Fecal impaction
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| Fecal impaction | |
| Classification and external resources | |
| ICD-9 | 560.39 |
|---|---|
| DiseasesDB | 9450 |
| MedlinePlus | 000230 |
| MeSH | D005244 |
A fecal impaction is a solid, immobile bulk of stool that can develop in the rectum as a result of chronic constipation.
Contents |
[edit] Symptoms
Symptoms include chronic constipation. There can be fecal incontinence and paradoxical diarrhea as liquid stool passes around the obstruction. Complications may include necrosis and ulcers of the rectal tissue. Abdominal pain and bloating could also be present depending on the severity of the condition. Impaction may last up to 2-3 hours depending on the cause of the impaction.
[edit] Treatment
Non-invasive treatments are similar to those for constipation and include increased intake of fluids and dietary fiber, and physical exercise. However, once fecal impaction occurs, these methods are usually not successful. The mainstay of treatment are enemas to soften the impaction and disimpaction, i.e digital (or typically with a spoonlike instrument) manipulation by a health practitioner. Use of stimulant laxatives may be dangerous because of the possibility of stercoral perforation. Surgery may be necessary if the bowel becomes totally obstructed. Serious pain may occur as time passes. Many times, fecal impaction may be relieved through digital manipulation of the fecal matter in the rectum. Manipulation of the fecal matter in the anus to remove the impaction may be the only alternative to hospital treatment. The pain of this procedure is usually quite high but will subside once fecal matter is passed through the rectum and anus. Usually, once the initial impacted fecal matter is maneuvered out, the rest of the fecal matter will quickly follow and relief will be instantaneous.
[edit] Causes
Many things cause fecal impaction. Medications such as narcotic pain relievers (oxycodone, hydrocodone, tramadol, etc) and certain sedatives may cause fecal matter to become hard and dry, thus impacting the rectum. When medication is the cause of the impaction, one has to wait until the effects of the medication wear off until they will be able to manually remove the feces. Of course, if this is impractical one must go to the hospital and have a professional take care of the problem.
Manual removal of fecal impaction is often required in obese client in traction, after barium enema, and in poorly hydrated older adults.
[edit] Prevention
Cutting down on pain medications, and drinking plenty of liquids. Also being more active and eating more fiber. Also stool softeners and laxatives may help prevent impaction altogether.
[edit] See also
[edit] References
- Wrenn K (1989). "Fecal impaction". N Engl J Med 321 (10): 658–62. PMID 2671728.
- healthcentral.com
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