Fecal Impaction
Definition
Fecal impaction is when stool cannot exit the body.
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Causes
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.
Risk Factors
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
- Inactivity
- A diet that is low in fiber
- Medical conditions that make bowel movements difficult
Symptoms
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
- Lightheadedness
- Confusion
Diagnosis
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.
Treatment
Talk with your doctor about the best treatment plan for you. Options include:
Medications
Your doctor may start with medications to help you pass the stool. These may include:
- Stool softeners
- Glycerine suppositories
- Laxatives
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
Prevention
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.
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/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