Also known as: Impaction of the bowels
- You not move around much and spend most of your time in a chair or bed.
- You have a disease of the brain or nervous system that damages the nerves that go to the muscles of the intestines.
- Anticholinergics, which affect the interaction between nerves and muscles of the bowel
- Medicines used to treat diarrhea, if they are taken too often
- Narcotic pain medicine, such as methadone and codeine
- Abdominal cramping and bloating
- Rectal bleeding
- Small, semi-formed stools
- Straining when trying to pass stools
- Bladder pressure or loss of bladder control
- Lower back pain
- Rapid heartbeat or light-headedness from straining to pass stool
- A health care provider will need to insert one or two fingers into the rectum and slowly break up the mass into smaller pieces so that it can come out.
- This process must be done in small steps to avoid causing injury to the rectum.
- Suppositories inserted into the rectum may be given between attempts to help clear the stool.
- Take a detailed history of your diet, bowel patterns, laxative use, medications, and medical problems
- Examine you carefully.
- Recommend changes in your diet, how to use laxatives and stool softeners, special exercises, lifestyle changes, and other special techniques to retrain your bowel.
- Follow you closely to make sure the program works for you.
- Tear (ulceration) of the rectal tissue
- Tissue death (necrosis) or rectal tissue injury
A fecal impaction is a large lump of dry, hard stool that stays stuck in the rectum. It is most often seen in people who are constipated for a long time.
Constipation is when you are not passing stool as often or as easily as is normal for you. Your stool becomes hard and dry, and it is difficult to pass.
Fecal impaction often occurs in people who have had constipation for a long time and have been using laxatives. The problem 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.
You are at more risk for chronic constipation and fecal impaction if:
Certain drugs slow the passage of stool through the bowels:
Common symptoms include:
Other possible symptoms include:
Exams and Tests
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 check for colon or rectal cancer.
Treating a fecal impaction involves steps to remove 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.
Most people who have 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.
When to Contact a Medical Professional
Tell your health care provider if you have chronic diarrhea or fecal incontinence after a long period of constipation. Also tell your health care provider if you have any of the following symptoms:
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.
Madoff RD. Diseases of the rectum and anus. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 147.
- Review date:
- November 13, 2014
- Reviewed by:
- George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.