Skip to main content

Advertisement

Log in

Management and prevention of fecal impaction

  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Fecal impactions occur in both sexes at any age but are particularly concentrated in children, in the institutionalized or impaired elderly, and in patients with certain psychiatric disorders or medical conditions that predispose to obstipation. The clinical consequences may be disabling and occasionally life threatening. Clinical manifestations include fecal incontinence, abdominal distention and pain, anorexia, weight loss, intestinal obstruction, and stercoral ulceration with bleeding or colonic perforation. Diagnosis begins with recognition of possible fecal impaction and confirmation by digital examination or abdominal radiography. Management consists of disimpaction, colon evacuation, and a maintenance bowel program to prevent recurrent impactions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Di Lorenzo C, Benninga MA: Pathophysiology of pediatric fecal incontinence. Gastroenterology 2004, 126(1 Suppl 1):S33–S40.

    Article  PubMed  Google Scholar 

  2. Harari D: Constipation and fecal incontinence in old age. In Brocklehurst’s Textbook of Geriatric Medicine and Gerontology, edn 6. Edited by Tallis RC, Fillit HM. London: Elsevier Science Ltd; 2003:1311–1322.

    Google Scholar 

  3. DeLillo AR, Rose S: Functional bowel disorders in the geriatric patient: constipation, fecal impaction and fecal incontinence. Am J Gastroenterol 2000, 95:901–905.

    Article  CAS  Google Scholar 

  4. Eitan A, Bickel A, Katz IM: Fecal impaction in adults: report of 30 cases of seed bezoars in the rectum. Dis Colon Rectum 2006, 49:1768–1771.

    Article  PubMed  Google Scholar 

  5. Schnelle JF, Leung FW: Urinary and fecal incontinence in nursing homes. Gastroenterology 2004, 126(1 Suppl 1):S41–S47.

    Article  PubMed  Google Scholar 

  6. Read NW, Abouzekry L, Read MG, et al.: Anorectal function in elderly patients with fecal impaction. Gastroenterology 1985, 89:959–966.

    PubMed  CAS  Google Scholar 

  7. Read NW, Abouzekry L: Why do patients with fecal impactions have fecal incontinence? Gut 1986, 27:283–287.

    Article  PubMed  CAS  Google Scholar 

  8. Youle MS, Read NW: Effect of painless rectal distension on gastrointestinal transit of a solid meal. Dig Dis Sci 1984, 29:902–906.

    Article  PubMed  CAS  Google Scholar 

  9. Boccia G, Buonavolonta R, Coccorullo P, et al.: Dyspeptic symptoms in children: the result of a constipation-induced cologastric brake? Clin Gastroenterol Hepatol 2008, 6:556–560.

    Article  PubMed  Google Scholar 

  10. Smith RG, Lewis S: The relationship between digital rectal examination and abdominal radiographs in elderly patients. Age Ageing 1990, 19:142–143.

    Article  PubMed  CAS  Google Scholar 

  11. Loubieres Y, Chereau O: Images in clinical medicine: severe fecal impaction. N Engl J Med 2005, 352:e12.

    Article  PubMed  Google Scholar 

  12. Gattuso JM, Kamm MA, Halligan SM, Bartram CI: The anal sphincter in idiopathic megarectum: effects of manual disimpaction under general anesthesia. Dis Colon Rectum 1996, 39:435–439.

    Article  PubMed  CAS  Google Scholar 

  13. Tiongco FP, Tsang TK, Pollack J: Use of oral GoLytely solution in relief of refractory fecal impaction. Dig Dis Sci 1997, 42:1454–1457.

    Article  PubMed  CAS  Google Scholar 

  14. Wood BP, Katzberg RW: Tween 80/Diatrizoate enemas in bowel obstruction. AJR Am J Roentgenol 1978, 130:747–750.

    PubMed  CAS  Google Scholar 

  15. Candy DC, Edwards D, Geraint M: Treatment of fecal impaction with polyethylene glycol plus electrolytes (PEG + E) followed by a double-blind comparison of PEG + E versus lactulose as maintenance therapy. J Ped Gastroenterol Nutri 2006, 43:65–70.

    Article  CAS  Google Scholar 

  16. Guest JF, Candy DC, Clegg JP, et al.: Clinical and economic impact of using macrogol 3350 plus electrolytes in an outpatient setting compared to enemas and suppositories and manual evacuation to treat paediatric faecal impaction based on actual clinical practice in England and Wales. Curr Med Res Opin 2007, 23:2213–2225.

    Article  PubMed  Google Scholar 

  17. Staiano A, Andreotti MR, Greco L, et al.: Long-term follow-up of children with chronic idiopathic constipation. Dig Dis Sci 1994, 39:561–564.

    Article  PubMed  CAS  Google Scholar 

  18. Chassagne P, Jego A, Gloc P, et al.: Does treatment of constipation improve fecal incontinence in institutionalized elderly patients? Age Ageing 2000, 29:159–164.

    Article  PubMed  CAS  Google Scholar 

  19. Ouslander JG, Simmons S, Schnelle J, et al.: Effects of prompted voiding on fecal incontinence among nursing home residents. J Am Geriatr Soc 1996, 44:424–428.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Arnold Wald.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wald, A. Management and prevention of fecal impaction. Curr Gastroenterol Rep 10, 499–501 (2008). https://doi.org/10.1007/s11894-008-0091-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11894-008-0091-y

Keywords

Navigation