Questions regarding diagnosis & treatment for impaction

My 3 yr old veiled has not pooped in almost 3 weeks. I took him in to see his vet 5 days ago and she said that I was doing everything right, he appears to be very healthy, I know how well they hide illness though. The only thing she suggested I change was the brand of multi vitamin I use. She also thought that bringing his temp up just a little might help. Its normally about 85, now 88-90 in his basking spot. He gets about 10 mins 2-3×'s a week in a luke warm shower, has a mistking that goes off several times a day. This last week and a half I have also made sure to hand mist him with warm water. The vet said he looks well hydrated so she wasn't really concerned about that. He has had a bad habit of eating dirt when he gets the chance, thats why we are changing the multi vitamin in case its a deficiency he is trying to compensate for. She said to give him another week, that is up the day after tomorrow, if he still has not pooped its time to look for an obstruction/impaction, possibly from eating dirt.

My question is how do they do that? I should have asked her while I was there but she made me feel so hopeful that it prob would not get to this point. So I didn't think about it. Also, if that is the problem, how is it fixed? Is this a Surgical procedure? I think I am just wanting to emotionally prepare myself for what we may be dealing with. And if he's having surgery of any kind I want to take time off work. I'd imagine that once it is concluded that this is the necessary treatment it should be done somewhat immediately.
He is still drinking & wants to eat. The vet thought it'd be better to fast him until we know for sure. I was bad though & did give him a couple of smallish hornworms yesterday thinking maybe it might help speed this poop thing up a bit. He was very happy & ate them up right away.

Side note... He has real plants in his enclosure & I do have screen on top of the dirt cut around the plants & river rock on top of the screen in an effort to prevent him from even getting to it. But sometimes he still finds a way.
 
You can try feeding canned pumpkin, which is very high in fiber and helps to move stool.
Typically, they'll do an X-ray to check for one.
What sort of soil is he consuming and why not cover the soil surface with large stones or screen he can't eat?
 
I've used grapes and tons of water. My vet has also prescribed lactulose. As mentioned above the vet usually does an x-ray and I've read here that some have surgery.
 
I had a veiled that got to lava glass that i didnt realize was in the live plants i had 5yrs ago and he got so impacted his back legs went paralyzed due to the impaction pushing on a nurve in his back. The vet did surgery on him now i am not trying to be negative but mine passed away on the way home the vet had me slowly push mineral oil in his vent for a few days first but since he had lost feeling in his legs i think he couldnt feel to push it out anymore and the vet said that his intestinal tract had changed to black and die around the blockage due to the lava glass after that i put huge quarts rocks and screen in all live plants i dont ever want to go through that again it broke my heart to lose my best friend i wish you and your little friend good luck and please keep us updated this hit my heart
 
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