Fecal impaction

A fecal impaction is a solid, immobile bulk of stool that can develop in the rectum as a result of chronic constipation.

Symptoms

Symptoms include chronic constipation. There can be fecal incontinence and paradoxical diarrhea as liquid stool passes around the obstruction. Complications may include necrosis and ulcers of the rectal tissue.

Treatment

Non-invasive treatments are similar to those for constipation and include increased intake of fluids and dietary fiber, and physical exercise. However, once fecal impaction occurs, these methods are usually not successful.

The mainstay of treatment are enemas to soften the impaction and disimpaction, i.e. digital manipulation by a health practitioner. Use of stimulant laxatives may be dangerous because of the possibility of stercoral perforation. Surgery may be necessary if the bowel becomes totally obstructed.

See also

• Fecaloma

Manual removal of fecal impaction is often required in obese client in traction, after barium enema, and poorly hydrated older adult.

References

• Wrenn K (1989). "Fecal impaction". N Engl J Med 321 (10): 658–62.
• healthcentral.com