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by Scholten A

Fecal Impaction

Definition

Fecal impaction is when stool (poop) cannot leave the body. Without treatment, it can lead to other problems.
The Digestive Pathway
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Causes

This problem is caused by:
  • Stool (poop) that is too large, hard, and dry to pass, or
  • Weak intestine muscles

Risk Factors

Fecal impaction is more common in people over 65 years old and toddlers. Other things that raise the risk are:
  • Long-term constipation
  • Withholding stool (poop)—a common cause in children
  • A history of fecal impaction
  • Medicines such as:
    • Certain blood pressure medicines
    • Narcotics
    • Antipsychotics and tricyclic antidepressants
    • Iron supplements
  • A diet that is low in fiber and fluids
  • Not being physically active
  • Medical problems that make it hard to pass stools

Symptoms

Symptoms may include:
  • Straining, with problems passing stools
  • Belly pain or rectal discomfort
  • Belly swelling
  • Nausea and vomiting
  • Leaking stool or sudden episodes of watery stool
  • Lack of hunger
  • Problems passing urine, or leaking urine
  • Headache, lightheadedness, fast heartbeat, or problems breathing
Older people and those with certain brain problems may also have:
  • More problems thinking
  • Restlessness

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. This may include a rectal exam with a gloved finger. Blood tests may also be done.
Images can show how severe the problem is. The doctor may look at the intestines with:

Treatment

The goals are to remove the stuck stool and treat underlying causes. Options are:
Medicines to help pass the stool, such as:
  • Stool softeners or laxatives taken by mouth
  • Suppositories—medicine inserted into the rectum
Medicines may be needed until the bowel works well again.
The doctor may also remove the stool. Options are:
  • Removal by gloved hand
  • An enema—fluid is injected into the large intestine
  • Surgery—rarely needed

Prevention

Fecal impaction can often be prevented with:
  • A diet rich in fiber and fluids
  • Not using medicines that can cause problems passing stool
  • Regular physical activity
  • Regular bowel habits

RESOURCES

American Gastrointestinal Association
https://www.gastro.org
Family Doctor—American Academy of Family Physicians
https://familydoctor.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology
https://www.cag-acg.org
Health Canada
https://www.canada.ca

References

Constipation and impaction. Harvard Health Publishing website. Available at: https://www.health.harvard.edu/a%5Fto%5Fz/constipation-and-impaction-a-to-z . Accessed July 30, 2021.
Constipation in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-adults . Accessed July 30, 2021.
Constipation in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-children . Accessed July 30, 2021.
Gastrointestinal complications. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-pdq#section/%5F15. Accessed July 30, 2021.
Serrano Falcón B, Barceló López M, et al. Fecal impaction: a systematic review of its medical complications. BMC Geriatr. 2016;16:4

Revision Information

  • Reviewer: EBSCO Medical Review Board Dan Ostrovsky, MD
  • Review Date: 07/2021
  • Update Date: 07/30/2021