A fecal impaction is a large lump of dry, hard stool that remains stuck in the rectum. It is most often seen in patients with long-term constipation.
Constipation is when you are not passing stool as often as you normally do. Your stool becomes hard and dry, and it is difficult to pass.
Fecal impaction is often seen in people who have had constipation for a long time and have been using laxatives. Impaction is even more likely when the laxatives are stopped suddenly. The muscles of the intestines forget how to move stool or feces on their own.
Persons at risk for chronic constipation and fecal impaction include those who:
Certain drugs slow the passage of stool through the bowels:
Common symptoms include:
Other possible symptoms include:
The health care provider will examine your stomach area and rectum. The rectal exam will reveal a hard mass of stool in the rectum.
If there has been a recent change in your bowel habits, your doctor may recommend a colonoscopy to evaluate for colon or rectal cancer.
Treating a fecal impaction involves removing the impacted stool. After that, measures are taken to prevent future fecal impactions.
Often a warm mineral oil enema is used to soften and lubricate the stool. However, enemas alone are usually not enough to remove a large, hardened impaction.
The mass may have to be broken up by hand. This is called manual removal:
Surgery is rarely needed to treat a fecal impaction. An overly widened colon (megacolon) or complete blockage of the bowel may require emergency removal of the impaction.
Almost anyone who has had a fecal impaction will need a bowel retraining program. Your doctor and a specially trained nurse or therapist will:
With treatment, the outcome is good.
Tell your health care provider if you are experiencing chronic diarrhea or fecal incontinence after a long period of constipation. Also notify your health care provider if you are experiencing any of the following symptoms:
Impaction of the bowels
Lembo AJ, Ullman SP. Constipation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 18.
Nelson H. Diseases of the rectum and anus. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 148.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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