Fecal Impaction

Causes

Fecal impaction 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 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
• Restlessness

Diagnosis

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:

• X-rays
• CT scan
• Ultrasound
• Sigmoidoscopy—a tube inserted into the large intestine to view the area

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