In fecal impaction, the stool becomes so hard and dry that it cannot pass through the colon or rectum that it causes abdominal pain, bloating, nausea, vomiting, and other symptoms. If left untreated, it can result in serious complications. We will discuss in this blog post what causes fecal impaction, its symptoms, how to diagnose it, how to treat it, and how to prevent it.
The main cause of fecal impaction is constipation, which is difficulty or infrequency in having bowel movements. Constipation can be caused by various factors, such as:
Lack of fiber, water, or nutrients in the diet
High-fat or low-carbohydrate diet
Lack of physical activity or exercise
Stress, anxiety, or depression
Medications that slow down the bowel movement, such as opioids, antacids, antidepressants, or antihistamines
Medical conditions that affect the nerves or muscles of the digestive system, such as diabetes, thyroid disorders, Parkinson’s disease, spinal cord injury, or stroke
Obstruction or blockage in the colon or rectum, such as tumors, polyps, diverticulitis, or hemorrhoids
Complications from surgery or radiation therapy on the abdomen or pelvis
Aging, which can reduce the bowel motility and muscle tone
Some people are more prone to fecal impaction than others, such as:
Older adults, especially those who live in nursing homes or have limited mobility
Children, especially those who have behavioral or psychological issues that make them avoid or delay having bowel movements
People who travel frequently or have irregular schedules that disrupt their normal bowel habits
People who have a history of chronic constipation or fecal impaction
Fecal impaction can cause various symptoms, depending on the severity and location of the impaction. Some of the common symptoms are:
Abdominal pain, cramping, discomfort, or pressure
Abdominal bloating or distension
Nausea, vomiting, or loss of appetite
Headache, fatigue, or malaise
Fecal incontinence, which is the leakage of liquid or soft stool around the hard stool
Fecal soiling, which is the staining of the underwear or clothing with stool
Rectal bleeding, which can be due to hemorrhoids, fissures, or ulcers caused by the hard stool
Urinary symptoms, such as difficulty urinating, urinary incontinence, or urinary tract infection, due to the pressure of the stool on the bladder or urethra
Some of the severe symptoms that indicate a medical emergency are:
Fever, chills, or sweating, which can be signs of infection or inflammation in the abdomen
Rapid heart rate, low blood pressure, or dizziness, which can be signs of shock or dehydration
Confusion, agitation, or loss of consciousness, which can be signs of brain damage or organ failure due to lack of oxygen or blood flow
Your doctor will ask you about your medical history, medications, diet, and bowel habits as well as perform a physical examination, which may include:
Abdominal examination, to check for tenderness, swelling, or masses
Rectal examination, to feel for the presence and location of the hard stool
Digital removal, which is the manual extraction of some of the stool using a gloved finger
X-ray, to see the size and shape of the stool and the colon
CT scan or MRI, to get a more detailed image of the stool and the surrounding organs
Blood tests, to check for signs of infection, inflammation, dehydration, or electrolyte imbalance
Colonoscopy or sigmoidoscopy, which are procedures that use a flexible tube with a camera to look inside the colon and rectum
In order to treat fecal impaction, the primary goal is to remove the stool and restore normal bowel function. Some treatment options include:
It can be taken as a pill, liquid, or powder. Examples of oral laxatives include bisacodyl, senna, magnesium citrate, polyethylene glycol, or lactulose.
Saline, mineral oil, glycerin, and phosphate are some examples of enemas, which are solutions injected into the rectum to loosen stool and stimulate bowel movements.
A suppository is a solid or semi-solid medication that is inserted into the rectum to dissolve and stimulate bowel movements. They can be made from glycerin, bisacodyl, or docusate sodium.
The stool is manually removed by a doctor or nurse in a clinic or hospital using a gloved finger, a spatula, or a suction device. Sedation or anesthesia may be required.
The stool is removed with a scalpel, scissors, or a laser by a surgeon in an operating room under general or local anesthesia. Surgery is usually reserved for severe cases of fecal impaction that do not respond to other treatments or that cause complications such as perforation, infection, or bleeding.
Fecal impaction can be prevented by avoiding or treating constipation and maintaining a healthy bowel function. Some of the prevention tips are:
Drink plenty of fluids, especially water, to keep the stool soft and hydrated
Eat a balanced diet that is rich in fiber, such as fruits, vegetables, whole grains, nuts, and seeds, to bulk up the stool and stimulate the bowel movement
Exercise regularly, at least 30 minutes a day, to improve the blood circulation and muscle tone of the digestive system
Avoid or limit foods and drinks that can cause constipation, such as dairy products, processed foods, alcohol, or caffeine
Follow a regular bowel routine, such as going to the bathroom at the same time every day, preferably after a meal, and not ignoring the urge to have a bowel movement
Use laxatives, enemas, or suppositories only as directed by your doctor, and not for more than a week, as they can cause dependency, dehydration, or electrolyte imbalance
Review your medications with your doctor, and ask if any of them can cause constipation or fecal impaction, and if there are any alternatives or adjustments that can be made
Seek medical attention if you have symptoms of fecal impaction, such as abdominal pain, bloating, nausea, vomiting, or fecal incontinence, and do not try to remove the stool by yourself
Depending on the cause and severity of fecal impaction, different methods can be used to treat it. It can cause discomfort, distress, and complications. You can also prevent fecal impaction by following a healthy lifestyle and avoiding or treating constipation. Talk to your doctor or a gastroenterologist, a specialist in digestive diseases, if you have any questions or concerns. In addition to diagnosing, treating, and preventing fecal impaction, they can assist you in improving your bowel health as well.
