Fecal Impaction

Overview

Definition

Fecal impaction is when 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, 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

SymptomsandDiagnosis

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:

  • X-rays
  • Sigmoidoscopy

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.

Treatments

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.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

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/%5F15. Accessed December 20, 2017.