People with severe, long-term constipation — a problem that affects approximately 20 percent of adults — may eventually go on to develop a fecal impaction, according to an article published in Clinical Interventions in Aging. (1) It isn’t pretty, but what essentially happens is that a mass of dried-out stool gets stuck and can end up blocking the colon instead of exiting your system smoothly and comfortably.
Watery stoolAbdominal pain, especially after eatingAn ongoing urge to have a bowel movementHeadacheBloatingNausea and vomitingLoss of appetiteWeight lossFeeling under the weatherStraining to pass stoolPassing small, hard “marbles” of stoolBleeding from the rectumStool leakageA feeling of pressure on the bladderLoss of bladder controlLow back pain
RELATED: Soluble vs. Insoluble Fiber: How to Know What’s Right for You if You Have IBS Children may develop a fecal impaction when they withhold stool during toilet training, fear passing stool because of previous pain or discomfort, avoid using the bathroom because they don’t want to interrupt their play, or don’t drink enough fluids or eat enough fiber. (You may hear your doctor refer to the condition as encopresis.) Other factors that can contribute to the condition include poor diet, and not paying attention to the need to use the bathroom because of depression or other illnesses, per past research. (5) There are other potential causes. They include: (3,4)
Skimping on drinking fluidsA diet that’s low in fiberPelvic floor dysfunctionA history of chronic constipationDependence on laxatives to have a bowel movementMedications that reduce intestinal movement, such as narcotic pain medications, iron supplements, calcium supplements, or calcium channel blockersA disorder of the large intestine and rectum, such as Hirschsprung’s disease or Chagas diseaseA thyroid condition or another metabolic disorder, such as diabetes or uremia
As long as fecal impaction is diagnosed and treated quickly, it generally won’t lead to complications. And most people will go on to have normal bowel habits. One issue, though, is that fecal impaction can recur if constipation continues. A study cited often in the literature found that 39 percent of people with fecal impaction had experienced it before. (6) If constipation is a chronic issue, try to work with your healthcare provider or a specialist to address it. Another technique, known as distal washout, involves softening the stool with an enema or rectal suppository so it can be eliminated. Or your doctor might prescribe an oral solution of polyethylene glycol or an oral laxative made of magnesium citrate. You might receive one of these three treatments or some combination of them. In rare cases, your doctor may use a sigmoidoscope to wash out the bowel with water and clear the impaction. (2,7) Those experiencing pelvic floor dysfunction may benefit from physical therapy.
Medication Options
The following medications may be used to treat fecal impaction:
EnemasSuppositoriesOral laxatives
Alternative and Complementary Therapies
Fecal impaction can’t be solved by alternative or complementary therapies, but a study published in Evidenced-Based Complementary and Alternative Medicine found that acupuncture and some herbal treatments, including the fiber supplement psyllium, eased chronic constipation, which, when left untreated, can lead to fecal impaction. (8) RELATED: Does Medicare Cover Acupuncture?
Prevention of Fecal Impaction
After a fecal impaction has been treated and the rectum has been cleared of stool, it’s important to carefully follow a bowel retraining program to prevent another episode. You’ll probably be instructed to:
Drink plenty of water.Eat sufficient amounts of fiber. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), adults should get 22 to 34 grams of fiber a day. (9) The exact amount depends on your sex and age.Use the bathroom regularly; when you feel the urge to defecate, don’t delay.Get regular exercise.Try bowel training, which involves conditioning yourself to pass stool at around the same time each day to avoid developing severe constipation again.Try Kegel exercises, which may help strengthen pelvic and rectal muscles.See a physical therapist if you’re experiencing pelvic floor dysfunction.
Occasionally using over-the-counter stool softeners or fiber supplements can help as well. But be aware that using laxatives too often can compound the problem, making it more difficult to pass stool.
An ulcer of the colonBowel obstruction, meaning you can’t have a bowel movement or even pass gasPerforation (a rupture that develops in your intestinal tract)Peritonitis (an inflammation of the abdominal lining)
RELATED: Race-Adjusted Medicine May Deprive Black Patients of Treatment Fecal impaction may also be a side effect of certain types of cancer or cancer treatments, or pain medications. (7,12) Fecal impaction can also cause urinary incontinence or fecal incontinence.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) offers a wealth of information on constipation and other digestive disorders, as does the American College of Gastroenterology.
These medical center websites, among others, also offer information on fecal impaction:
Harvard HealthMount Sinai
