Fecal impaction is a severe bowel condition in which a hard, dry mass of stool becomes stuck in the colon or rectum. This immobile mass will block the passage and cause a buildup of waste, which a person will be unable to pass.
Fecal impaction disturbs the normal gastrointestinal process in which digested food passes from the stomach to the intestines and then into the colon and rectum.
Without treatment, fecal impaction can cause severe damage. Therefore, people experiencing any of the symptoms should visit their doctor as soon as possible.
Fecal impaction can cause a range of symptoms, which include:
- liquid stool leaking from the rectum
- pain or discomfort in the abdomen
- abdominal bloating
- nausea or vomiting
- feeling the need to push
- a headache
- unintentional weight loss
- a feeling of fullness and not wanting to eat
People should seek treatment as quickly as possible if they suspect that they have an impacted bowel. Without treatment, symptoms can become more severe and may include:
- rapid heart rate
- feeling confused
- hyperventilating or feeling breathless
- becoming irritated and agitated
- incontinence, where a person loses control over urination or bowel movements
There are several causes of fecal impaction, including:
Constipation can occur when stools become hard and dry or when bowel movements become less frequent. Causes of constipation include:
- a diet low in fiber — a person should consume 30 grams (g) of fiber daily to help soften stools
- inadequate fluid intake
- a sedentary lifestyle — regular exercise will help muscles in the bowel wall to stay strong
- ignoring the urge to defecate
- certain medications
- anal fissures or hemorrhoids — the pain these cause can make a person resist the urge to pass stool, resulting in constipation
Overuse of laxatives
Repeated and excessive use of laxatives affects a person's colon. The body becomes dependent on the laxatives to help with bowel movements. As a result, the colon becomes less able to perform this process naturally.
Other medical conditions
Some medical conditions may cause fecal impaction as a side effect.
These conditions include:
Lack of mobility
A lack of mobility due to injury or aging can weaken the abdominal muscles and reduce colonic mass movements. This impairs the body's ability to pass stool on its own and could result in fecal impaction.
Some medicines can impair gastrointestinal motility, including:
- opiate analgesics
- anticholinergic agents
- calcium channel blockers
- iron preparations
Although it is rare, fecal impaction can occur as the result of anorectal surgery.
It is possible to determine whether or not a person has fecal impaction using several different methods.
Initially, a doctor is likely to ask about the following factors to build up a picture of the individual's medical history:
- how often they go to the bathroom and when they last went
- how often they are constipated
- how much liquid they drink
- how much fiber they eat
- whether they use laxatives
- what medications they take
The doctor will then perform a physical exam by pressing down on the stomach to feel for the mass. They may also insert a finger into the rectum to try to feel for it or to detect any other problems that could be causing the symptoms.
In some cases, an X-ray may be necessary to check for the mass.
Another option is a sigmoidoscopy, which is a procedure involving the insertion of a thin tube with a light and a lens at its end into the lower colon.
It is vital that a person with fecal impaction receives treatment to remove the mass of stool. Not doing so could cause severe complications, possibly even death.
There are several different treatments for fecal impaction. The most common remedy is a procedure called an enema where a doctor will insert a specific fluid into the rectum that softens the stool and makes it easier to push out.
If an enema fails to work, it may be necessary to break the stool down and remove it by hand. Removing the stool should result in a person's bowel movements returning to normal, and any side effects should go away.
Other possible treatments for fecal impaction include:
A doctor may recommend oral laxatives. These make the colon produce more water, which softens the mass, allowing the body to pass it through and excrete it. Laxatives are also available to buy over the counter.
Following insertion into the rectum, these will draw water into the area to soften the mass of stool.
During water irrigation, a doctor will insert a small hose into the rectum and flush the area with water, encouraging the stool to soften and break down.
A doctor may massage the rectum after this procedure to help the stool move through, before removing it via another tube.
People with a fecal impaction should not try to remove the mass by themselves or wait for it to go away on its own. Instead, they must make an appointment with a doctor, who will advise them on the best treatment to cure the issue.
However, a person can adapt their food choices to help keep their bowel movements regular and avoid constipation. A diet high in fiber can aid regular bowel movements, and natural laxatives such as tea, coffee, and prune juice may be beneficial if a person feels constipated.
The complications of fecal impaction can range in severity and are more likely to occur if people delay seeking treatment for the condition. Complications typically include:
- tearing of the colon wall
- anal tears
- anal bleeding
If a person suspects that there is any problem with their colon, digestive health, or bowel movements, they should make an appointment to see their doctor as soon as possible.
There are several lifestyle changes that people can make to reduce their risk of fecal impaction. These include:
- taking regular exercise and staying active
- eating a diet high in fiber
- drinking plenty of water
- avoiding alcohol
- using the bathroom when the need arises rather than waiting
While it is not always possible to do so, avoiding the use of laxatives and trying to prevent constipation will lower the chance of a person experiencing fecal impaction.
A doctor may also recommend taking stool softeners to help stool pass along more smoothly.
Fecal impaction is a common gastrointestinal problem. Prompt and successful treatment will minimize a person's discomfort and the risk of complications. Not treating fecal impaction is dangerous and can cause serious side effects.
Making diet and lifestyle changes can help people to avoid reoccurrence.