Concept

Fecal impaction

Summary
A fecal impaction or an impacted bowel is a solid, immobile bulk of feces that can develop in the rectum as a result of chronic constipation (a related term is fecal loading which refers to a large volume of stool in the rectum of any consistency). Fecal impaction is a common result of neurogenic bowel dysfunction and causes immense discomfort and pain. Its treatment includes laxatives, enemas, and pulsed irrigation evacuation (PIE) as well as digital removal. It is not a condition that resolves without direct treatment. Symptoms of a fecal impaction include the following: Chronic constipation Fecal incontinence-- paradoxical overflow diarrhea (encopresis) as a result of liquid stool passing around the obstruction Abdominal pain and bloating Loss of appetite Complications may include necrosis and ulcers of the rectal tissue, which if untreated can cause death. There are many possible causes; these include a long period of physical inactivity, failure to consume adequate dietary fiber, dehydration, and deliberate retention of fecal matter. Medications such as fentanyl, buprenorphine, methadone, codeine, oxycodone, hydrocodone, morphine, and hydromorphone as well as certain sedatives that reduce intestinal movement may cause fecal matter to become too large, hard and/or dry to expel. Specific conditions, such as irritable bowel syndrome, certain neurological disorders, paralytic ileus, gastroparesis, diabetes, enlarged prostate gland, distended colon, an ingested foreign object, inflammatory bowel diseases such as Crohn's disease and colitis, and autoimmune diseases such as amyloidosis, celiac disease, lupus, and scleroderma can cause a fecal impaction. Hypothyroidism can also cause chronic constipation because of sluggish, slower, or weaker colon contractions. Iron supplements or increased blood calcium levels are also potential causes. Spinal cord injury is a common cause of constipation, due to ileus.
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