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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board

Definition

Fecal impaction is when stool (poop) cannot leave the body. Without treatment, it can lead to other problems.

The Digestive Pathway
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Causes

This problem 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 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, 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 health history. 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:

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

RESOURCES

American Gastrointestinal Association  https://www.gastro.org 

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

Health Canada  https://www.canada.ca 

References

Constipation and impaction. Harvard Health Publishing website. Available at: https://www.health.harvard.edu/a%5Fto%5Fz/constipation-and-impaction-a-to-z . Accessed July 30, 2021.

Constipation in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-adults . Accessed July 30, 2021.

Constipation in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-children . Accessed July 30, 2021.

Gastrointestinal complications. National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-pdq#section/%5F15. Accessed July 30, 2021.

Serrano Falcón B, Barceló López M, et al. Fecal impaction: a systematic review of its medical complications. BMC Geriatr. 2016;16:4

Revision Information

  • Reviewer: EBSCO Medical Review Board Dan Ostrovsky, MD
  • Review Date: 07/2021
  • Update Date: 07/30/2021