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Fecal Impaction

Nicole A. Doria, MD, Anna L. Silverman, MD and Marie L. Borum, MD, EdD, MPH Reviewed 06/2018
 


BASICS

DESCRIPTION

Incomplete evacuation of feces leading to the formation of a large, firm, immovable mass of stool in the rectum or distal sigmoid colon with resultant partial or complete obstruction...

DIAGNOSIS

HISTORY

  • Abdominal pain and bloating

  • Constipation

  • Rectal discomfort

  • Incomplete evacuation, use of digital maneuvers

  • Fecal incontinence, paradoxical (overflow) diarrhea

  • Nausea, vomiting, anorexia

  • Gen...

TREATMENT

GENERAL MEASURES

  • Treatment centers on removal of the impaction and prevention of recurrence.

  • Manual disimpaction and extraction of fecal mass is often required.

  • For stool located higher in the ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Maintain ≥3 bowel movements/week. 

DIET

High fiber (20 to 25 g/day) with adequate hydration (minimum 2 L/day). Fermentable (soluble) fiber sources...

REFERENCES

1
Rao SS, Go JT. Update on the management of constipation in the elderly: new treatment options. Clin Interv Aging.  2010;5:163–171. {L-End} [View Abstract on OvidMedline]
2
Higgins PD, ...

ADDITIONAL READING

  • Obokhare I. Fecal impaction: a cause for concern? Clin Colon Rectal Surg.  2012;25(1):53–58.

  • Rey E, Barcelo M, Jiménez Cebrián MJ, et al. A nation-wide study of prevalence and r...

SEE ALSO

Constipation; Diarrhea, Chronic; Encopresis 

CODES

ICD10

  • K56.41 Fecal impaction

  • K59.00 Constipation, unspecified

  • R15.9 Full incontinence of feces

ICD9

  • 560.32 Fecal impaction

  • 564.00 Constipation, unspecified

  • 787.60 Full incontinence of feces

SNOMED

  • 446350...

CLINICAL PEARLS

  • Constipation and fecal impaction are common in elderly and hospitalized patients.

  • Opioids are a common cause of constipation and resultant impaction. Use a bowel hygiene regimen for pat...

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