• Fecal Impaction

    Definition

    Fecal impaction is when dry, hard stool cannot exit the body.
    The Digestive Pathway
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    Causes

    Stool may not be able to exit the body if it is too large and/or the intestinal muscles are too weak.

    Risk Factors

    Certain factors may increase your risk of fecal impaction, such as:
    • Long-term constipation
    • Withholding bowel movements—a common cause in children
    • The use of certain medications such as pain medication or medications used to treat diarrhea
    • Long-term use of laxatives, especially if they are stopped too quickly
    • Inactivity
    • A diet that is low in fiber
    • Medical conditions that make bowel movements difficult

    Symptoms

    Symptoms may include:
    • Being unable to have a bowel movement
    • Pain in the back and/or abdomen
    • Nausea and vomiting
    • Abdominal swelling
    • Urinating more or less often
    • Difficulty breathing
    • Rapid heartbeat
    • Lightheadedness
    • Leaking stool or sudden episodes of watery diarrhea
    • Confusion

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. A digital rectal exam may also be done.
    Your bodily fluids may be checked. This can be done with blood tests.
    Your bodily structures may need to be viewed to determine the severity of the impaction. This can be done with:

    Treatment

    Talk with your doctor about the best treatment plan for you. Options include:

    Medications

    Your doctor may initially advise medications to help you pass the stool. This may include:
    • Stool softeners
    • Glycerine suppositories
    • Laxatives
    Your doctor may advise long-term use of stool-softeners while your bowel function slowly returns to normal

    Removing the Impacted Stool

    The impacted stool may be removed through:
    • Manual removal by a healthcare provider
    • An enema
    • Surgery—rarely

    Prevention

    To help return your bowel function to normal and prevent future fecal impaction problems:
    • Eat plenty of fiber-rich foods.
    • Drink plenty of fluids.
    • Exercise regularly.
    • Take stool softeners as advised by your doctor.
    • Try to train your bowels by trying to have a bowel movement at the same time each day.
    • Go to the bathroom as soon as you have the urge.
    • Keep track of your bowel movements so you know if you are becoming constipated.

    RESOURCES

    American Gastrointestinal Association https://www.gastro.org

    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    CANADIAN RESOURCES

    Canadian Association of Gastroenterology https://www.cag-acg.org

    Health Canada http://www.hc-sc.gc.ca

    References

    Constipation in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900171/Constipation-in-children. Updated June 2, 2016. Accessed October 3, 2016.

    Fecal impaction. National Cancer Institute website. Available at: http://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-pdq#link/%5F15. Updated May 12, 2015. Accessed November 10, 2015.

    Fecal impaction (child). University of Minnesota Medical Center website. Available at: http://www.uofmmedicalcenter.org/HealthLibrary/Article/512029EN. Accessed November 10, 2015.

    Revision Information

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