St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Fecal impaction

    Impaction of the bowels

    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.

    Causes

    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:

    • Do not move around much and spend most of their time in a chair or bed
    • Have diseases of the brain or nervous system that damage the nerves that go to the muscles of the intestines

    Certain drugs slow the passage of stool through the bowels:

    • 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 medication, such as methadone and codeine

    Symptoms

    Common symptoms include:

    • Abdominal cramping and bloating
    • Leakage of liquid or sudden episodes of watery diarrhea in someone who has chronic constipation
    • Rectal bleeding
    • Small, semi-formed stools
    • Straining when trying to pass stools

    Other possible symptoms include:

    • Bladder pressure or loss of bladder control
    • Lower back pain
    • Rapid heartbeat or light-headedness from straining to pass stool

    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 evaluate for colon or rectal cancer.

    Treatment

    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:

    • 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.

    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:

    • 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

    Outlook (Prognosis)

    With treatment, the outcome is good.

    Possible Complications

    • Tear (ulceration) of the rectal tissue
    • Tissue death (necrosis) or rectal tissue injury

    When to Contact a Medical Professional

    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:

    • Abdominal pain and bloating
    • Blood in the stool
    • Sudden constipation with abdominal cramps, and an inability to pass gas or stool. In this case, do not take any laxatives. Call your health care provider immediately.
    • Very thin, pencil-like stools

    References

    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.

    BACK TO TOP

    • Digestive system

      illustration

    • Digestive system organs

      illustration

      • Digestive system

        illustration

      • Digestive system organs

        illustration

      Self Care

        Tests for Fecal impaction

          Review Date: 1/31/2011

          Reviewed 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.

          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. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
          adam.com

          A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


          Back  |  Top
          About Us
          Contact Us
          History
          Mission
          Locations & Directions
          Quality Reports
          Annual Reports
          Honors & Awards
          Community Health Needs
          Assessment

          Newsroom
          Services
          Brain & Spine
          Cancer
          Heart
          Maternity
          Orthopedics
          Pulmonary
          Sleep Medicine
          Urgent Care
          Women's Services
          All Services
          Patients & Visitors
          Locations & Directions
          Find a Physician
          Tour St. Luke's
          Patient & Visitor Information
          Contact Us
          Payment Options
          Financial Assistance
          Send a Card
          Mammogram Appointments
          Health Tools
          My Personal Health
          mystlukes
          Spirit of Women
          Health Information & Tools
          Clinical Trials
          Health Risk Assessments
          Employer Programs -
          Passport to Wellness

          Classes & Events
          Classes & Events
          Spirit of Women
          Donate & Volunteer
          Giving Opportunities
          Volunteer
          Physicians & Employees
          For Physicians
          Remote Access
          Medical Residency Information
          Pharmacy Residency Information
          Physician CPOE Training
          Careers
          Careers
          St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
          Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile