Fecal Impaction: A Cause for Concern?

Abstract

Fecal impaction (FI) is a common cause of lower gastrointestinal tract obstruction lagging behind stricture for diverticulitis and colon cancer. It is the result of chronic or severe constipation and most commonly found in the elderly population. Early recognition and diagnosis is accomplished by way of an adequate history and physical examination in conjunction with an acute abdominal series. Prompt identification and treatment minimizes the risks of complications such as bowel obstruction leading to aspiration, stercoral ulcers, perforation, and peritonitis. Treatment options include gentle proximal softening in the absence of complete bowel obstruction, distal washout, and manual extraction. Surgical resection of the involved colon or rectum is reserved for cases of FI complicated by ulceration and perforation leading to peritonitis. Recurrence is common, and can be managed by increasing dietary fiber content to 30 gm/day, increased water intake, and discontinuation of medications that can contribute to colonic hypomotility.

Impaired colonic motility and reduction in tachykinin signalling in the aged mouse

“…Aging is frequently associated with chronic constipation which can predispose sufferers to fecal impaction and overflow incontinence (Obokhare, 2012). Chronic constipation is a major cause of morbidity in older people and affects around 30-40% of community dwelling adults over the age of 65 years and up to 74% of the institutionalised elderly (Gallagher and O'Mahony, 2009;Rao and Go, 2010).…”

Mountain Papaya Seeds Causing Fecal Impaction in Children

“…The typical presenting symptoms of fecal impaction are similar to those found in intestinal obstruction from any cause, including abdominal pain and distention, nausea, vomiting, and anorexia (1). In all 3 cases, the children presented with failure to pass stool for 3-5 days following ingestion of the fruit.…”

“…Fecal impaction is a common gastrointestinal disorder and a source of significant patient discomfort with potential for major morbidity especially in the pediatric and elderly population (1). Commonly found in the rectum, it is defined as the inability to evacuate large hard inspissated concreted stool or bezoar lodged in the lower gastrointestinal tract.…”

“…Commonly found in the rectum, it is defined as the inability to evacuate large hard inspissated concreted stool or bezoar lodged in the lower gastrointestinal tract. It is also known as coprostasis or inspissated stool syndrome (1). Stool retention in children is a known precipitating factor.…”

Abdominal cause of asymmetric lower limb oedema

“…It is characterized by the accumulation of hardened stools, most frequently in distal colon and rectum [1,2]. Liquid stools from the proximal colon can pass through the impacted stools causing overflow incontinence, sometimes mistaken for diarrhoea [1].…”