Fecal impaction is when stool (poop) cannot leave the body. Without treatment, it can lead to other problems.
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Fecal impaction is caused by:
- Stool (poop) that is too large, hard, and dry to pass, or
- Weak intestine muscles
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
- 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 of fecal impaction 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 (pee), or leaking urine
- Headache, lightheadedness, fast heartbeat, or problems breathing
Older people and those with certain brain problems may also have:
- More problems thinking
The doctor will ask about symptoms and past health. 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:
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
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
- Constipation and impaction. Harvard Health Publishing website. Available at: https://www.health.harvard.edu/a_to_z/constipation-and-impaction-a-to-z .
- Constipation in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-adults
- Constipation in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-children .
- Gastrointestinal complications. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-pdq#section/_15.
- Louwagie V, Steinman MD, Wang MH. Fecal impaction in adults. JAAPA. 2023;36(5):19-22.
- April Scott, NP
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