Summary about Disease
Fecal impaction is a condition where a large, hard mass of stool becomes stuck in the rectum or lower colon and cannot be expelled. It's a severe form of constipation and can lead to significant discomfort and complications if left untreated.
Symptoms
Abdominal cramping and bloating
Rectal pain
Leakage of liquid stool or mucus around the impacted stool
Feeling the urge to have a bowel movement but being unable to pass stool
Nausea and vomiting
Headache
General feeling of discomfort or illness
Paradoxical diarrhea (liquid stool bypassing the impaction)
Causes
Chronic constipation
Ignoring the urge to defecate
Dehydration
Lack of fiber in the diet
Sedentary lifestyle
Certain medications (e.g., opioids, antacids containing aluminum or calcium, anticholinergics)
Neurological conditions (e.g., spinal cord injury, multiple sclerosis)
Bowel obstruction
Structural abnormalities in the colon or rectum
Weakness or lack of muscle tone in the abdomen
Medicine Used
Stool softeners: Docusate sodium (Colace)
Osmotic laxatives: Polyethylene glycol (MiraLAX), magnesium citrate
Stimulant laxatives: Bisacodyl (Dulcolax), senna
Enemas: Mineral oil enema, saline enema, sodium phosphate enema
Manual disimpaction: A healthcare provider may need to physically remove the impacted stool.
Is Communicable
No, fecal impaction is not communicable. It's a condition that develops within an individual and is not caused by an infectious agent.
Precautions
Maintain a high-fiber diet (fruits, vegetables, whole grains).
Drink plenty of water.
Engage in regular physical activity.
Respond promptly to the urge to defecate.
Review medications with a doctor to identify potential constipation-causing drugs.
Consider using stool softeners or mild laxatives under a doctor's supervision if prone to constipation.
Establish a regular bowel routine.
Proper toilet habits
How long does an outbreak last?
Fecal impaction doesn't have outbreaks. The duration depends on the severity and how quickly it's treated. Without treatment, it can persist indefinitely and lead to serious complications. With treatment, relief can be achieved within hours to a few days, depending on the method used.
How is it diagnosed?
Physical examination: A digital rectal exam (DRE) is typically performed.
Medical history: Reviewing the patient's symptoms, bowel habits, and medications.
Abdominal X-ray: May be used to confirm the presence of a large fecal mass.
Colonoscopy or sigmoidoscopy: In some cases, may be performed to rule out other underlying conditions.
Timeline of Symptoms
The timeline of symptoms varies, but generally follows this pattern:
Gradual onset: Constipation may worsen over days or weeks.
Initial symptoms: Abdominal discomfort, infrequent bowel movements, straining.
Progression: As impaction worsens, symptoms become more pronounced: rectal pain, bloating, leakage of liquid stool, inability to pass stool.
Advanced stages: Nausea, vomiting, severe abdominal pain may develop.
Important Considerations
Fecal impaction can be more common in elderly individuals, people with disabilities, and those taking certain medications.
Untreated fecal impaction can lead to serious complications, including bowel obstruction, bowel perforation, and rectal ulcers.
Manual disimpaction should only be performed by a healthcare professional.
Prevention is key through diet, hydration, and regular bowel habits.
Recurrent fecal impaction warrants further investigation to identify underlying causes.