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Fecal Impaction

    Fecal impaction is a mass of dry, hard stool that will not pass out of the colon or rectum.

    Fecal impaction is dry stool that cannot pass out of the body. Patients with fecal impaction may not have gastrointestinal (GI) symptoms. Instead, they may have problems with circulation, the heart, or breathing. If fecal impaction is not treated, it can get worse and cause death.

    A common cause of fecal impaction is using laxatives too often.

    Repeated use of laxatives in higher and higher doses makes the colon less able to respond naturally to the need to have a bowel movement. This is a common reason for fecal impaction. Other causes include:

    • Opioid pain medicines.
    • Little or no activity over a long period.
    • Diet changes.
    • Constipation that is not treated. See the section above on causes of constipation.

    Certain types of mental illness may lead to fecal impaction.

    Symptoms of fecal impaction include being unable to have a bowel movement and pain in the abdomen or back.

    The following may be symptoms of fecal impaction:

    • Being unable to have a bowel movement.
    • Having to push harder to have a bowel movement of small amounts of hard, dry stool.
    • Having fewer than the usual number of bowel movements.
    • Having pain in the back or abdomen.
    • Urinating more or less often than usual, or being unable to urinate.
    • Breathing problems, rapid heartbeat, dizziness, low blood pressure, and swollen abdomen.
    • Having sudden, explosive diarrhea (as stool moves around the impaction).
    • Leaking stool when coughing.
    • Nausea and vomiting.
    • Dehydration.
    • Being confused and losing a sense of time and place, with rapid heartbeat, sweating, fever, and high or low blood pressure.

    These symptoms should be reported to the health care provider.

    Assessment includes a physical exam and questions like those asked in the assessment of constipation.

    The doctor will ask questions similar to those for the assessment of constipation:

    • How often do you have a bowel movement? When and how much?
    • When was your last bowel movement? What was it like (how much, hard or soft, color)?
    • Was there any blood in your stool?
    • Has your stomach hurt or have you had any cramps, nausea, vomiting, gas, or feeling of fullness near the rectum?
    • Do you use laxatives or enemas regularly?
    • What do you usually do to relieve constipation? Does this usually work?
    • What kind of food do you eat?
    • How much and what type of fluids do you drink each day?
    • What medicines are you taking? How much and how often?
    • Is this constipation a recent change in your normal habits?
    • How many times a day do you pass gas?
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