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Fecal Impaction

Fee-kal Im-pak-shun

 

Definition

Fecal impaction is when stool cannot exit the body.

The Digestive Pathway

Copyright © Nucleus Medical Media, Inc.

 

Causes    TOP

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    TOP

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    TOP

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    TOP

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    TOP

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    TOP

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

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