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Fecal impaction

Impaction of the bowels

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.

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Causes

Constipation is when you are not passing stool as often or as easily as is normal for you. Your stool becomes hard and dry. This makes it 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:

Symptoms

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 show a hard mass of stool in the rectum.

You may need to have a colonoscopy if there has been a recent change in your bowel habits. This is done to check for colon or rectal cancer.

Treatment

Treatment for the condition starts with removal of the impacted stool. After that, steps 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 not enough to remove a large, hardened impaction in most cases.

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 provider and a specially trained nurse or therapist will:

Outlook (Prognosis)

With treatment, the outcome is good.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Tell your provider if you have chronic diarrhea or fecal incontinence after a long period of constipation. Also tell your provider if you have any of the following symptoms:

Related Information

Encopresis
Constipation
Over-the-counter pain relievers
Necrosis
Constipation - self-care

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: Elsevier Saunders; 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: Elsevier Saunders; 2011:chap 147. 

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Review Date: 1/22/2015  

Reviewed By: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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