Fecal impaction is when stool cannot exit the body.
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Stool may not be able to exit the body if it is too large, hard and dry, and/or the intestinal muscles are too weak.
Factors that may increase your chances of fecal impaction:
- 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
- A diet that is low in fiber
- Medical conditions that make bowel movements difficult
Symptoms may include:
- Having to push harder or inability to have a bowel movement
- Having fewer bowel movements than usual that may consist of small amounts of hard, dry stool
- Pain in the back and/or abdomen
- Leaking stool or sudden episodes of watery diarrhea
- Nausea and vomiting
- Abdominal swelling
- Urinating more or less often
- Difficulty breathing
- Rapid heartbeat
You will be asked about your symptoms and medical history. A physical exam will be done. This may include a rectal exam. Blood tests may also be needed.
Images of your abdomen may be needed to see how severe the impaction is. This can be done with:
The tension on the anal sphincter may also be measured. The sphincter is a small muscle that holds feces in or allows it to pass out.
Talk with your doctor about the best treatment plan for you. Options include:
Your doctor may start with medications to help you pass the stool. These may include:
- Stool softeners
- Glycerine suppositories
Medications may need to be continued until your bowel begins to work normally again.
Removing the Impacted Stool
The impacted stool may need to be removed. Options include:
- Manual removal by a healthcare provider
- An enema—fluid is injected into the colon
- Surgery—rarely needed
To help return your bowel function to normal and prevent future 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.
American Gastrointestinal Association
Family Doctor—American Academy of Family Physicians
Canadian Association of Gastroenterology
Constipation and impaction. Harvard Health Publishing website. Available at: https://www.health.harvard.edu/digestive-health/constipation-and-impaction. Accessed December 20, 2017.
Constipation in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116186/Constipation-in-adults. Updated November 22, 2017. Accessed December 20, 2017.
Constipation in children. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900171/Constipation-in-children. Updated August 24, 2017. Accessed December 20, 2017.
Gastrointestinal complications. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-pdq#section/_15. Accessed December 20, 2017.
Last reviewed November 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 2/7/2018