Digestion is the process of breaking down food in the gut so that it is in easily absorbable forms. The food travels from the mouth to the food pipe, stomach, small bowel, and large bowel to be finally eliminated through the anus. The small bowel (small intestine) absorbs nutrients from the food. The remaining portion enters the large bowel (large intestine). The large intestine absorbs water and salts from the food material that has not been digested and gets rid of any leftover waste products called feces (poop or stools). The discharge or elimination of feces from the body is called excretion or defecation. Sometimes, the waste becomes stuck (impacted feces) in the large intestine due to various reasons. When feces stay in the bowel for long, they form a hard and dry mass that gets stuck in the rectum (the last part of the large bowel). This is called fecal impaction. Once fecal impaction occurs, the intestine will not be able to remove the feces from the body through the normal contraction process. Hence, it’s typically impossible to excrete wastes from the body, defecate, or poop with impacted feces. Impacted feces can block the intestine, preventing the new waste/feces formed to get excreted and causing further accumulation of feces. There are several treatment options available for impacted feces.
What are the causes of fecal impaction?
The main cause of fecal impaction is constipation. Constipation is difficulty passing or infrequent passing of stools. Chronic constipation can result in fecal impaction. The causes of constipation include:
- Side effects of certain medications
- Poor nutrition
- Lack of fiber in the diet
- Chronic medical conditions such as diabetes or thyroid disorders and other medical illnesses
- Problems in the digestive system
- Frequent diarrhea
- Intestinal obstruction (causes may include adhesions [fibrous bands of tissue], hernia, and tumors)
- Complications from pelvic or colorectal surgery
- continuous vomiting
- Spinal cord injury
What are the symptoms of impacted feces?
Symptoms of fecal impaction are serious and require immediate medical attention. The signs and symptoms include:
- Encopresis or stool soiling (leakage of liquid stool)
- Abdominal pain
- Abdominal discomfort
- Feeling of fullness
- Urge but unable to defecate
- Fecal material in the vomit
- Loss of weight
- Loss of appetite
- Increased heart rate
- Rapid breathing
- Mental confusion
- Loss of bladder control
What are the complications of fecal impaction?
If not treated, fecal impaction may lead to the following complications:
How is impacted feces treated?
Treatment options include:
- Laxatives: This is generally the first method of treatment for fecal impaction. Oral laxatives or medicated suppository (medication placed into the rectum) can help.
- Manual removal: If laxatives don’t work, the doctor may suggest removing the feces manually. The doctor would insert their gloved finger with a numbing lubricant into the rectum to remove the blockage.
- Enema: If the entire blockage can’t be removed manually, the doctor may use an enema to remove the impacted feces. An enema is a small, fluid-filled bottle with a nozzle attached. The nozzle is inserted into the rectum and the bottle is squeezed, releasing the liquid into the large intestine. The fluid lubricates the intestine and moistens the feces, making it easier to dislodge. The force of the fluid also helps dislodge the feces. The doctor may also routinely perform enemas for patients undergoing certain surgeries or for those who are on prolonged bed rest.
- Water irrigation: Water irrigation involves pushing a small hose up through the rectum and into the colon. The hose is connected to a machine, and water is released through the tube. After irrigating the intestine with water, the doctor massages the abdomen, moving the waste out of the rectum through another tube.
- Treatment of the underlying cause of fecal impaction
Prevention of fecal impaction and lifestyle modifications for healthy bowel movements
One of the main ways to prevent fecal impaction is to prevent constipation. Ways to prevent constipation and maintain healthy bowel movements include:
- Drinking plenty of fluids every day to prevent dehydration
- Drinking fluids that act as natural laxatives such as prune juice, coffee, and tea
- Eating foods that are rich in fiber such as whole wheat, oats, fruits, and vegetables
- Reducing the intake of foods that are high in sugar
- Exercising regular
- Managing stress
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