite noticeable and is usually only in one corner of the tank. For all the signs of infection, please look at the article again – they’re all there.

      Besides impaction, there are other reasons a leopard gecko might lack appetite – we have a special article on that I recommend you check out. Considering the sex and the time of the year, if there is absolutely nothing else wrong and the tank is properly set up, she might be ovulating. But please see other potential reasons.

  4. Hi, i’m glad to read this article, my leopard gecko have bowel impaction problem, and now I knew I can give some oliver oil to help them. In my country, a lot people tell me give them Nutri BAC probiotics to help them to make a bowel movement , it’s that correct?(sorry if my english weird)

    1. Hi Ika,

      I’m glad the article was helpful and I hope you’ve resolved the impaction issue. Once it has passed, the most important thing is to find the reason why the impaction happened in the first place to prevent it from happening again. I don’t know anything about NutriBAC except that I see it has been registered for use in reptiles and has no known side effects, so there is probably no reason not to use it. However, it’s not a substitution for oil because oil mechanically helps push the blockage out. Probiotics can’t do that.

  5. Hi, my leopard gecko (about 1 year old, i’ve had him for 2 months) hasn’t been pooping for the last 9 days (3 meals of mealworms). He hates being picked up (without him climbing on me) so i’m afraid turning him upside down to see his belly would stress him out. I just tried a warm bath a few minutes ago. Is it okay if i give him peanut oil instead of olive?
    He isnt showing these following symptoms:
    1. Appetite loss
    2. Clocoa licking
    3. Lethargy
    4. Weigh loss
    5. Bloating

    1. Hi Mia,
      First, I completely support that you don’t want to forcefully pick up your leo. However, consider putting him on flat glass or transparent plastic so you can check out his belly by looking under, just in case.
      To be honest, I am not sure about using peanut oil – I’ve never used it, and no reliable sources confirm it’s safe. Vegetable oil might be a 3rd line alternative, but I wouldn’t risk peanut oil.
      Just put a drop of the oil on your leos lips (be careful about the nostrils!) and he should automatically try to lick it off.
      Use the oil treatment together with the bath.
      Also, I would stop feeding him until he passes the poop.
      Keep an eye on the symptoms – if he seems to be getting worse, I would recommend a vet ASAP.

  6. My 3.5 yr old Leo has stopped eating for like 3 weeks. Thought he may be impacted. Was going to set u an appointment but tried the baths first. A bit of “poop” was scraped on the paper towel so I thought we were getting better. Tonight he dropped his tail. Safe to take him to vet or wait to not stress him more?

    1. Hi Diana,
      Believe it or not, three weeks of “food strike” isn’t terrible or life-threatening in the leo world, but it is certainly a cue something might be wrong. There are numerous reasons a leopard gecko can stop eating. You haven’t provided many other details, so it’s hard to conclude. For example, a healthy female can stop eating if she’s carrying an egg (and this can happen without a male around). Low temps can play a role. Also, stress from seemingly trivial reasons such as too much handling can also trigger the issue.

      A lack of appetite or anorexia on its own isn’t a sign of impaction – please refer to other symptoms of impaction to check. Also, you can check out our articles on food avoidance and stress in leopard geckos.
      I’m pointing out stress here because tail-dropping requires either mishandling or extreme stress levels. Illness can cause tail dropping, but it is rarely the case in my experience.
      You can try special formulas – the so-called gecko slurry, as mentioned in the article “Why Is Your Leopard Gecko Not Eating?” – to get some nutrition into your pet.
      Let us know how the situation worked out for you.

  7. My daughter has an almost 1 year old gecko. We noticed over the weekend he is dragging his back legs and hasn’t pooped. There is a dark spot on his belly so we are fairly certain it’s impaction. She has tried a few warm baths (although not sure we are doing it correctly) and we tried giving him olive oil tonight but he would not open his mouth or lick it. We do not have a reptile vet anywhere near us. She is scared to death he is gonna die. What do we do?

    1. Hi Dawn,
      First, I hope you have resolved the issue by now – sorry that replies sometimes take so long.

      Besides impaction, a dark spot on the belly can also be a sign of internal bleeding or parasites – considering that your leo has been dragging his back legs, I wonder if he hasn’t fallen from somewhere or got physically injured.
      As for the oil, putting a liquid on the gecko’s lips will almost always lead to a licking response – just be careful not to get the oil into the nostrils!
      If all the home remedies fail, I’m afraid there is no other option to recommend besides taking your gecko to the vet, even if it means a longer drive. IMHO, it is certainly less stressful than having your pet die without trying everything you could. Again, I hope all is well now.

    1. Hey Tom,

      In short, no. Just because your gecko has pooped once, does not mean he or she is automatically in the clear. However, if your gecko is pooping regularly and has no other symptoms, then he or she is likely doing just fine.


  8. I feel like my leo is constipated, he is very active and does NOT show any signs of
    Cloaca licking
    Appetite loss
    An unusual dark spot on the underside of the belly
    Weight loss
    He just looks bigger then normal and only poops every 4 days. I use eco earth (Conut Shavings) but almost always tong feed him on a pice of tile. He has a great apitite so mabe he is just fat?

    1. Hello Ashley,

      If your leopard gecko is active and doesn’t show any other signs of being constipated, then it’s likely that he’s just fine. Adult Leopard geckos typically poop every two to three times a week, but some may go a bit longer in between bowel movements. If your Leo is eating well and doesn’t appear to be in any discomfort, then there’s no need to worry.

      As for being overweight, leopard geckos can certainly become obese if they’re not fed a balanced diet and don’t get enough exercise. If you think your Leo may be overweight, you can try offering him smaller meals more often throughout the day instead of one large meal. You can also try placing his food on the other side of the tank so he has to walk to get it. These simple changes can help encourage your leopard gecko to be more active and help him shed any excess weight.


  9. Hi! I think my 20 year old Leo is in trouble 🙁 I noticed yesterday and today what looks like feces still attached to his underside. He isn’t eating even though he has a few crickets running around his tank. He is extremely skidding, to the point I’ve never even held him. I’d like tongue the warm bath but across that with stress him even more. Help!!

    1. Hey Jenn,

      I am sorry to hear that your Leo is not doing well. It sounds like he may be constipated, which can be caused by a few different things.

      • Cold weather can affect digestion and cause constipation, so if it is too cold in his tank he may be having trouble.

      • Dehydration can also cause constipation, so make sure he is drinking enough water.

      • Another possibility is that substrate (bedding) may be stuck around his vent, which can make it difficult for him to defecate.

      If his vent is clean and he is well-hydrated, he should be able to pass the feces on his own.

      If he is still having trouble, you can try giving him a warm bath, which may help him to relax and pass the feces.

      Be sure not to stress him out even more, though, so monitor him closely during the bath. If he is still struggling, please take him to a reptile vet for further assistance.

  10. Um, my leopard gecko is really pale and hasn’t shed yet. She has no dark spot under her belly, an interest in food and is eating, a full water dish, she’s not licking her cloaca (as far as I’ve seen yet). She doesn’t move a lot in general in the 3 years I’ve owned her however, when needed to pick her up to examine her belly she sprinted and (she just ate a cricket and moved really fast to get it too.) The only think that concerns me is that she hasn’t shed starting from 9:00 Pm last night to 4:53 Am. (she’s usually faster than this with shedding) Should I be concerned?

    1. Hi Madeleine,

      I wouldn’t worry too much this early on, just keep an eye on her. Check your temperatures are good and that her moist hide is clean but damp.

  11. I am the owner of a 7-8 week old leopard gecko, and recently he hasn’t been eating as much as he should. I just moved him to a bigger cage on Tuesday which might have caused him some initial stress, but now he has gone three days eating 8 then 6 then 3 insects (today). I placed him in a glass container and looked at his stomach, and there is a small black or blue-ish dot that is not where his stomach is and more in the higher stomach region of his body. I’m thinking he may have some impaction possibly from food? I have him on paper towels so substrate shouldn’t be an issue. I gave him a warm bath and some olive oil tonight to see if that helps. What do you recommend I should do? Should I schedule an appointment as soon as possible, or be patient? He has been pooping every night pretty well as well.

    1. Hi Maya,

      This could be a small impaction or potentially a slight internal bleed. The move may have caused some additional stress, make sure he has plenty of places to hide and check that your temperatures are all good. Try to restrict handling as this may stress him more, if things are not better within another day then I would suggest taking him to the vet. Hopefully he’ll go for a poop soon.

  12. My leopard gecko is impacted and my mom says she’s not and that “we don’t know yet” she hasn’t pooped out her last meal of big mealworms. Should we stop getting the big mealworms?

    1. Hi Sophia,

      Giant mealworms should be given in moderation as they are difficult to digest and have been known to cause gut impaction. You don’t have to completely stop feeding them to your gecko but definitely restrict the number and opt for other insects over these.

  13. Is it possible my leo is just full? the only symptoms she has are lethargy and bloating. She’s still pooping etc.

    1. Hi Elizabeth,

      It is possible that your gecko is lethargic because she just ate a lot and needs time to digest. Are there any dark spots on her underside or any signs of impaction?

  14. I’ve had my granddaughters Leo about 3 weeks now he stopped eating about 2 weeks ago I took him to the vet his stomach is extended she’s having me give him a supplement four times a day with mineral oil
    I cannot get her mouth open I’ve done everything it’s taken me an hour each time just to feed her I’m sure it’s stressing her out I literally cannot get her mouth open I just don’t know what to do now.
    I have another, different vet appt Friday, a week away, I hope she can survive

    1. Hey, Christine. So sorry you’re dealing with this problem – especially since it’s your granddaughter’s pet!

      Definitely follow your vet’s advice, and it’s never a bad idea to get a second opinion. As for prying open the lizard’s mouth, that can be tricky: You must be gentle, but it can also take a bit of pressure to convince the lizard to open up.

      One trick I’ve used over the years is to use a very soft spatula (not a pancake turner, but an actual spatula). They’re usually the perfect combination of firm, yet flexible, and they often get the job done. If that doesn’t work, you can try a credit card or business card – just be as gentle as possible.

      Best of luck! Our fingers are crossed for you!

    2. Would this work for babies? I just got a leopard gecko that has an obvious impaction, tummy has large dark area and very hard. How often with olive oil? Skin is very thin and I don’t think they could survive surgery.

      1. Hi Chelsi,

        Yes you can try a warm bath and tiny drop of olive oil for baby geckos. If this does not work get your gecko to a vet, there are steps that can be taken by your vet, for example laxatives or an enema, before resorting to surgery.

Leave a Reply

Your email address will not be published. Required fields are marked *

Get Answered Today 👇

While we try to answer all your questions, we aren’t always available, and it can take several days before we get back to you. We recommend asking a licensed veterinarian if your question is urgent and involves your pet’s health. They are available 24/7!

Picture of Katarina Samurovic
Katarina Samurovic
Katarina is an environmental analyst and has been involved in herpetology research. She's been keeping reptiles for 20 years, mostly different species of turtles and leopard geckos. Her 2 lovely leos, Sonya and Mia are 21 and 20 years old.