Definition

Fecal impaction is when stool (poop) cannot leave the body. Without treatment, it can lead to other problems.

The Digestive Pathway

Copyright © Nucleus Medical Media, Inc.

Causes

This problem is caused by:

  • Stool (poop) that is too large, hard, and dry to pass, or
  • Weak intestine muscles

Risk Factors

Fecal impaction is more common in people over 65 years old and toddlers. Other things that raise the risk are:

  • Long-term constipation
  • Withholding stool (poop)—a common cause in children
  • A history of fecal impaction
  • Medicines such as:
    • Certain blood pressure medicines
    • Narcotics
    • Antipsychotics and tricyclic antidepressants
    • Iron supplements
  • A diet that is low in fiber and fluids
  • Not being physically active
  • Medical problems that make it hard to pass stools

Symptoms

Symptoms may include:

  • Straining, with problems passing stools
  • Belly pain or rectal discomfort
  • Belly swelling
  • Nausea and vomiting
  • Leaking stool or sudden episodes of watery stool
  • Lack of hunger
  • Problems passing urine, or leaking urine
  • Headache, lightheadedness, fast heartbeat, or problems breathing

Older people and those with certain brain problems may also have:

  • More problems thinking
  • Restlessness

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. This may include a rectal exam with a gloved finger. Blood tests may also be done.

Images can show how severe the problem is. The doctor may look at the intestines with:

Treatment

The goals are to remove the stuck stool and treat underlying causes. Options are:

Medicines to help pass the stool, such as:

  • Stool softeners or laxatives taken by mouth
  • Suppositories—medicine inserted into the rectum

Medicines may be needed until the bowel works well again.

The doctor may also remove the stool. Options are:

  • Removal by gloved hand
  • An enema—fluid is injected into the large intestine
  • Surgery—rarely needed

Prevention

Fecal impaction can often be prevented with:

  • A diet rich in fiber and fluids
  • Not using medicines that can cause problems passing stool
  • Regular physical activity
  • Regular bowel habits
RESOURCES:

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

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

CANADIAN RESOURCES:

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

Health Canada
https://www.canada.ca

REFERENCES:

Constipation and impaction. Harvard Health Publishing website. Available at: https://www.health.harvard.edu/a_to_z/constipation-and-impaction-a-to-z . Accessed July 30, 2021.

Constipation in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-adults . Accessed July 30, 2021.

Constipation in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-children . Accessed July 30, 2021.

Gastrointestinal complications. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-pdq#section/_15. Accessed July 30, 2021.

Serrano Falcón B, Barceló López M, et al. Fecal impaction: a systematic review of its medical complications. BMC Geriatr. 2016;16:4

Last reviewed July 2021 by EBSCO Medical Review Board Dan Ostrovsky, MD  Last Updated: 7/30/2021