What Is Fecal Impaction?

woman in abdominal discomfort
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Fecal impaction (FI) is a state of severe constipation in which one experiences a stool that is so hard that it is unable to be passed with a bowel movement. FI typically occurs when a person has not had a bowel movement for many days. The stool blockage is most likely to be located in the rectum.

Associated Symptoms of FI

In addition to the discomfort of constipation, a person with FI may also experience:

In rare cases, untreated fecal impaction can result in serious health complications, such as bowel ulceration or perforation, and peritonitis.

Risk Factors for FI

FI is most often seen in the elderly who are residing in nursing homes. It can also occur in children, particularly those who withhold the stool out of anxiety about having a bowel movement or to avoid a perceived risk that stool passage will be painful. FI can also be experienced by people who use narcotics and develop a condition known as narcotic bowel syndrome.

Other at risk groups include people with neurological conditions, such as Alzheimer's or Parkinson's disease, dementia, spinal cord injury, or stroke.

Many medications have the side effect of constipation, which could then raise the risk for FI. Laxative abuse, itself, can raise one's risk of impaction.

Structural and functional conditions involving the rectal area can also result in FI.

Treatment of FI

The first line of treatment involves the use of enemas and/or laxatives in an effort to soften the hardened stool so that it can be passed. In severe cases, the blockage may need to be manually removed by a medical professional.

Prevention of FI

Because impaction is likely to re-occur, preventative strategies are essential. Increasing dietary fiber and water consumption can be very helpful. It is likely that one's physician would recommend regular use of stool softeners or other laxatives, and may recommend changes to any medications that are contributing to constipation. Bowel retraining exercises may also be recommended.

When to Call the Doctor

You should let your doctor know if you think your bowels are impacted. You should seek immediate medical attention if you experience:

  • Severe abdominal pain
  • Bleeding from the rectum
  • Fever

Also Known As:

  • Coprostasis
  • Inspissated stool syndrome

Sources:

Obokhare, I. "Fecal Impaction: A Cause for Concern?" Clinics in Colon and Rectal Surgery 2012 25:53-58.

Minocha, A. & Adamec, C. (2011) The Encyclopedia of the Digestive System and Digestive Disorders (2nd Ed.) New York:Facts on File.

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