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Fecal Impaction

Marie L Borum, MD, EdD, MPH Reviewed 06/2022
 


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 seeks to remove of the impaction and prevent recurrence.

  • Lactulose reduces fecal impaction  (5)[A].

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

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Identify and eliminate potential causes of constipation.

  • Aim to maintain ≥3 bowel movements/week.

DIET

High fiber (20 to 25 g/day) with adequate hy...

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.  ...

ADDITIONAL READING

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

  • ...

SEE ALSO

Constipation; Diarrhea, Chronic; Encopresis 

CODES

ICD10

  • K56.41 Fecal impaction

  • K59.00 Constipation, unspecified

  • R15.9 Full incontinence of feces

SNOMED

  • 44635007 Fecal impaction (disorder)

  • 14760008 Constipation (disorder)

  • 302690004 Encopresis (disorder...

CLINICAL PEARLS

  • Constipation and fecal impaction are common in older adults and hospitalized patients.

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

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